Abstract:
:Handover communication improvement initiatives typically employ a "one size fits all" approach. A human factors perspective has the potential to guide how to tailor interventions to roles, levels of experience, settings, and types of patients. We conducted ethnographic observations of sign-outs by attending and resident physicians in 2 medical intensive care units at one institution. Digitally audiotaped data were manually analyzed for content using codes and time spent using box plots for emergent categories. A total of 34 attending and 58 resident physician handovers were observed. Resident physicians spent more time for "soon to be discharged" and "higher concern" patients than attending physicians. Resident physicians spent less time discussing patients which they had provided care for within the last 3 days ("handbacks"). The study suggested differences for how handovers were conducted for attending and resident physicians for 3 categories of patients; handovers differ on the basis of role or level of expertise, patient type, and amount of prior knowledge of the patient. The findings have implications for new directions for subsequent research and for how to tailor quality improvement interventions based upon the role, level of experience, level of prior knowledge, and patient categories.
journal_name
Qual Manag Health Carejournal_title
Quality management in health careauthors
Mount-Campbell AF,Rayo MF,OʼBrien JJ Jr,Allen TT,Patterson ESdoi
10.1097/QMH.0000000000000114subject
Has Abstractpub_date
2016-10-01 00:00:00pages
225-230issue
4eissn
1063-8628issn
1550-5154pii
00019514-201610000-00006journal_volume
25pub_type
杂志文章abstract::To see the world systematically through the practice of systems thinking means to see the relationship in the phenomena we experience. The systems view is not just another way of improving an object, a process, or even services. It should not be viewed as a method that is focused only on "quality." The intrinsic value...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-199807010-00004
更新日期:1998-10-01 00:00:00
abstract::Recently, many have begun to explore the possibility of using analytical methods associated with continuous quality improvement in the efforts to improve health care. Central to this paradigm is the proposition that such analytical methods can be used to identify and react to variations in the processes and outcomes o...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:
更新日期:1992-10-01 00:00:00
abstract:PURPOSE:Adherence to new guidelines for the use of ipecac syrup, gastric lavage, cathartics, and activated charcoal by a poison control center was studied with a quality improvement framework. METHODS:The rates of gastric decontamination were monitored through an electronic case record system. In February 2002, a revi...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-200610000-00008
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Inability to obtain timely medications is a patient safety concern that can lead to delayed or incomplete treatment of illness. While there are many patient and system factors contributing to postdischarge medication nonadherence, availability and insurance-related barriers are preventable. P...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0000000000000264
更新日期:2020-10-01 00:00:00
abstract::Patients' perceptions provide valuable insight into areas for improvement and opportunities for strategic planning. Using both quantitative and qualitative research methods, the topics of what drives patient satisfaction, what delights patients, and what disappoints patients were examined. A case study approach was us...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:
更新日期:1997-04-01 00:00:00
abstract:OBJECTIVE:This pilot study describes the development of an instrument to measure nursing quality knowledge, skills, and attitudes for practicing pediatric oncology nurses. Because many nurse leaders of academic centers are responsible for outcomes at both local and global level, ensuring nursing quality is critical, gi...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0b013e3181aea256
更新日期:2009-07-01 00:00:00
abstract:OBJECTIVES:This article explores and describes key processes facilitating the integration of neophyte graduate nurses into safe and effective organizational systems and processes as part of a hospital's overall local clinical governance and clinical risk management (CRM) program. METHODS:This study was undertaken usin...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/01.QMH.0000316994.02039.80
更新日期:2008-04-01 00:00:00
abstract::A lost surgical specimen prompted an investigation of both the human processes and the systemic factors involved in surgical specimen handling regarding how health care organizations approach medical error prevention and patient safety promotion. Quality improvement techniques and the conceptual error model of James R...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-200110010-00006
更新日期:2001-10-01 00:00:00
abstract:CONTEXT:Residents often fail to escalate narcotics to ensure pain relief in patients with cancer because of fear of overdose. A computer simulation of patients in pain may provide a way to improve management without fear of harm. We developed a pain care simulation to train residents. STUDY DESIGN/MEASURES: Thirty-one ...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/01.QMH.0000326722.70708.0d
更新日期:2008-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:The mission of nonprofit health care clinics is particularly challenging to fulfill given the large number of uninsured and underinsured people they serve. In addition, these clinics feel pressure to provide services in an efficient manner to prevent patient no-shows and encourage the continua...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0000000000000215
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVES:To determine whether employees working for a transformational leader perceive their leader as more effective than do those working for a transactional leader. To assess whether employees in private hospitals are more likely to perceive their leaders as transformational than are employees in public hospitals....
journal_title:Quality management in health care
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1097/00019514-200410000-00009
更新日期:2004-10-01 00:00:00
abstract::"Quality" of care has become one of the main foci of the American health care system during the last 20 years. As costs escalated in all areas of health care, the purchasers and consumers of health care have begun to demand accountability for the products they purchase. The initial focus of the system was "quality of ...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-200407000-00005
更新日期:2004-07-01 00:00:00
abstract::The American patient and consumer groups are increasing pressure on physicians and health care organizations to improve and document the quality of care that they deliver. A leading cause of inadequate care is the significant variations in medical practice that cannot be explained by patient differences, which persist...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-199908010-00003
更新日期:1999-10-01 00:00:00
abstract:BACKGROUND:Although often used in health care settings as a method for continuous quality improvement, experience with the breakthrough collaborative in nonclinical health care settings is limited. In this article, we report pilot data from a social services collaborative conducted in 2007 to 2009 in Sweden, with speci...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0b013e3181c58e20
更新日期:2009-10-01 00:00:00
abstract::Each department in a hospital is given the responsibility of managing its own day-to-day work. For the hospital as a whole to change, the individual departments must undergo a similar change. As each department aligns itself with the purposes of the whole organization, synergy is created and the hospital gradually, in...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:
更新日期:1993-10-01 00:00:00
abstract::In determining intervention effects, quality improvement researchers typically use statistical testing--Fisher's "significance testing" and/or Neyman and Pearson's "hypothesis testing." Such tests are employed in an effort to demonstrate whether or not a statistically and practically significant difference exists when...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/01.QMH.0000338551.05512.1b
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND:Metformin is recommended as initial therapy for most patients with type 2 diabetes mellitus. Its most serious adverse effect, lactic acidosis, is a rare entity with a high mortality rate. Despite well-publicized contraindications, metformin is inappropriately prescribed to many hospitalized patients. OBJECT...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0b013e31826d1ef9
更新日期:2012-10-01 00:00:00
abstract::This article proposes a new class of control charts that may be used for monitoring and improving the quality of care. Unlike conventional control charts that rely on observed performance data, these charts use risk-adjusted data in addition to the observed data. The resulting time-ordered charts are capable of reduci...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-200301000-00004
更新日期:2003-01-01 00:00:00
abstract::The aim of this study is to empirically identify and present different kinds of practice-based improvement ideas developed in health care services. The focus is on individual placement needs, problems/issues, and the ability to organize work on the development, implementation, and institutionalization of ideas for the...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0b013e3182134b3c
更新日期:2011-04-01 00:00:00
abstract:CONTEXT:The phrase "Science of Improvement" or "Improvement Science" is commonly used today by a range of people and professions to mean different things, creating confusion to those trying to learn about improvement. In this article, we briefly define the concepts of improvement and science, and review the history of ...
journal_title:Quality management in health care
pub_type: 历史文章,杂志文章
doi:10.1097/QMH.0b013e31829a6a15
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:In Thailand, hospital accreditation (HA) is widely recognized as one of the system tools to promote effective operation of universal health coverage. This nationwide study aims to examine the relationship between accredited statuses of the provincial hospitals and their mortality outcomes. METHOD:A 5-year r...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0000000000000256
更新日期:2020-07-01 00:00:00
abstract::Pay for performance cannot consist of a one-size-fits-all approach. Variation in quality and cost of care is best measured using a single "value" (quality/cost) score that is decomposed into component cost and quality for every health care encounter type. Economic incentives must be enough to focus the provider's atte...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-200501000-00004
更新日期:2005-01-01 00:00:00
abstract::In 1998, the Veterans Health Administration invested in the creation of the Veterans Administration National Quality Scholars Fellowship Program (VAQS) to train physicians in new ways to improve the quality of health care. We describe the curriculum for this program and the lessons learned from our experience to date....
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-200210030-00006
更新日期:2002-04-01 00:00:00
abstract::The aim of this study was to explore and evaluate managers' views of a large-scale improvement program, including their experiences and opinions about improvement initiatives and drivers for change. The study is based on a survey used in 2 nationwide mappings of improvement initiatives and developmental trends in Swed...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0b013e31828bc276
更新日期:2013-04-01 00:00:00
abstract:PURPOSE:Medical home care has been identified as a model for improving primary care delivery and population-specific quality and safety outcomes. Questions remain how this model affects older adult quality. This systematic review addresses 2 important questions: Are quality and safety outcomes associated with medical h...
journal_title:Quality management in health care
pub_type: 杂志文章,评审
doi:10.1097/QMH.0000000000000041
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVES:Although 65% of the hospitals in Taiwan claim to be applying the clinical pathway concept, most hospitals do not implement this concept effectively. The purpose of this study was to determine the reasons for the improper or inappropriate application of the clinical pathway design in hospitals. METHODS:This ...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-200601000-00007
更新日期:2006-01-01 00:00:00
abstract::Improving health care quality is increasingly recognized as a national priority in the United States. As a result, more and more health care organizations can be expected to undertake quality improvement (QI) initiatives. A question being raised with increasing frequency is: "Which QI activities need review by an inst...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-200307000-00006
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND:Popular quality improvement tools such as Six Sigma and Lean Systems (SS/L) claim to provide health care managers the opportunity to improve health care quality on the basis of sound methodology and data. However, it is unclear whether these 2 quality improvement tools actually improve health care quality. ...
journal_title:Quality management in health care
pub_type: 杂志文章,评审
doi:10.1097/QMH.0b013e3181eb140e
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVE:We explored the associations between opioid dose and multiple measures of pain. STUDY DESIGN AND MEASURES:Thirty-two consecutive patients admitted solely for an acute exacerbation of cancer-related pain or for surgery were followed for their entire hospital stay (115 days of pain). For each hospital day, we ...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0000000000000009
更新日期:2013-10-01 00:00:00
abstract::Accountability in health care has taken on new dimensions with the drive to base contracting and provider of care selection upon data driven "report cards." The measurement and development of reportable outcomes are driving providers to move their organizations from a focus not only on "caring" but to one highly cogni...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-200009010-00005
更新日期:2000-10-01 00:00:00