Abstract:
BACKGROUND:There has been evidence in recent years that people with intellectual disabilities in acute hospitals are at risk of preventable deterioration due to failures of the healthcare services to implement the reasonable adjustments they need. The aim of this paper is to explore the challenges in monitoring and preventing patient safety incidents involving people with intellectual disabilities, to describe patient safety issues faced by patients with intellectual disabilities in NHS acute hospitals, and investigate underlying contributory factors. METHODS:This was a 21-month mixed-method study involving interviews, questionnaires, observation and monitoring of incident reports to assess the implementation of recommendations designed to improve care provided for patients with intellectual disabilities and explore the factors that compromise or promote patient safety. Six acute NHS Trusts in England took part. Data collection included: questionnaires to clinical hospital staff (n = 990); questionnaires to carers (n = 88); interviews with: hospital staff including senior managers, nurses and doctors (n = 68) and carers (n = 37); observation of in-patients with intellectual disabilities (n = 8); monitoring of incident reports (n = 272) and complaints involving people with intellectual disabilities. RESULTS:Staff did not always readily identify patient safety issues or report them. Incident reports focused mostly around events causing immediate or potential physical harm, such as falls. Hospitals lacked effective systems for identifying patients with intellectual disabilities within their service, making monitoring safety incidents for this group difficult.The safety issues described by the participants were mostly related to delays and omissions of care, in particular: inadequate provision of basic nursing care, misdiagnosis, delayed investigations and treatment, and non-treatment decisions and Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) orders. CONCLUSIONS:The events leading to avoidable harm for patients with intellectual disabilities are not always recognised as safety incidents, and may be difficult to attribute as causal to the harm suffered. Acts of omission (failure to give care) are more difficult to recognise, capture and monitor than acts of commission (giving the wrong care). In order to improve patient safety for this group, the reasonable adjustments needed by individual patients should be identified, documented and monitored.
journal_name
BMC Health Serv Resjournal_title
BMC health services researchauthors
Tuffrey-Wijne I,Goulding L,Gordon V,Abraham E,Giatras N,Edwards C,Gillard S,Hollins Sdoi
10.1186/1472-6963-14-432subject
Has Abstractpub_date
2014-09-24 00:00:00pages
432issn
1472-6963pii
1472-6963-14-432journal_volume
14pub_type
杂志文章,多中心研究abstract:BACKGROUND:Limited health literacy (HL) and numeracy have been shown to be associated with a wide array of poor health-related outcomes, knowledge, and behaviors. The purpose of this study was to evaluate the clinical utility of brief HL and numeracy screening items in identifying Spanish-speaking adults' HL and numera...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-015-1046-2
更新日期:2015-09-14 00:00:00
abstract:BACKGROUND:In response to long waiting lists and problems with access to primary care physiotherapy, several Primary Care Trusts (PCTs) (now Clinical Commissioning Groups CCGs) developed physiotherapy-led telephone assessment and treatment services. The Medical Research Council (MRC) funded PhysioDirect trial was a ran...
journal_title:BMC health services research
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12913-016-1349-y
更新日期:2016-03-28 00:00:00
abstract:BACKGROUND:Hospital deaths following several hospital admissions or long hospital stays may be indicative of a low quality of dying. Although place of death has been extensively investigated at population level, hospital use in the last months of life and its determinants have been studied less often, especially in Eur...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-7-69
更新日期:2007-05-08 00:00:00
abstract:BACKGROUND:Nursing and midwifery research activity is an important indicator of the quality of healthcare services and the status of nursing profession. The main aim of this study was to assess the research activity in nursing and midwifery field in Arab countries. METHOD:The current study implemented bibliometric met...
journal_title:BMC health services research
pub_type: 杂志文章,评审
doi:10.1186/s12913-019-4178-y
更新日期:2019-05-28 00:00:00
abstract:BACKGROUND:Despite the context of individualization of public policies and promotion of independent living, residential care facilities (RCFs) (called "établissements medico-sociaux" in France) still represent the main system used by disabled people. Through a study of their daily mobility, this article proposes a geog...
journal_title:BMC health services research
pub_type: 杂志文章,多中心研究
doi:10.1186/s12913-017-2602-8
更新日期:2017-09-29 00:00:00
abstract:BACKGROUND:The aim of the study is to translate and cross-culturally adapt, for use in the Italian context, the Communication Assessment Tool (CAT) developed by Makoul and colleagues. METHODS:The study was performed in the out-patient clinic of the Surgical Department of Cardarelli Hospital in Naples, Italy. It involv...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1411-9
更新日期:2016-04-29 00:00:00
abstract:BACKGROUND:Partnerships between clinicians and researchers could increase the generalizability of research findings and increase uptake of research results across populations. Yet engaging clinicians in research is challenging. Clinical Data Research Networks (CDRNs) provide access to a broad array of clinical data, pa...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-3399-9
更新日期:2018-07-20 00:00:00
abstract:BACKGROUND:HIV diagnosis in South Africa is based on a point-of-care testing (PoCT) algorithm with paper-based record-keeping. Aggregated testing data are reported routinely. To facilitate improved HIV case-based surveillance, the Western Cape Province implemented a unique pilot intervention to digitise PoCT results, a...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05517-7
更新日期:2020-08-06 00:00:00
abstract:BACKGROUND:Trust has been introduced as the cornerstone of the public and health providers' relation. Public trust in primary health care (PHC) is crucial and must be measured. The aim of this study was to develop and validate PHC trust measurement tool. METHODS:This was a psychometric study to develop PHC trust measu...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4340-6
更新日期:2019-07-19 00:00:00
abstract:BACKGROUND:As many other European healthcare systems the Danish healthcare system (DHS) has targeted chronic condition care in its reform efforts. Benchmarking is a valuable tool to identify areas for improvement. Prior work indicates that chronic care coordination is poor in the DHS, especially in comparison with care...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-11-347
更新日期:2011-12-22 00:00:00
abstract:BACKGROUND:Clinical practice guidelines aim to enhance patient safety by reducing inappropriate variations in practice. Despite considerable efforts to enhance the use of clinical practice guidelines, adherence is often suboptimal. We investigated to what extent workplace affiliation explains variation of self-reported...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-015-1157-9
更新日期:2015-11-10 00:00:00
abstract:BACKGROUND:Despite the growing literature on the efficiency and productivity of the Chinese healthcare system, less attention has been given to examining the undesirable outputs linked to healthcare services, including environmental pollution. Taking the atmospheric environmental pollution resulting from the incinerati...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05496-9
更新日期:2020-07-22 00:00:00
abstract:BACKGROUND:Compare changes in types of hospital service revenues between traditional Chinese medicine (TCM) hospitals and Western-medicine based general hospitals. METHODS:97 TCM hospitals and 103 general hospitals were surveyed in years of 2000 and 2004. Six types of medical service revenue between the two types of h...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-11-212
更新日期:2011-09-06 00:00:00
abstract:BACKGROUND:Cell-free fetal DNA sequencing based non-invasive prenatal testing (NIPT) for Down syndrome (DS) has become widely available. In Hong Kong, obstetric providers in the public sector refer women identified at high risk of having a child with Down syndrome to obstetric providers in the private sector for NIPT. ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-3540-9
更新日期:2018-09-21 00:00:00
abstract:BACKGROUND:Despite efforts by professional societies to reduce low value care, many reports indicate that unnecessary tests, such as nuclear myocardial perfusion imaging (MPI), are commonly used in contemporary practice. The degree to which lack of awareness and professional liability concerns drive these behaviors war...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2510-y
更新日期:2017-08-11 00:00:00
abstract:BACKGROUND:Job satisfaction is an important predictor of an individual's intention to leave the workplace. It is increasingly being used to consider the retention of health workers in low-income countries. However, the determinants of job satisfaction vary in different contexts, and it is important to use measurement m...
journal_title:BMC health services research
pub_type: 杂志文章,多中心研究
doi:10.1186/s12913-016-1558-4
更新日期:2016-07-27 00:00:00
abstract:BACKGROUND:World Health Organization (WHO) predicted that there will be a shortfall of skilled healthcare by 2035 with the greatest shortfall in Africa and Southeast Asia due to satisfaction with payment and incentives. Low job satisfaction of health workers can result in increased staff turnover and absenteeism, which...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4317-5
更新日期:2019-07-16 00:00:00
abstract:BACKGROUND:Under a constrained health care budget, cost-increasing technologies may displace funds from existing health services. However, it is unknown what services are displaced and how such displacement takes place in practice. The aim of our study was to investigate how the Dutch hospital sector has dealt with the...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05086-9
更新日期:2020-03-30 00:00:00
abstract:BACKGROUND:Clinical documentation systems, such as templates, have been associated with process utilization. The T-System emergency department (ED) templates are widely used but lacking are analyses of the templates association with processes. This system is also unique because of the many different template options av...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-11-65
更新日期:2011-03-24 00:00:00
abstract:BACKGROUND:Travel burden is a key element in conceptualizing geographic access to health care. Prior research has shown that both rural and minority populations bear disproportionate travel burdens. However, many studies are limited to specific types of patient or specific locales. The purpose of our study was to quant...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-7-40
更新日期:2007-03-09 00:00:00
abstract:BACKGROUND:Root cause analysis (RCA) originated in the manufacturing engineering sector but has been adapted for routine use in healthcare to investigate patient safety incidents and facilitate organizational learning. Despite the limitations of the RCA evidence base, healthcare authorities and decision makers in NHS S...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-13-50
更新日期:2013-02-07 00:00:00
abstract:BACKGROUND:Family planning services in the post-partum period, termed post-partum family planning (PPFP) is critical to cover the unmet need for contraception, especially when institutional delivery rates have increased. However, the intention to choose PPFP methods such as post-partum intrauterine devices (PPIUD) rema...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-4969-1
更新日期:2020-02-17 00:00:00
abstract:BACKGROUND:To evaluate the cost-effectiveness of trimetazidine (TMZ) as add-on therapy to standard-of-care (SoC) compared to SoC alone in patients with chronic stable angina who did not respond adequately to first line therapy with b-blockers, nitrates or calcium channel antagonists in Greece. METHODS:A Markov model w...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1779-6
更新日期:2016-09-27 00:00:00
abstract:BACKGROUND:Cardiovascular disease (CVD) is the leading cause of death in the US and incurs high health care costs. While many initiatives promote the implementation of ABCS (aspirin therapy, blood pressure control, cholesterol management, and smoking cessation) measures, most primary care practices (PCPs) lack quality ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-3189-4
更新日期:2018-06-04 00:00:00
abstract:BACKGROUND:After election in 1994, the South African government implemented national and regional programmes, such as the Wild Coast Spatial Development Initiative (SDI), to provoke economic growth and to decrease inequities. CIET measured development in the Wild Coast region across four linked cross-sectional surveys ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-11-S2-S5
更新日期:2011-12-21 00:00:00
abstract:BACKGROUND:A growing body of evidence supports the link between hospital organisational culture and health outcomes. Organisational culture is thus an essential consideration for hospital accreditation, a practice of systematically assessing the quality of hospital care against accepted standards. This study assesses t...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4279-7
更新日期:2019-07-09 00:00:00
abstract:BACKGROUND:The national strategy for treatment of chronic diseases - including MS - and changes in the Swedish welfare system, call for analyses of the use of, and patient satisfaction with, care in a long-term perspective. The aim was therefore to explore the use of care and the predictive value of personal factors, d...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-015-1144-1
更新日期:2015-10-24 00:00:00
abstract:BACKGROUND:To examine the association between rurality and health in Scotland, after adjusting for differences in individual and practice characteristics. METHODS: DESIGN:Mortality and hospital record data linked to two cross sectional health surveys. SETTING:Respondents in the community-based 1995 and 1998 Scottish...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-12-43
更新日期:2012-02-17 00:00:00
abstract:BACKGROUND:There has been a substantial increase in research on mental illness related stigma over the past 10 years, with many measures in use. This study aims to review current practice in the survey measurement of mental illness stigma, prejudice and discrimination experienced by people who have personal experience ...
journal_title:BMC health services research
pub_type: 杂志文章,评审
doi:10.1186/1472-6963-10-80
更新日期:2010-03-25 00:00:00
abstract:BACKGROUND:Risperidone long-acting injection (LAI) is mostly administered twice weekly to people with schizophrenia by nurses at community mental health centres (CMHC) or through mobile outreach visits. This study estimates the cost of resource utilisation associated with the administration of risperidone LAI and the p...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-11-236
更新日期:2011-09-26 00:00:00