Abstract:
RATIONALE, AIMS AND OBJECTIVES:Little is known about the quality of occupational health care provided to National Health Service (NHS) staff. We designed the first national clinical audits of occupational health care in England. We chose to audit depression and back pain as health care workers have high levels of both conditions compared with other employment sectors. The aim of the audits was to drive up quality of care for staff with these conditions. The object of this paper is to describe how we developed an audit methodology and overcame challenges presented by the organization and delivery of occupational health care for NHS staff. METHODS:We designed two retrospective case note audits which ran simultaneously. Sites submitted up to 40 cases for each audit. We used duplicate case entry to test inter-rater reliability and performed selection bias checks. Participants received their site's audit results, benchmarked against the national average, within 4 months of the end of the data entry period. We used electronic voting at a results dissemination conference to inform implementation activities. RESULTS:Occupational Health departments providing services to 278 (83%) trusts in England participated in one or both audits. Median kappa scores were above 0.7 for both pilot and full audits, indicating 'good' levels of inter-rater reliability. In total, 79% of participants at a dissemination conference said that they had changed their clinical practice either during data collection (52%) or following receipt of their audit results (27%). CONCLUSIONS:Clinical audit can be conducted successfully in the occupational health setting. We obtained meaningful data that have stimulated local and national quality improvement activities. Our methodology would be transferable to occupational health settings outside the NHS and in other countries.
journal_name
J Eval Clin Practjournal_title
Journal of evaluation in clinical practiceauthors
Williams S,Rogers C,Peel P,Harvey SB,Henderson M,Madan I,Smedley J,Grant Rdoi
10.1111/j.1365-2753.2010.01574.xsubject
Has Abstractpub_date
2012-04-01 00:00:00pages
283-9issue
2eissn
1356-1294issn
1365-2753journal_volume
18pub_type
杂志文章abstract:RATIONALE, AIMS AND OBJECTIVES:We aim to determine the prevalence of reconciliation errors (REs) at admission to surgery departments, report their potential clinical impact and analyse possible risk factors. METHODS:Prospective observational study was conducted for 8 months in a regional public hospital in Spain. The ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12403
更新日期:2016-02-01 00:00:00
abstract::Most clinicians take for granted a simple, reductionist understanding of medical knowledge that is at odds with how they actually practice medicine; routine medical decisions incorporate more complicated kinds of information than most standard accounts of medical reasoning suggest. A better understanding of the struct...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2010.01387.x
更新日期:2010-04-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Explicit criteria have been used worldwide to identify suboptimal prescribing such as potentially inappropriate prescriptions (PIPs). The objective of our study was to determine prevalence, types and factors associated with PIPs in older people discharged from an Albanian hospital. METHO...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12521
更新日期:2016-10-01 00:00:00
abstract:RATIONALE:There is growing interest in validating tools aimed at supporting the clinical decision-making process and research. However, an increased bureaucratization of clinical practice and redundancies in the measures collected have been reported by clinicians. Redundancies in clinical assessments affect negatively ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,随机对照试验
doi:10.1111/jep.12539
更新日期:2016-10-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Efforts to implement evidence-based medicine (EBM) training in developing countries are limited. We describe the results of an international effort to improve research capacity in a developing country; we conducted a course aimed at improving basic EBM attitudes and identified challenges....
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2011.01635.x
更新日期:2011-08-01 00:00:00
abstract::Progressive improvements in antihypertensive drug therapy over the past four decades have provided clear benefits in limiting cardiovascular complications. Unfortunately, and largely inexplicably, the inclusion in meta-analyses of defective trials plus the employment of inappropriate diagnostic criteria for adverse co...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,评审
doi:10.1046/j.1365-2753.2001.00300.x
更新日期:2001-05-01 00:00:00
abstract::Some of the weaknesses of the randomized controlled trial (RCT) are pointed out, among them unavoidable biases, the possibility of coming to erroneous conclusions by the 'luck of the draw' and the fact that most such experiments lack a doctor/patient relationship and are of little assistance in clinical decision makin...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1046/j.1365-2753.1997.00007.x
更新日期:1997-08-01 00:00:00
abstract:OBJECTIVE:To assess the association of the quality of allocation concealment with heterogeneity in age, the P value of the primary outcome and statistical significance of the primary outcome. STUDY DESIGN AND SETTING:We extracted data from articles published in four major medical journals in 2017 and 2018 that reporte...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,评审
doi:10.1111/jep.13313
更新日期:2020-08-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Peer review groups are considered helpful for quality improvement in primary care. An interactive educational programme for small peer groups was developed, focusing on the implementation of newly developed treatment guidelines. The aim is to evaluate the effect of the programme on adhere...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1365-2753.2005.00625.x
更新日期:2006-12-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Errors in hospitals during the preparation and administration of intravenous drugs to infants and children have been reported to a rate of 13% to 84%. This study aimed to investigate the potential for hazardous events that may lead to an accident for preparation and administration of drug...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12748
更新日期:2017-08-01 00:00:00
abstract:INTRODUCTION:Several international studies have been conducted on student burnout. To contribute to the clinical examination as well as research on the mental health of students, the MBI-SS (Maslach Burnout Inventory-Student Survey) has been validated and used in different countries but not in French. OBJECTIVE:The ai...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12771
更新日期:2017-12-01 00:00:00
abstract:RATIONAL, AIMS, AND OBJECTIVES:Registries are a powerful tool to assess specific performance measurements and quality of care in acute coronary syndromes (ACSs). In Portugal, ProACS is a nationwide registry of ACS that has been active for the past 15 years, and our objective was to assess specific quality indicators fo...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,多中心研究
doi:10.1111/jep.12881
更新日期:2018-04-01 00:00:00
abstract:UNLABELLED:RATIONAL AND AIMS: In recent years, guidelines for treatment of patients with chronic heart failure (CHF) have been updated. Insight in current pharmacological and non-pharmacological treatment of CHF in primary care, which was non-optimal in earlier studies, is limited. We aim to describe current pharmacolo...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2010.01455.x
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:Child psychoanalytic psychotherapy has been criticized for its reluctance to embrace evidence-based practice. This study aims to explore the historical narrative of a sample of child psychoanalytic psychotherapists about progress in developing the evidence base. METHODS:Fourteen psychotherapists were interv...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2011.01638.x
更新日期:2013-08-01 00:00:00
abstract:RATIONALE:This paper reports an initiative which promoted evidence-based practice in pressure risk assessment and management among home nursing clients in Melbourne, Australia. AIM AND OBJECTIVES:The aim of this study was to evaluate the introduction and uptake of the Australian Wound Management Association Guidelines...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2012.01870.x
更新日期:2013-10-01 00:00:00
abstract:AIM:To find out whether a successful multifaceted implementation approach of a local evidence-based guideline on postoperative body temperature measurements (BTM) was persistent over time, and which factors influenced long-term adherence. METHODS:Mixed methods analysis. Patient records were retrospectively examined to...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2011.01687.x
更新日期:2012-08-01 00:00:00
abstract:RATIONALE:Data about health care organizations (HCOs) are not useful until they are interpreted. Such interpretations are influenced by the theoretical lenses used by the researcher. OBJECTIVE:Our purpose was to suggest the usefulness of theories of complex adaptive systems (CASs) in guiding research interpretation. S...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2009.01359.x
更新日期:2010-02-01 00:00:00
abstract::The types of diseases, or categories of suffering, referred to as medically unexplained symptoms or syndromes (MUS) are the focus for the following commentary. Such cases seem to invite reflection. The very nature of such complex patterns of disease and suffering raises a number of fundamental epistemological and onto...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12430
更新日期:2016-08-01 00:00:00
abstract:AIMS AND OBJECTIVES:We report findings from a qualitative study to identify patient views of community hospital care. We consider how far these were in accord with the hospital staffs' views. This constituted part of a wider randomized controlled trial (RCT). The methodological challenges in seeking to identify patient...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1365-2753.2006.00653.x
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:To evaluate the impact of protocol-based care on nursing roles, practice and service delivery. DESIGN:Case study evaluation informed by realistic evaluation methodology. Qualitative data collection methods were used including non-participant observation, post-observation interviews with nurses and patients, ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2008.01015.x
更新日期:2008-10-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:The incidence of falls and fall-related injuries in older age is predicted to increase concomitantly with global population ageing, representing a serious challenge to health care systems. In spite of the availability of policy and practice guidelines for the prevention of falls and fall-...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2009.01307.x
更新日期:2010-12-01 00:00:00
abstract:RATIONALE:Variability in indications for total hip replacement (THR) and unequal waiting times may limit health care access. OBJECTIVE:To analyse the relationship between appropriateness and previously developed surgical priority instruments. METHOD:Multicentre cross-validation study of patients placed on the waiting...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1365-2753.2010.01362.x
更新日期:2011-02-01 00:00:00
abstract::Tough but constructive criticisms of evidence-based medicine (EBM) have without doubt informed the evolution and serial reconstitutions of this approach to clinical decision making and behaviour. Yet, concerns about EBM persist and as EBM changes in response to reflection and criticism, so too do the criticisms themse...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2006.00617.x
更新日期:2006-08-01 00:00:00
abstract::Recent years have witnessed the rising star of evidence-based medicine (EBM) as an approach towards rationalizing clinical practice in the face of an exponentially growing body of knowledge. Along with it, however, a sense of unease is rising among practising doctors, as they feel that well-intentioned principles may ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2003.00473.x
更新日期:2004-05-01 00:00:00
abstract:INTRODUCTION:Recently, some leaders of the evidence-based medicine (EBM) movement drew attention to the "unintended" negative consequences associated with EBM. The term 'cognitive biases plus' was introduced in part I to encompass cognitive biases, conflicts of interests, fallacies and certain behaviours. HYPOTHESIS:'...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,评审
doi:10.1111/jep.12291
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Metaphors are central to the human understanding of complex issues; through the immediate associations they evoke and frame problems and suggest solutions. Our suggestion of Music in the Park as a metaphor for health systems reform brings to the forefront the environmentally diverse but bounded spaces of hea...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2010.01460.x
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVE:Quality of life (QoL) is an important consideration in the care of patients with chronic neuromuscular disorder (NMD). The current study sought to determine the factor structure of the Medical Outcomes Study Short-Form 36 (SF-36) version 2 in patients with NMD to determine the appropriateness of using this in...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2010.01513.x
更新日期:2012-02-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:The primary aim of this study is to gain an insight into hospital pharmacists' current practice and perceptions towards medicine reconciliation and to identify common challenges preventing pharmacists from providing this service. METHODS:A cross-sectional study was conducted over 2 month...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12565
更新日期:2016-12-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:In the context of an ageing population, increasing numbers of older people with long-term conditions are presenting to secondary health care facilities in the United Kingdom having experienced a fall or fall-related injury. Despite such observations, falls and long-term conditions have tr...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12128
更新日期:2014-08-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Loss of situation awareness (SA) by health professionals during handover is a major threat to patient safety in perinatal care. SA refers to knowing what is going on around. Adequate handover communication and process may support situation assessment, a precursor of SA. This study describ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12103
更新日期:2014-04-01 00:00:00