-
Journal of Patient Safety Jan 2021As we approach the 20th anniversary of the Institute of Medicine's report To Err Is Human: Building a Safer Health System, it is important to assess the progress we have...
OBJECTIVES
As we approach the 20th anniversary of the Institute of Medicine's report To Err Is Human: Building a Safer Health System, it is important to assess the progress we have made with respect to patient safety thus far. This study reviews all the existing master's-level degree programs worldwide and assesses them to determine trends and disagreements.
METHODS
Web-based searches were performed using phrases such as "masters," "education," "patient safety," and "healthcare quality." Communication with programs representatives was used to obtain pertinent data not represented on the programs' webpages.
RESULTS
Twenty-five programs exist worldwide, 17 of which within North America. These programs are predominantly taught in a part-time format, with many providing an online setting for learning and requiring various forms of scholarship.
CONCLUSIONS
Programs varied widely in credit hour structure and duration, as well as primary competencies. This highlights the need for the development of program standards to ensure the quality of such programs, as have been developed in other professional fields. Information pertaining to these programs including similarities, differences, trends, and characteristics is detailed in this section. The existence and development of these programs are paramount to future progression in health care, to prevent future errors by studying previous ones, thus improving health care.
Topics: Education, Medical, Graduate; Humans; Patient Safety; Quality of Health Care
PubMed: 32740135
DOI: 10.1097/PTS.0000000000000762 -
International Journal For Quality in... Sep 2016To determine whether clinical supervision (CS) of health professionals improves patient safety. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To determine whether clinical supervision (CS) of health professionals improves patient safety.
DATA SOURCES
Databases MEDLINE, PsychINFO, CINAHL, EMBASE and AMED were searched from earliest date available. Additional studies were identified by searching of reference lists and citation tracking.
STUDY SELECTION
Two reviewers independently applied inclusion and exclusion criteria. Thirty-two studies across three health professions [medicine (n = 29), nursing (n = 2) and paramedicine (n = 1)] were selected.
DATA EXTRACTION
The quality of each study was rated using the Medical Education Research Study Quality Instrument. Risk ratios (RR) were calculated for patient safety outcomes of mortality, complications, adverse events, reoperation following initial surgery, conversion to more invasive surgery and readmission to hospital.
RESULTS OF DATA SYNTHESIS
Results of meta-analyses provided low-quality evidence that supervision of medical professionals reduced the risk of mortality (RR 0.76, 95% CI 0.60-0.95, I(2) = 76%) and supervision of medical professionals and paramedics reduced the risk of complications (RR 0.69, 95% CI 0.53-0.89, I(2) = 76%). Due to a high level of statistical heterogeneity, sub-group analyses were performed. Sub-group analyses provided moderate-quality evidence that direct supervision of surgery significantly reduced the risk of mortality (RR 0.68, 95% CI 0.50-0.93, I(2) = 33%) and direct supervision of medical professionals conducting non-surgical invasive procedures significantly reduced the risk of complications (RR 0.33, 95% CI 0.24-0.46, I(2) = 0%).
CONCLUSIONS
CS was associated with safer surgery and other invasive procedures for medical practitioners. There was a lack of evidence about the relationship between CS and safer patient care for non-medical health professionals.
Topics: Health Personnel; Patient Safety; Quality Improvement
PubMed: 27283436
DOI: 10.1093/intqhc/mzw059 -
Revista Brasileira de Enfermagem 2020to assess the patient safety culture of the health team working in three maternity hospitals. (Observational Study)
Observational Study
OBJECTIVES
to assess the patient safety culture of the health team working in three maternity hospitals.
METHODS
observational, cross-sectional, comparative study. 301 professionals participated in the study. The Hospital Survey on Patient Safety Culture questionnaire validated in Brazil was used. For data analysis, it was considered a strong area in the patient safety culture when positive responses reached over 75%; and areas that need improvement when positive responses have reached less than 50%. To compare the results, standard deviation and thumb rule were used.
RESULTS
of the 12 dimensions of patient safety culture, none obtained a score above 75%, with nine dimensions scoring between 19% and 43% and three dimensions between 55% and 57%.
CONCLUSIONS
no strong dimensions for safety culture were identified in the three maternity hospitals. It is believed that these results may contribute to the development of policies that promote a culture of safety in institutions.
Topics: Adult; Brazil; Cross-Sectional Studies; Female; Humans; Obstetrics and Gynecology Department, Hospital; Organizational Culture; Patient Safety; Safety Management; Surveys and Questionnaires
PubMed: 32667406
DOI: 10.1590/0034-7167-2019-0576 -
Journal of Advanced Nursing Jan 2020To obtain a comprehensive insight of the impact of patient and family engagement on patient safety and identify issues in implementing this approach.
AIMS
To obtain a comprehensive insight of the impact of patient and family engagement on patient safety and identify issues in implementing this approach.
BACKGROUND
Patient and family engagement is increasingly emerging as a potential approach for improving patient safety.
DESIGN
Mixed method multilevel synthesis.
DATA SOURCES
PubMed, CINAHL, Embase, and Cochrance Library (January 2009-April 2018).
REVIEW METHODS
The review was conducted according to the principles recommended by the Cochrane Handbook for Systematic Review and in accordance with the PRISMA guidelines.
RESULTS
Forty-two relevant studies were identified. Common intervention groups included 'direct care' and 'organization' levels with 'consultation' and 'involvement' approaches, while the 'health system' level and 'partnership and shared leadership' approaches were rarely implemented. Findings revealed positive effects of the interventions on patient safety. Most study participants expressed their willingness to engage in or support patient and family engagement. However, existing gaps and barriers in implementing patient and family engagement were identified.
CONCLUSION
Future research should further focus on issuing consensus guidelines for implementing patient and family engagement in patient safety, extending the research scope for all aspects of patient and family engagement and patient safety and identifying priority areas for action that is suitable for each health facility.
IMPACT
Policymakers should issue guidelines for implementing patient and family engagement in healthcare systems which would enable healthcare providers to implement patient and family engagement and improve patient safety appropriately and effectively.
Topics: Family; Female; Humans; Male; Patient Safety; Patients
PubMed: 31588602
DOI: 10.1111/jan.14227 -
BMJ Quality & Safety Jun 2012
Topics: Emergency Service, Hospital; Humans; Patient Safety
PubMed: 22595546
DOI: 10.1136/bmjqs-2012-001109 -
PloS One 2020Various patient safety interventions have been implemented since the late 1990s, but their evaluation has been lacking. To obtain basic information for prioritizing...
Various patient safety interventions have been implemented since the late 1990s, but their evaluation has been lacking. To obtain basic information for prioritizing patient safety interventions, this study aimed to extract high-priority interventions in Japan and to identify the factors that influence the setting of priority. Six perspectives (contribution, dissemination, impact, cost, urgency, and priority) on 42 patient safety interventions classified into 3 levels (system, organizational, and clinical) were evaluated by Japanese experts using the Delphi technique. We examined the relationships of the levels and the perspectives on interventions with the transition of the consensus state in rounds 1 and 3. After extracting the high-priority interventions, a chi-squared test was used to examine the relationship of the levels and the impact/cost ratio with high priority. Regression models were used to examine the influence of each perspective on priority. There was a significant relationship between the level of interventions and the transition of the consensus state (p = 0.033). System-level interventions had a low probability of achieving consensus. "Human resources interventions," "professional education and training," "medication management/reconciliation protocols," "pay-for performance (P4P) schemes and financing for safety," "digital technology solutions to improve safety," and "hand hygiene initiatives" were extracted as high-priority interventions. The level and the impact/cost ratio of interventions had no significant relationships with high priority. In the regression model, dissemination and impact had an influence on priority (β = -0.628 and 0.941, respectively; adjusted R-squared = 0.646). The influence of impact and dissemination on the priority of interventions suggests that it is important to examine the dissemination degree and impact of interventions in each country for prioritizing interventions.
Topics: Cost-Benefit Analysis; Delphi Technique; Expert Testimony; Health Policy; Health Priorities; Japan; Patient Safety
PubMed: 32941481
DOI: 10.1371/journal.pone.0239179 -
Otolaryngologic Clinics of North America Feb 2019Surgeons can use simulation to improve the safety of the systems they work within, around, because of, and despite. Health care is a complex adaptive system that can... (Review)
Review
Surgeons can use simulation to improve the safety of the systems they work within, around, because of, and despite. Health care is a complex adaptive system that can never be completely knowable; simulation can expose aspects of patient care delivery that are not necessarily evident prospectively, during planning, or retrospectively, during investigations or audits. The constraints of patient care processes and adaptive capacity of health care providers may become most evident during simulations conducted "in situ" using real teams and real equipment, in actual patient care locations.
Topics: Clinical Competence; Humans; Patient Care Team; Patient Safety; Quality Improvement; Simulation Training
PubMed: 30249446
DOI: 10.1016/j.otc.2018.08.005 -
Evidence Report/technology Assessment Mar 2013To review important patient safety practices for evidence of effectiveness, implementation, and adoption. (Review)
Review
OBJECTIVES
To review important patient safety practices for evidence of effectiveness, implementation, and adoption.
DATA SOURCES
Searches of multiple computerized databases, gray literature, and the judgments of a 20-member panel of patient safety stakeholders.
REVIEW METHODS
The judgments of the stakeholders were used to prioritize patient safety practices for review, and to select which practices received in-depth reviews and which received brief reviews. In-depth reviews consisted of a formal literature search, usually of multiple databases, and included gray literature, where applicable. In-depth reviews assessed practices on the following domains: • How important is the problem? • What is the patient safety practice? • Why should this practice work? • What are the beneficial effects of the practice? • What are the harms of the practice? • How has the practice been implemented, and in what contexts? • Are there any data about costs? • Are there data about the effect of context on effectiveness? We assessed individual studies for risk of bias using tools appropriate to specific study designs. We assessed the strength of evidence of effectiveness using a system developed for this project. Brief reviews had focused literature searches for focused questions. All practices were then summarized on the following domains: scope of the problem, strength of evidence for effectiveness, evidence on potential for harmful unintended consequences, estimate of costs, how much is known about implementation and how difficult the practice is to implement. Stakeholder judgment was then used to identify practices that were "strongly encouraged" for adoption, and those practices that were "encouraged" for adoption.
RESULTS
From an initial list of over 100 patient safety practices, the stakeholders identified 41 practices as a priority for this review: 18 in-depth reviews and 23 brief reviews. Of these, 20 practices had their strength of evidence of effectiveness rated as at least "moderate," and 25 practices had at least "moderate" evidence of how to implement them. Ten practices were classified by the stakeholders as having sufficient evidence of effectiveness and implementation and should be "strongly encouraged" for adoption, and an additional 12 practices were classified as those that should be "encouraged" for adoption.
CONCLUSIONS
The evidence supporting the effectiveness of many patient safety practices has improved substantially over the past decade. Evidence about implementation and context has also improved, but continues to lag behind evidence of effectiveness. Twenty-two patient safety practices are sufficiently well understood, and health care providers can consider adopting them now.
Topics: Delivery of Health Care; Health Personnel; Humans; Patient Safety
PubMed: 24423049
DOI: No ID Found -
Journal of Healthcare Quality Research 2019
Topics: Humans; Patient Safety; Respect
PubMed: 30935818
DOI: 10.1016/j.jhqr.2019.01.006 -
Bulletin of the World Health... Jul 2018Primary care lags behind secondary care in the reporting of, and learning from, incidents that put patient safety at risk. In primary care, there is no universally...
Primary care lags behind secondary care in the reporting of, and learning from, incidents that put patient safety at risk. In primary care, there is no universally agreed approach to classifying the severity of harm arising from such patient-safety incidents. This lack of an agreed approach limits learning that could lead to the prevention of injury to patients. In a review of research on patient safety in primary care, we identified 21 existing approaches to the classification of harm severity. Using the World Health Organization's (WHO's) International Classification for Patient Safety as a reference, we undertook a framework analysis of these approaches. We then developed a new system for the classification of harm severity. To assess and classify harm, most existing approaches use measures of symptom duration (11/21), symptom severity (11/21) and/or the level of intervention required to manage the harm (14/21). However, few of these approaches account for the deleterious effects of hospitalization or the psychological stress that may be experienced by patients and/or their relatives. The new classification system we developed builds on WHO's International Classification for Patient Safety and takes account not only of hospitalization and psychological stress but also of so-called near misses and uncertain outcomes. The constructs we have outlined have the potential to be applied internationally, across primary-care settings, to improve both the detection and prevention of incidents that cause the most severe harm to patients.
Topics: Hospitalization; Humans; Medical Errors; Patient Safety; Primary Health Care; Quality of Health Care; World Health Organization
PubMed: 29962552
DOI: 10.2471/BLT.17.199802