Abstract：
RATIONALE, AIMS AND OBJECTIVES:This study aimed to apply the 'systems approach' to patient safety in order to identify causes for delays and errors in lung cancer diagnoses following an abnormal chest radiograph. METHODS:In the first part of this study, the systems approach to patient safety was comprehensively reviewed by three radiologists and seven patient safety experts. In the second part of this study, a retrospective review was performed of all patients referred to the lung cancer multidisciplinary team (MDT) meeting over a 1-year period. All abnormal chest radiograph reports were examined and a root-cause analysis performed of cases where errors and delays in diagnoses were deemed to have occurred. RESULTS:A total of 124 cases were reviewed, of which 36 (29%) patients had an abnormal preceding chest radiograph prior to MDT referral. In six cases, serious errors from delay and lack of follow-up were identified. These are analysed and discussed in detail in this article. Application of the systems approach to each case identified poor communication and lack of clinical action as prime causes. CONCLUSIONS:Both reporting radiologists and referring clinicians have a responsibility to ensure appropriate action following an abnormal chest radiograph. The main error lies in communication between the referring clinicians and the radiologists. Direct electronic communication is potentially a more robust method to overcome this.
journal_name
J Eval Clin Practjournal_title
Journal of evaluation in clinical practiceauthors
Bhaludin BN,Shelmerdine SC,Arora S,Senbanjo T,Parthipun Adoi
10.1111/jep.12178subject
Has Abstractpub_date
2014-08-01 00:00:00pages
453-9issue
4eissn
1356-1294issn
1365-2753journal_volume
20pub_type
杂志文章abstract：RATIONALE, AIMS AND OBJECTIVES:Wristbands are essential for accurate patient identification. Some evidence suggests that missing wristbands is not an infrequent occurrence in acute hospitals. The National Patient Safety Agency (NPSA) has developed guidance on patient identification for hospitals in England and Wales. H...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2008.01004.x
更新日期：2009-04-01 00:00:00
abstract：RATIONALE:Recent reports indicate that approximately 10% of in-patients in UK hospitals are involved in an adverse event (these reports also state that 50% of these events are preventable). This is indeed a worrying finding, and indicates the need to look at how these incidents are handled or indeed, what is done to mi...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2011.01759.x
更新日期：2012-12-01 00:00:00
abstract：RATIONALE, AIMS AND OBJECTIVES:Invasive pneumococcal diseases (IPD) are associated with substantial burden in adults (≥50 years). Moreover, adults with vascular, metabolic or respiratory diseases have been shown to have a 3-6 times higher risk of IPD when compared with their healthy controls. These persons at higher ri...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/jep.12131
更新日期：2014-08-01 00:00:00
abstract：RATIONALE, AIMS AND OBJECTIVES:Issues of overuse, underuse and misuse are paramount and lead to avoidable morbidity and mortality. Although evidence-based practice is advocated, the widespread implementation of this kind of practice remains a challenge. This is also the case for evidence-based practice related to the p...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2008.01019.x
更新日期：2009-04-01 00:00:00
abstract：RATIONALE AIMS AND OBJECTIVES:Pulmonary aspiration is a feared complication of anaesthesia that is associated with significant morbidity and mortality. Within the small existing body of literature on medical malpractice claims related to periprocedural aspiration, very little information is available regarding the case...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/jep.13086
更新日期：2019-10-01 00:00:00
abstract：BACKGROUND:Evidence-based practice (EBP) is a worldwide approach to improving health care. There is, however, a shortage of studies examining whether or not newly graduated health care professionals are actually applying EBP in their daily work. OBJECTIVES:To examine the application of EBP in clinical practice by regi...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2009.01316.x
更新日期：2009-12-01 00:00:00
abstract：RATIONALE, AIMS AND OBJECTIVES:Traditional continuing medical education programmes that offer passive learning have been shown to be poorly effective at changing doctors' clinical behaviour. A multifaceted evidence-based medicine (EBM) intervention was conducted at the largest health maintenance organization (HMO) in I...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章,随机对照试验
doi：10.1111/j.1365-2753.2007.00859.x
更新日期：2007-08-01 00:00:00
abstract：OBJECTIVE:To evaluate control of blood pressure (BP) and diabetes and the associated risk factors in diabetic hypertensives treated by diabetic clinic primary care physicians. METHODS:A retrospective analysis of the medical records of diabetic hypertensives from six primary care diabetic clinics in Bahrain. RESULTS:T...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章,多中心研究
doi：10.1111/j.1365-2753.2005.00511.x
更新日期：2005-04-01 00:00:00
abstract：OBJECTIVES:The purpose of this study is to examine Electronic Health Record (EHR) adoption among Florida doctors who treat the elderly. This analysis contributes to the EHR adoption literature by determining if doctors who disproportionately treat the elderly differ from their counterparts with respect to the utilizati...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2009.01277.x
更新日期：2010-12-01 00:00:00
abstract：RATIONALE, AIMS AND OBJECTIVES:The implementation of automated dispensing cabinets (ADCs) in healthcare facilities appears to be increasing, in particular within Australian hospital emergency departments (EDs). While the investment in ADCs is on the increase, no studies have specifically investigated the impacts of ADC...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/jep.12445
更新日期：2016-04-01 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：OBJECTIVE:The purpose of the current study was to assess, in patients scheduled for primary total knee replacement (TKR), the effects of pre-surgery waiting time on pain and functional limitations related to the knee joint undergoing surgery, on health-related quality of life (HRQoL) and on contralateral knee pain 6 mo...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2010.01541.x
更新日期：2012-02-01 00:00:00
abstract：OBJECTIVE:To discuss the usefulness of health care information technology (HIT) in assisting care providers minimize uncertainty while simultaneously increasing efficiency of the care provided. STUDY DESIGN:An ongoing study of HIT, performance measurement (clinical and production efficiency) and their implications to ...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2010.01483.x
更新日期：2011-12-01 00:00:00
abstract：BACKGROUND:Development of chronic disease risk prediction models has become a growing area of research in recent years. The internal validity of such models is sometimes lower than estimated from the development sample. Overfitting or overoptimism of the developed model and/or differences between the samples are likely...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2012.01834.x
更新日期：2013-04-01 00:00:00
abstract：:Clinical guidelines are essential in promoting the implementation of evidence-based practice within the NHS. But there are two broad schools of thought about their development and implementation: the first argues that guidelines should be entirely evidence-based and tolerates a degree of complexity which may make the ...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.1998.tb00088.x
更新日期：1998-11-01 00:00:00
abstract：:The aim was to determine whether there are differences among family physicians (FPs) and general practitioners (GPs) in terms of their preference for different classes of antihypertensives, either alone or in combinations, in uncomplicated cases of hypertension and to determine the extent of adherence to WHO/ISH guide...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1046/j.1365-2753.2002.00370.x
更新日期：2002-11-01 00:00:00
abstract：INTRODUCTION:Non-routine events (NREs) are atypical or unusual occurrences in a pre-defined process. Although some NREs in high-risk clinical settings have no adverse effects on patient care, others can potentially cause serious patient harm. A unified strategy for identifying and describing NREs in these domains will ...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/jep.13456
更新日期：2020-08-16 00:00:00
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：INTRODUCTION:The patient-centred medical home (PCMH) is an important part of health care reform. While there is hope, the PCMH model can facilitate the provision of higher quality care, the extent to which organizational climate within the PCMH supports the implementation of evidence-based practices (EBPs) is unknown. ...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/jep.13050
更新日期：2019-08-01 00:00:00
abstract：RATIONALE, AIMS AND OBJECTIVES:Diagnostic reasoning and treatment decisions are a key competence of doctors. A model based on values and probability provides a conceptual framework for clinical judgments and decisions, and also facilitates the integration of clinical and biomedical knowledge into a diagnostic decision....
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章,评审
doi：10.1111/j.1365-2753.2007.00931.x
更新日期：2008-10-01 00:00:00
abstract：:Performance indicators for healthcare organizations represent a strategy for accountability worldwide. A universal approach to either the design for indicators or their applicability to local needs remains a work in progress. The Maryland Hospital Association's Quality Indicator Project (QIP) is the only indicator-bas...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1046/j.1365-2753.2003.00374.x
更新日期：2003-05-01 00:00:00
abstract：OBJECTIVES:To assess the evidence for tai chi in reducing resting blood pressure (BP) in the elderly. METHODS:Databases were searched up to February 2009. All randomized clinical trials (RCTs) testing the effects of tai chi on resting BP in the elderly were considered. The selection of studies, data extraction and val...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章,评审
doi：10.1111/j.1365-2753.2009.01210.x
更新日期：2010-08-01 00:00:00
abstract：RATIONALE, AIMS AND OBJECTIVES:Short-term intensive insulin therapy (IIT) early in the course of type 2 diabetes can improve pancreatic beta-cell function and even induce normoglycemia that persists post-therapy. In spite of this benefit, insulin is often delayed until late in the course of disease partly because of it...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2010.01552.x
更新日期：2012-04-01 00:00:00
abstract：RATIONALE, AIMS AND OBJECTIVES:Handovers within and between health care settings are known to affect quality of care. Health care organizations, struggle how to guarantee best care during handovers. The aim of this paper is to evaluate handover practices in Dutch birth centres from a process perspective, to identify ob...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/jep.12939
更新日期：2018-06-01 00:00:00
abstract：BACKGROUND:Recent research indicates that allied health clinicians have difficulty articulating client needs and priorities into specific and measurable goals. As a result, a number of strategies to facilitate improvement in allied health clinicians' goal-setting skills have been recommended in the literature. In order...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章,随机对照试验
doi：10.1111/j.1365-2753.2008.01104.x
更新日期：2010-02-01 00:00:00
abstract：:I discuss the lack of precision in the term 'clinical reasoning' and its relationship to evidence-based medicine and critical thinking. I examine critical thinking skills, their underemphasis in medical education and successful attempts to remediate them. Evidence-based medicine (and evidence-based psychiatry) offer m...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/jep.12324
更新日期：2015-06-01 00:00:00
abstract：:Often, when conducting programme evaluations or studying the effects of policy changes, researchers may only have access to aggregated time series data, presented as observations spanning both the pre- and post-intervention periods. The most basic analytic model using these data requires only a single group and models...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2010.01504.x
更新日期：2011-12-01 00:00:00
abstract：RATIONALE, AIMS AND OBJECTIVES:Health-care professions have long been considered prone to work-related stress, yet recent research in Bulgaria indicates alarmingly high levels of burnout. Cloninger's inventory is used to analyse and evaluate correlation between personality characteristics and degree of burnout syndrome...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2012.01895.x
更新日期：2012-12-01 00:00:00
abstract：OBJECTIVE:To study which tests general practitioners used to diagnose a urinary tract infection (UTI) in children and which patient characteristics were associated with test choice. DESIGN:Retrospective chart review on the diagnosis of UTIs in children in Dutch general practices who were diagnosed as having a UTI. A t...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2008.01037.x
更新日期：2009-06-01 00:00:00
abstract：UNLABELLED:Medical tradition considers a physical examination (PE) an essential part of the clinical encounter. In real medical practice, however, a full PE may not be necessary when the diagnosis is clear after anamnesis and general impression. We assessed the value of PEs in 500 diagnoses of upper respiratory infecti...
journal_title：Journal of evaluation in clinical practice
pub_type： 杂志文章
doi：10.1111/j.1365-2753.2008.00980.x
更新日期：2009-02-01 00:00:00
