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Seminars in Vascular Surgery Sep 2023The promise of artificial intelligence (AI) in health care has propelled a significant uptrend in the number of clinical trials in AI and global market spending in this... (Review)
Review
The promise of artificial intelligence (AI) in health care has propelled a significant uptrend in the number of clinical trials in AI and global market spending in this novel technology. In vascular surgery, this technology has the ability to diagnose disease, predict disease outcomes, and assist with image-guided surgery. As we enter an era of rapid change, it is critical to evaluate the ethical concerns of AI, particularly as it may impact patient safety and privacy. This is particularly important to discuss in the early stages of AI, as technology frequently outpaces the policies and ethical guidelines regulating it. Issues at the forefront include patient privacy and confidentiality, protection of patient autonomy and informed consent, accuracy and applicability of this technology, and propagation of health care disparities. Vascular surgeons should be equipped to work with AI, as well as discuss its novel risks to patient safety and privacy.
Topics: Humans; Privacy; Patient Safety; Artificial Intelligence; Health Facilities; Healthcare Disparities
PubMed: 37863615
DOI: 10.1053/j.semvascsurg.2023.06.002 -
BMJ Open Quality Apr 2024Examine how Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) can be used to manage patient safety and improve the standard of care for...
BACKGROUND
Examine how Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) can be used to manage patient safety and improve the standard of care for patients.
METHODS
In order to improve key medical training in areas like surgical safety management, blood transfusion closed-loop management, drug safety management and identity recognition, we apply the TeamSTEPPS teaching methodology. We then examine the effects of this implementation on changes in pertinent indicators.
RESULTS
Our hospital's perioperative death rate dropped to 0.019%, unscheduled reoperations dropped to 0.11%, and defined daily doses fell to 24.85. Antibiotic usage among hospitalised patients declined to 40.59%, while the percentage of antibacterial medicine prescriptions for outpatient patients decreased to 13.26%. Identity recognition requirements were implemented at a rate of 94.5%, and the low-risk group's death rate dropped to 0.01%. Critical transfusion episodes were less common, with an incidence of 0.01%. The physician's TeamSTEPPS Teamwork Perceptions Questionnaire and Teamwork Attitudes Questionnaire scores dramatically improved following the TeamSTEPPS team instruction course.
CONCLUSION
An evidence-based team collaboration training programme called TeamSTEPPS combines clinical practice with team collaboration skills to enhance team performance in the healthcare industry and raise standards for medical quality, safety, and effectiveness.
Topics: Humans; Patient Safety; Patient Care Team; Surveys and Questionnaires; Quality Improvement; Safety Management
PubMed: 38670556
DOI: 10.1136/bmjoq-2023-002669 -
African Journal of Paediatric Surgery :... 2023The clinical handover process has been directly associated with patient safety. Improving patient handover can improve patients' safety and ultimate outcomes; therefore,... (Review)
Review
INTRODUCTION
The clinical handover process has been directly associated with patient safety. Improving patient handover can improve patients' safety and ultimate outcomes; therefore, this review was conducted to examine the literature available on interventions that make handovers more effective.
METHODS
MEDLINE (EBSCO) was searched for interventions that improve the efficacy of clinical handovers. Studies were excluded if they were irrelevant, not published in peer-reviewed journals, not published in English, or were based on animal studies. A total of 1087 publications were retrieved and sorted by relevance. The eligibility of the articles was determined by reading through the titles and abstracts then full texts, and reference searching. Six studies were selected for this literature review.
RESULTS
A number of handover interventions were explored. One intervention was changing the handover location to patients' bedside; Bradley et al. found that bedside handovers decreased handover time and patient adverse events. Another intervention was providing education on handovers which Sand-Jecklin et al. associated with reductions in adverse events. Moreover, Lee et al. used simulation-based education and found that it significantly improved nurses' knowledge, performance competence, and self-efficacy. Another intervention was the transforming care at the bedside (TCAB) framework which incorporated multidimensional strategies and emphasized handover as part of patient centeredness; these strategies improved patient safety, yet the results cannot be attributed solely to handover modifications. Meanwhile, Hada et al. implemented a mixture of interventions and found that they improved patient safety and reduced adverse events.
CONCLUSION
The interventions explored were bedside handovers, providing education and simulation-based education on handovers, emphasizing patient centeredness as part of TCAB strategies, and implementing a mixture of interventions. All interventions reduced adverse events, although some improvements were not significant. Due to the limited evidence available to support the efficacy of the interventions on improving clinical handovers, the results remain inconclusive.
Topics: Humans; Patient Handoff; Clinical Competence; Educational Status; Patient Safety
PubMed: 37470550
DOI: 10.4103/ajps.ajps_82_22 -
Healthcare Quarterly (Toronto, Ont.) Apr 2024Patient safety provides an important foundation for high-quality care. Research in Canada and elsewhere has identified substantial levels of harm in hospitals and other...
Patient safety provides an important foundation for high-quality care. Research in Canada and elsewhere has identified substantial levels of harm in hospitals and other settings; these results spurred the development and spread of safety practices, along with strategies to strengthen organizational training, incident reporting and analysis and a host of resources intended to reduce the burden of harm. Yet, despite these efforts, 20 years after the publication of the Canadian Adverse Event study (Baker et al. 2004) and other studies, many leaders believe progress in patient safety has stalled (NEJM Catalyst 2023). Indeed, some recent studies indicate that the levels of harm have increased. One notable study by David Bates and colleagues (2023), building on approaches used in earlier studies, identified at least one adverse event in 23.6% of a random sample of patients in Massachusetts hospitals in 2018. Among 978 events, 22.7% were judged preventable and one-third required at least substantial intervention or prolonged recovery.
Topics: Humans; Patient Safety; Canada; Medical Errors; Safety Management; Hospitals
PubMed: 38881480
DOI: 10.12927/hcq.2024.27327 -
Ugeskrift For Laeger Nov 2023
Topics: Humans; Patient Safety; Technology
PubMed: 38018733
DOI: No ID Found -
British Journal of Anaesthesia Sep 2023An increasing number of patients are receiving sedation or anaesthesia in locations outside of the operating room. Compared with the operating room, anaesthesia...
An increasing number of patients are receiving sedation or anaesthesia in locations outside of the operating room. Compared with the operating room, anaesthesia providers working in a non-operating room anaesthesia (NORA) location report significantly lower perceived levels of safety, and higher levels of anxiety, stress, and workload. These results are likely to affect the well-being of staff in NORA locations and are clinically relevant in terms of patient safety.
Topics: Humans; Anesthesia; Anesthesiology; Operating Rooms; Patient Safety; Anxiety
PubMed: 37442727
DOI: 10.1016/j.bja.2023.06.055 -
Journal of the American Academy of... Oct 2023Patient safety (PS) and quality improvement (QI) have gained momentum over the last decade and are becoming more integrated into medical training, physician... (Review)
Review
Patient safety (PS) and quality improvement (QI) have gained momentum over the last decade and are becoming more integrated into medical training, physician reimbursement, maintenance of certification, and practice improvement initiatives. While PS and QI are often lumped together, they differ in that PS is focused on preventing adverse events while QI is focused on continuous improvements to improve outcomes. The pillars of health care as defined by the 1999 Institute of Medicine report "To Err is Human: Building a Safer Health System" are safety, timeliness, effectiveness, efficiency, equity, and patient-centered care. Implementing a safety culture is dependent on all levels of the health care system. Part 1 of this CME will provide dermatologists with an overview of how PS fits into our current health care system and will include a focus on basic QI/PS terminology, principles, and processes. This article also outlines systems for the reporting of medical errors and sentinel events and the steps involved in a root cause analysis.
Topics: Humans; Quality Improvement; Patient Safety; Dermatology; Curriculum; Safety Management
PubMed: 35143912
DOI: 10.1016/j.jaad.2022.01.049 -
Journal of Biomedical Informatics Dec 2023Content coverage of patient safety ontology and classification systems should be evaluated to provide a guide for users to select appropriate ones for specific... (Review)
Review
BACKGROUND
Content coverage of patient safety ontology and classification systems should be evaluated to provide a guide for users to select appropriate ones for specific applications. In this review, we identified and compare content coverage of patient safety classifications and ontologies.
METHODS
We searched different databases and ontology/classification repositories to identify these classifications and ontologies. We included patient safety-related taxonomies, ontologies, classifications, and terminologies. We identified and extracted different concepts covered by these systems and mapped these concepts to international classification for patient safety (ICPS) and finally compared the content of these systems.
RESULTS
Finally, 89 papers (77 classifications or ontologies) were analyzed. Thirteen classifications have been developed to cover all medical domains. Among specific domain systems, most systems cover medication (16), surgery (8), medical devices (3), general practice (3), and primary care (3). The most common patient safety-related concepts covered in these systems include incident types (41), contributing factors/hazards (31), patient outcomes (29), degree of harm (25), and action (18). However, stage/phase (6), incident characteristics (5), detection (5), people involved (5), organizational outcomes (4), error type (4), and care setting (3) are some of the less covered concepts in these classifications/ontologies.
CONCLUSION
Among general systems, ICPS, World Health Organization's Adverse Reaction Terminology (WHO-ART), and Ontology of Adverse Events (OAE) cover most patient safety concepts and can be used as a gold standard for all medical domains. As a result, reporting systems could make use of these broad classifications, but the majority of their covered concepts are related to patient outcomes, with the exception of ICPS, which covers other patient safety concepts. However, the ICPS does not cover specialized domain concepts. For specific medical domains, MedDRA, NCC MERP, OPAE, ADRO, PPST, OCCME, TRTE, TSAHI, and PSIC-PC provide the broadest coverage of concepts. Many of the patient safety classifications and ontologies are not formally registered or available as formal classification/ontology in ontology repositories such as BioPortal. This study may be used as a guide for choosing appropriate classifications for various applications or expanding less developed patient safety classifications/ontologies. Furthermore, the same concepts are not represented by the same terms; therefore, the current study could be used to guide a harmonization process for existing or future patient safety classifications/ontologies.
Topics: Humans; Patient Safety; Biological Ontologies
PubMed: 37984548
DOI: 10.1016/j.jbi.2023.104549 -
Irish Journal of Medical Science Dec 2023Measuring and monitoring safety (MMS) is critical to the success of safety improvement efforts in healthcare. However, a major challenge to improving safety is the lack...
BACKGROUND
Measuring and monitoring safety (MMS) is critical to the success of safety improvement efforts in healthcare. However, a major challenge to improving safety is the lack of high quality information to support performance evaluation.
AIMS
The aim of this study was to use Vincent et al.'s MMS framework to evaluate the methods used to MMS in Irish hospitals and make recommendations for improvement.
METHODS
The first phase of this qualitative study used document analysis to review national guidance on MMS in Ireland. The second phase consisted of semi-structured interviews with key stakeholders on their understanding of MMS. The MMS framework was used to classify the methods identified.
RESULTS
Six documents were included for analysis, and 24 semi-structured interviews were conducted with key stakeholders working in the Irish healthcare system. A total of 162 methods of MMS were identified, with one method of MMS addressing two dimensions. Of these MMS methods, 30 (18.4%) were concerned with past harm, 40 (24.5%) were concerned with the reliability of safety critical processes, 16 (9.8%) were concerned with sensitivity to operations, 28 (17.2%) were concerned with anticipation and preparedness, and 49 (30%) were concerned with integration and learning.
CONCLUSIONS
There are a wide range of methods of MMS in Irish hospitals. It is suggested that there is a need to identify those methods of MMS that are particularly useful in reducing harm and supporting action and improvement and do not place a large burden on healthcare staff to either use or interpret.
Topics: Humans; Ireland; Patient Safety; Reproducibility of Results; Hospitals; Qualitative Research
PubMed: 36947387
DOI: 10.1007/s11845-023-03336-3 -
BMJ Quality & Safety Oct 2023
Topics: Humans; Patient Safety; Emergency Medical Services
PubMed: 37353315
DOI: 10.1136/bmjqs-2023-016184