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- Discontinuities, Gaps, and Hand-Off Problems 5
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- Medication Safety 6
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Search results for "Logistical Approaches"
- Logistical Approaches
Famolaro T, Yount ND, Hare R, et al. Rockville, MD: Agency for Healthcare Research and Quality; April 2019. AHRQ Publication No. 19-0033.
The Agency for Healthcare Research and Quality conducts safety culture surveys in a wide variety of clinical settings and makes the results publicly available on a regular basis. This report contains responses to the Community Pharmacy Survey on Patient Safety Culture from 331 participating pharmacies, most of which were chain drugstores or pharmacies within integrated health systems. The areas of strength were similar to the 2015 report, with most community pharmacies scoring well for patient counseling and openness of communication regarding unsafe situations. Inadequate staffing and production pressures were the commonly identified barriers to safety. A PSNet perspective explored safety issues in the community pharmacy setting in detail.
London, UK: Royal College of Physicians; 2018. ISBN: 9781860167270.
Lack of appropriate staffing can diminish the safety and effectiveness of medical services. This report explored staffing levels in United Kingdom trusts for three tiers of expertise and found them to be inadequate across the system. The paper provides recommendations for staffing decisions for individual organizations and emphasizes the need for improved focus on care provision during routine working hours to support a healthy work force and safe patient care.
Inspiring Ideas and Celebrating Successes: A Guidebook to Leading Patient Safety Practices in Ontario Hospitals.
OHA Patient Safety Support Service. Toronto, Ontario, Canada: Ontario Hospital Association; 2006.
This report shares successful patient safety strategies employed in Ontario hospitals to address medication safety, patient incident management, infection issues, and administrative process improvements.
The Effect of Health Care Working Conditions on Patient Safety. Evidence Report/Technology Assessment.
Evidence Report/Technology Assessment: Number 74. Rockville, MD: Agency for Healthcare Research and Quality; March 2003. AHRQ Publication No. 03-E024.
This report summarizes existing scientific evidence on the role health care working conditions play in patient safety efforts.
Cullen A. Uitgeverij van Brug: The Hague, The Netherlands; 2019. ISBN: 9789065232236.
Patient stories offer important insights regarding the impact medical errors have on patients and their families. This book shares the author's experience with medical error and spotlights how lack of transparency in European health care can contribute to avoidable process failures that result in patient harm.
Nurse staffing levels, missed vital signs and mortality in hospitals: retrospective longitudinal observational study.
Griffiths P, Ball J, Bloor K, et al. Health Services and Delivery Research. Southampton, UK: NIHR Journals Library; 2018.
Missed nursing care has been linked to safety problems, but ensuring reliable levels of nurse staffing remains challenging. This report provides the results of a 3-year investigation into whether tracking of vital signs by nursing staff could serve as a viable measure for safe patient coverage. The report identified correlations between low staffing, missed vital sign observation, length of stay, and likelihood of mortality. However, record review found no direct relationship between safety and staffing levels. A PSNet perspective examined the relationship between missed nursing care and patient safety.
Bipartisan Consensus: The Public Wants Well-Rested Medical Residents to Help Ensure Safe Patient Care.
Almashat S, Carome M, Wolfe S, Landrigan CP, Czeisler C. Washington, DC: Public Citizen; September 13, 2016.
Silver Spring, MD: Food and Drug Administration; October 2013.
This report outlines the FDA's plans to address drug shortages, including streamlining tracking processes and developing early warning signals to identify potential shortages.
Oakbrook Terrace, IL: The Joint Commission; September 2012. ISBN: 9781599407555.
This e-book provides tips for incorporating activities into daily hospital practice in conjunction with the 2013 National Patient Safety Goals.
Incorporating Health Information Technology Into Workflow Redesign: Request for Information Summary Report.
Carayon P, Karsh B-T, Cartmill RS, et al. Rockville, MD: Agency for Healthcare Research and Quality; October 2010. AHRQ Publication No. 10-0098-EF.
The report summarizes evidence related to the impact of health information technology on workflow in outpatient settings.
McHugh M, Garman A, McAlearney A, Song P, Harrison M. Chicago, IL: Health Research & Educational Trust; June 2010.
This publication describes human resources strategies to improve quality of care.
Ryan K, Levit K, Davis PH. HCUP Statistical Brief #87. Rockville, MD: Agency for Healthcare Research and Quality; March 2010.
Using data from the Healthcare Cost and Utilization Project, this report analyzed characteristics of weekend hospital stays and found that patients experienced delays in receiving care compared with patients admitted during the week.
Sixth Report of Session 2008–09. House of Commons Health Committee. London, England: The Stationery Office; July 3, 2009. Publication HC 151-I.
This government report analyzes the National Health Service's efforts to enhance patient safety and recommends improving certain areas, such as adopting technology, analyzing failure, and ensuring both practitioner education and adequate staffing.
Princeton, NJ: Robert Wood Johnson Foundation; November 2010.
Part I of this three-part series examines the quality improvement experience of four health care organizations and one state government. Part II examines how nursing intersects with health information technology implementation efforts. Part III examines how the design of the care environment affects patient outcomes.
National Quality Forum. Washington, DC: National Quality Forum; 2009.
The National Quality Forum's Safe Practices for Better Healthcare provide a blueprint for organizations to improve the quality and safety of patient care. The practices are organized into seven content areas: establishing leadership structures and systems, improving safety culture, honoring patient's wishes for informed consent and error disclosure, matching health care needs with delivery capacity, facilitating information transfer and clear communication between providers, managing medications safely, preventing health care–associated infections, and implementing safe practices for specific clinical conditions and sites of care. Since the last update in 2006, seven new practices have been added and others retired. The practices are defined so that organizations can measure the relationship between implementation of the practices and patient safety outcomes.
Ulmer C, Wolman DM, Johns MME, eds. Committee on Optimizing Graduate Medical Trainee (Resident) Hours and Work Schedule to Improve Patient Safety, Institute of Medicine. Washington, DC: The National Academies Press; 2008. ISBN: 9780309127721.
The 2003 regulations limiting housestaff work hours have had a profound impact on residency training. Although clinical outcomes appear to be unaffected, faculty and residents have expressed concern that education has been harmed, and the regulations' effect on patient safety remains unclear. The Institute of Medicine's report bases its recommendations on the growing body of research linking clinician fatigue and error, and recommends eliminating extended-duration shifts (defined as more than 16 hours), increasing days off, and improving sleep hygiene by reducing night duty and providing more scheduled sleep breaks. The report estimates that approximately $1.7 billion would be required to hire additional staff to allow residency programs to adhere to these recommendations. A related editorial discusses the balance between patient safety, resident safety, and resident education that was central to the development of these recommendations.
Wilkins K, Shields M. Ottawa, Canada: Statistics Canada; May 2008. Catalogue no. 82-003-X Health Reports.
This report describes results of a large survey of Canadian nurses and identifies work-related factors that contribute to medication errors.
Plymouth Meeting, PA: ECRI Institute; 2007. ISBN 0977914259.
This guide provides comprehensive tools for assessment, training, and implementation of safety efforts in the intensive care unit.
Kingston, ACT, Australia: Australian Medical Association; 2006.
This report outlines best practices for patient transfer and shares experiences from the field for Australian physicians and health care organizations that seek to improve their handoff processes.
Horrocks N, Pounder R. London, UK: Royal College of Physicians of London; September 2006. ISBN: 1860162886.
This report discusses risks associated with junior doctor night shift work and recommends ways to implement a shorter work week while maintaining effective patient coverage and care continuity.