Abstract:
BACKGROUND:Meaningful partnering with patients is advocated to enhance care delivery. Little is known about how this is operationalised at the point of care during hospital ward rounds, where decision-making concerning patient care frequently occurs. OBJECTIVE:Describe participation of patients, with differing preferences for participation, during ward rounds in acute medical inpatient services. METHODS:Naturalistic, multimethod design. Data were collected using surveys and observations of ward rounds at two hospitals in Melbourne, Australia. Using convenience sampling, a stratified sample of acute general medical patients were recruited. Prior to observation and interview, patient responses to the Control Preference Scale were used to stratify them into three groups representing diverse participation preferences: active control where the patient makes decisions; shared control where the patient prefers to make decisions jointly with clinicians; and passive control where the patient prefers clinicians make decisions. RESULTS:Of the 52 patients observed over 133 ward rounds, 30.8% (n=16) reported an active control preference for participation in decision-making during ward rounds, 25% (n=13) expressed shared control preference and 44.2% (n=23) expressed low control preference. Patients' participation was observed in 75% (n=85) of ward rounds, but few rounds (18%, n=20) involved patient contribution to decisions about their care. Clinicians prompted patient participation in 54% of rounds; and in 15% patients initiated their own participation. Thematic analysis of qualitative observation and patient interview data revealed two themes, supporting patient capability and clinician-led opportunity, that contributed to patient participation or non-participation in ward rounds. CONCLUSIONS:Participation in ward rounds was similar for patients irrespective of control preference. This study demonstrates the need to better understand clinician roles in supporting strategies that promote patient participation in day-to-day hospital care.
journal_name
BMJ Qual Safjournal_title
BMJ quality & safetyauthors
Redley B,McTier L,Botti M,Hutchinson A,Newnham H,Campbell D,Bucknall Tdoi
10.1136/bmjqs-2017-007292subject
Has Abstractpub_date
2019-01-01 00:00:00pages
15-23issue
1eissn
2044-5415issn
2044-5423pii
bmjqs-2017-007292journal_volume
28pub_type
杂志文章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
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更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:Transfers of care have become increasingly frequent and complex with shorter inpatient stays and changes in work hour regulations. Potential hazards exist with transfers. There are few reports of institution-wide efforts to improve handoffs. METHODS:An institution-wide physician handoff task force was devel...
journal_title:BMJ quality & safety
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abstract:OBJECTIVE:Administrative data systems are used to identify hospital-based patient safety events; few studies evaluate their accuracy. We assessed the accuracy of a new set of patient safety indicators (PSIs; designed to identify in hospital complications). STUDY DESIGN:Prospectively defined analysis of registry data (...
journal_title:BMJ quality & safety
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journal_title:BMJ quality & safety
pub_type: 杂志文章,评审
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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
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更新日期:2012-06-01 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
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journal_title:BMJ quality & safety
pub_type: 杂志文章
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journal_title:BMJ quality & safety
pub_type: 杂志文章,多中心研究
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更新日期:2012-12-01 00:00:00
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journal_title:BMJ quality & safety
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journal_title:BMJ quality & safety
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journal_title:BMJ quality & safety
pub_type: 杂志文章,多中心研究
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更新日期:2013-03-01 00:00:00
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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
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journal_title:BMJ quality & safety
pub_type: 杂志文章
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更新日期:2011-04-01 00:00:00
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journal_title:BMJ quality & safety
pub_type: 杂志文章
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更新日期:2013-10-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2019-10-01 00:00:00
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journal_title:BMJ quality & safety
pub_type: 杂志文章
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更新日期:2016-08-01 00:00:00
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pub_type: 杂志文章
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更新日期:2014-06-01 00:00:00
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更新日期:2012-02-01 00:00:00
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更新日期:2013-03-01 00:00:00
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更新日期:2014-11-01 00:00:00
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pub_type: 杂志文章
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更新日期:2018-10-01 00:00:00
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更新日期:2016-10-01 00:00:00
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更新日期:2012-06-01 00:00:00
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journal_title:BMJ quality & safety
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更新日期:2011-05-01 00:00:00
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pub_type: 杂志文章
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更新日期:2019-03-01 00:00:00
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pub_type: 杂志文章
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更新日期:2014-10-01 00:00:00
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journal_title:BMJ quality & safety
pub_type: 杂志文章,meta分析,评审
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更新日期:2014-04-01 00:00:00