Abstract:
OBJECTIVES:In order to improve its quality-assurance programme based on ISO 9001, the Central Sterile Supply Department of a public university hospital has performed a prospective risk analysis using the Preliminary Risk Analysis method (PRA). The objectives were the achievement of a global risk mapping related to the whole process of sterilising medical devices, and second, the implementation of corrective measures to reduce identified risks. METHODS:A multidisciplinary team, formed in January 2008, validated results at each step of the study. During the analysis, 416 hazardous situations were identified, among which 81 were quoted first in priority and led to the description of 141 risk scenarios. The PRA team assessed 42 scenarios with risk ranking assessed as 'acceptable under control' or 'unacceptable.' They adopted 23 follow-up actions measures and 13 safety parameters. RESULTS AND DISCUSSION:The PRA constitutes an appropriate tool for assessing quality-improvement policy and safety in healthcare facilities that can be easily integrated into standard quality-management systems.
journal_name
BMJ Qual Safjournal_title
BMJ quality & safetyauthors
Niel-Lainé J,Martelli N,Bonan B,Talon D,Desroches A,Prognon P,Vincent Fdoi
10.1136/bmjqs.2010.048074subject
Has Abstractpub_date
2011-08-01 00:00:00pages
698-703issue
8eissn
2044-5415issn
2044-5423pii
bmjqs.2010.048074journal_volume
20pub_type
杂志文章abstract:BACKGROUND:Few studies have investigated whether clinicians can use checklists to verify their diagnostic decisions. Checklists may improve accuracy by prompting clinicians to reconsider or recollect information but might impair decision making by adding to clinicians' cognitive load. This study assessed whether checkl...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2012-001537
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVE:Valid, reliable critical appraisal tools advance quality improvement (QI) intervention impacts by helping stakeholders identify higher quality studies. QI approaches are diverse and differ from clinical interventions. Widely used critical appraisal instruments do not take unique QI features into account and e...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2014-003151
更新日期:2015-12-01 00:00:00
abstract:OBJECTIVE:To examine how disciplinary tribunals assess different forms of misconduct in deciding whether to remove doctors from practice for professional misconduct. DESIGN AND SETTING:Multivariable regression analysis of 485 cases in which tribunals found doctors guilty of professional misconduct. The cases came from...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2012-000941
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:Experts in patient safety stress the importance of a shared culture of safety. Lack of consensus may be detrimental to patient safety. This study examines differences in patient safety culture perceptions among providers, management and staff in a large national survey of safety culture in ambulatory practic...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2014-003914
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:In 2005, The Joint Commission included medication reconciliation as a National Patient Safety Goal to reduce medication errors related to omissions, duplications and interactions. Hospitals continue to struggle to implement successful programmes that meet these objectives. METHODS:The authors used improveme...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs.2010.047845
更新日期:2011-04-01 00:00:00
abstract::This paper aims to draw attention to the social and micropolitical dimensions of attempting to implement improvements within healthcare organisations. It is argued that quality improvement initiatives, like other forms of organisational innovation, will fail unless they are conceived and implemented in such a way as t...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs.2010.046482
更新日期:2011-04-01 00:00:00
abstract:OBJECTIVE:To empirically assess the quality of hospital care in China and trends over a 5-year period during which the government significantly increased its investment in healthcare. DESIGN:Retrospective, observational study comparing hospital quality between two periods: October 2012-March 2013 and October 2017-Marc...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2018-008938
更新日期:2019-12-01 00:00:00
abstract::Current methods used to evaluate the effects of healthcare improvement efforts have limitations. Designs with strong causal inference-such as individual patient or cluster randomisation-can be inappropriate and infeasible to use in single-centre settings. Simpler designs-such as prepost studies-are unable to infer cau...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2019-009734
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:Advocates for quality and safety have called for healthcare that is patient-centred and decision-making that involves patients. OBJECTIVE:The aim of the paper is to explore the barriers and facilitators to patient-centred care in the hospital discharge process. METHODS:A qualitative study using purposive s...
journal_title:BMJ quality & safety
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjqs-2012-001165
更新日期:2012-12-01 00:00:00
abstract::Statistical hypothesis testing involving the comparison of three or more means and/or proportions is a frequent undertaking in medical statistics. For comparison of means, analysis of variance is a common choice and for comparison of proportions, χ(2) tests are common. However, both these approaches have important lim...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2011-000477
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVE:Implement and demonstrate feasibility of in situ simulations to identify latent safety threats (LSTs) at a higher rate than lab-based training, and reinforce teamwork training in a paediatric emergency department (ED). METHODS:Multidisciplinary healthcare providers responded to critical simulated patients in...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2012-000942
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:Timely reporting and acknowledgement are crucial steps in critical laboratory results (CLR) management. The authors previously showed that an automated pathway incorporating short messaging system (SMS) texts, auto-escalation, and manual telephone back-up improved the rate and speed of physician acknowledgem...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2011-000647
更新日期:2012-08-01 00:00:00
abstract:BACKGROUND:Interest in patient safety (PS) is growing exponentially, fuelled by epidemiological research unveiling the extent of unsafe care. However, there is little information about the frequency of harm in developing and transitional countries. To address this issue, the authors performed a study known as the Ibero...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs.2011.051284
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:Patient-reported outcome measures (PROMs) often produce skewed distributions of individual scores after a healthcare intervention. For health performance indicators derived from skewed distributions, funnel plots designed with symmetric control limits may increase the risk of false alarms about poor performa...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2011-000197
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:Our goal was to compare hospital scores from the most widely used commercial website in the USA to hospital scores from more systematic measures of patient experience and outcomes, and to assess what drives variation in the commercial website scores. METHODS:For a national sample of US hospitals, we compare...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2012-001360
更新日期:2013-03-01 00:00:00
abstract:OBJECTIVE:We sought to identify the characteristics of patients who experience medical emergency team calls in the radiology department (MET-RD) and the relationship between these characteristics and patient outcomes. DESIGN/PARTICIPANTS:Retrospective review of 111 inpatient MET-RD calls (May 2008-April 2010). SETTIN...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2011-000423
更新日期:2012-06-01 00:00:00
abstract:BACKGROUND:The safety-and-quality movement is now two decades old. Errors persist despite best efforts, indicating that there are entrenched overt and perhaps less explicit barriers limiting the success of improvement efforts. OBJECTIVES AND HYPOTHESES: To examine the perspectives of five groups of healthcare worker...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2011-051755
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVE:To determine the association between daily levels of registered nurse (RN) and nursing assistant staffing and hospital mortality. DESIGN:This is a retrospective longitudinal observational study using routinely collected data. We used multilevel/hierarchical mixed-effects regression models to explore the asso...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2018-008043
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Burnout is widespread among healthcare providers and is associated with adverse safety behaviours, operational and clinical outcomes. Little is known with regard to the explanatory links between burnout and these adverse outcomes. OBJECTIVES:(1) Test the psychometric properties of a brief four-item burnout ...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2014-002831
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:Existing evidence indicates that reducing nurse staffing and/or skill mix adversely affects care quality. Nursing shortages may lead managers to dilute nursing team skill mix, substituting assistant personnel for registered nurses (RNs). However, no previous studies have described the relationship between nu...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2018-008948
更新日期:2019-09-01 00:00:00
abstract:OBJECTIVES:To determine frequencies of healthcare workers (HCWs) speak up-related behaviours and the association of speak up-related safety climate with speaking up and withholding voice. DESIGN:Cross-sectional survey of doctors and nurses. Data were analysed using multilevel logistic regression models SETTING: 4 hosp...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2017-007388
更新日期:2018-10-01 00:00:00
abstract::Cystic fibrosis (CF) is a chronic disease requiring patients to have frequent specialty healthcare visits to delay progression of lung disease, prevent and treat failure to thrive and initiate early interventions to prevent acute illness and complications. The CF Foundation recommends that patients have visits with th...
journal_title:BMJ quality & safety
pub_type: 杂志文章,评审
doi:10.1136/bmjqs-2013-002345
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:To examine the association of consultants' experience with mortality by day of the week when elective surgery was performed. DESIGN:Retrospective observational study using English hospital administrative data. SETTING:All acute and specialist English National Health Service (NHS) hospitals carrying out elec...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2015-004105
更新日期:2016-05-01 00:00:00
abstract:OBJECTIVE:To describe the development of evidence-based electronic prescribing (e-prescribing) triggers and treatment algorithms for potentially inappropriate medications (PIMs) for older adults. DESIGN:Literature review, expert panel and focus group. SETTING:Primary care with access to e-prescribing systems. PARTIC...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs.2010.049635
更新日期:2011-10-01 00:00:00
abstract::People who are sick are often the most vulnerable in society. They frequently rely on caring and competent healthcare professionals and should and do have expectations of a safe and caring environment. In a recent unexpected adventure through the healthcare system, the organisation, professionalism, caring and compass...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2011-000235
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:Patient participation in care is a fundamental element of safe and high-quality healthcare with the potential to enhance health outcomes and improve patient satisfaction. OBJECTIVES:To test the efficacy of a clinician-facilitated, bedside multimedia (MyStay) intervention designed to support patient particip...
journal_title:BMJ quality & safety
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmjqs-2018-008975
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Diagnostic error is commonly defined as a missed, delayed or wrong diagnosis and has been described as among the most important patient safety hazards. Diagnostic errors also account for the largest category of medical malpractice high severity claims and total payouts. Despite a large literature on the inci...
journal_title:BMJ quality & safety
pub_type: 杂志文章,评审
doi:10.1136/bmjqs-2019-010822
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Distraction and interruption are endemic in the clinical environment and contribute to error. This study assesses whether simulation-based training with targeted feedback can improve undergraduate management of distractions and interruptions to reduce error-making. DESIGN:A prospective non-randomised contro...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2014-003272
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Quality of care is considered to be of central importance in healthcare, disability services and rehabilitation. People experiencing disability often access a range of health and social care services; for some, these services are integral parts of daily life. Little research has explored perspe...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs.2010.042812
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVE:Hospital-acquired pressure injuries are localised skin injuries that cause significant mortality and are costly. Nursing best practices prevent pressure injuries, including time-consuming, complex tasks that lack payment incentives. The Braden Scale is an evidence-based stratification tool nurses use daily to...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2017-007505
更新日期:2019-02-01 00:00:00