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Adie K, Fois RA, McLachlan AJ, Chen TF. Medication incident recovery and prevention utilising an Australian community pharmacy incident reporting system: the QUMwatch study. Eur J Clin Pharmacol 2021; 77:1381-1395. [PMID: 33646375 DOI: 10.1007/s00228-020-03075-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 12/22/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE To identify factors in community pharmacy that facilitate error recovery from medication incidents (MIs) and explore medication safety prevention strategies from the pharmacist perspective. METHODS Thirty community pharmacies in Sydney, Australia, participated in a 30-month prospective incident reporting program of MIs classified in the Advanced Incident Management System (AIMS) and the analysis triangulated with case studies. The main outcome measures were the relative frequencies and patterns in MI detection, minimisation, restorative actions and prevention recommendations of community pharmacists. RESULTS Participants reported 1013 incidents with 831 recovered near misses and 165 purported patient harm. MIs were mainly initiated at the prescribing (68.2%) and dispensing (22.6%) stages, and most were resolved at the pharmacy (76.9%). Detection was efficient within the first 24 h in 54.6% of MIs, but 26.1% required one month or longer; 37.2% occurred after the patient consumed the medicine. The combination of specific actions/attributes (85.5%), appropriate interventions (81.6%) and effective communication (77.7%) minimised MIs. An array of remedial actions were conducted by participants including notification, referral, advice, modification of medication regimen, risk management and documentation corrections. Recommended prevention strategies involved espousal of medication safety culture (97.8%), better application of policies/procedures (84.6%) and improvements in healthcare providers' education (79.9%). CONCLUSION Incident reporting provided insights on the human and organisational factors involved in the recovery of MIs in community pharmacy. Optimising existing safeguards and redesigning certain structures and processes may enhance the resilience of the medication use system in primary care.
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Affiliation(s)
- Khaled Adie
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
| | - Romano A Fois
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Andrew J McLachlan
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Timothy F Chen
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Duhn L, Godfrey C, Medves J. Scoping review of patients' attitudes about their role and behaviours to ensure safe care at the direct care level. Health Expect 2020; 23:979-991. [PMID: 32755019 PMCID: PMC7696111 DOI: 10.1111/hex.13117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 06/10/2020] [Accepted: 07/14/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND To improve harm prevention, patient engagement in safety at the direct care level is advocated. For patient safety to most effectively include patients, it is critical to reflect on existing evidence, to better position future research with implications for education and practice. METHODS As part of a multi-phase study, which included a qualitative descriptive study (Duhn & Medves, 2018), a scoping review about patient engagement in safety was conducted. The objective was to review papers about patients' attitudes and behaviours concerning their involvement in ensuring their safe care. The databases searched included MEDLINE, CINAHL and EMBASE (year ending 2019). RESULTS This review included 35 papers about "Patient Attitudes" and 125 papers about "Patient Behaviours"-indicative of growing global interest in this field. Several patterns emerged from the review, including that most investigators have focused on a particular dimension of harm prevention, such as asking about provider handwashing, and there is less known about patients' opinions about their role in safety generally and how to actualize it in a way that is right for them. While patients may indicate favourable attitudes toward safety involvement generally, intention to act or actual behaviours may be quite different. CONCLUSION This review, given its multi-focus across the continuum of care, is the first of its kind based on existing literature. It provides an important international "mapping" of the initiatives that are underway to engage patients in different elements of safety and their viewpoints, and identifies the gaps that remain.
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Affiliation(s)
- Lenora Duhn
- School of NursingQueen’s UniversityKingstonONCanada
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Rubbio I, Bruccoleri M, Pietrosi A, Ragonese B. Digital health technology enhances resilient behaviour: evidence from the ward. INTERNATIONAL JOURNAL OF OPERATIONS & PRODUCTION MANAGEMENT 2019. [DOI: 10.1108/ijopm-02-2018-0057] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeIn the healthcare management domain, there is a lack of knowledge concerning the role of resilience practices in improving patient safety. The purpose of this paper is to understand the capabilities that enable healthcare resilience and how digital technologies can support these capabilities.Design/methodology/approachWithin- and cross-case research methodology was used to study resilience mechanisms and capabilities in healthcare and to understand how digital health technologies impact healthcare resilience. The authors analyze data from two Italian hospitals through the lens of the operational failure literature and anchor the findings to the theory of dynamic capabilities.FindingsFive different dynamic capabilities emerged as crucial for managing operational failure. Furthermore, in relation to these capabilities, medical, organizational and patient-related knowledge surfaced as major enablers. Finally, the findings allowed the authors to better explain the role of knowledge in healthcare resilience and how digital technologies boost this role.Practical implicationsWhen trying to promote a culture of patient safety, the research suggests healthcare managers should focus on promoting and enhancing resilience capabilities. Furthermore, when evaluating the role of digital technologies, healthcare managers should consider their importance in enabling these dynamic capabilities.Originality/valueAlthough operations management (OM) research points to resilience as a crucial behavior in the supply chain, this is the first research that investigates the concept of resilience in healthcare systems from an OM perspective, with only a few authors having studied similar concepts, such as “workaround” practices.
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Duhn L, Medves J. A 5-facet framework to describe patient engagement in patient safety. Health Expect 2018; 21:1122-1133. [PMID: 30160006 PMCID: PMC6250877 DOI: 10.1111/hex.12815] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 06/21/2018] [Indexed: 11/30/2022] Open
Abstract
Background Health care remains unacceptably error prone. Recently, efforts to address this problem have included the patient and their family as partners with providers in harm prevention. Policymakers and clinicians have created patient safety strategies to encourage patient engagement, yet they have typically not included patient perspectives in their development or been comprehensively evaluated. We do not have a good understanding of “if” and “how” patients want involvement in patient safety during clinical interactions. Objective The objective of this study was to gain insight into patients’ perspectives about their knowledge, comfort level and behaviours in promoting their safety while receiving health care in hospital. Methods The study design was a descriptive, exploratory qualitative approach to inductively examine how adult patients in a community hospital describe health‐care safety and see their role in preventing error. Results The findings, which included participation of 30 patients and four family members, indicate that although there are shared themes that influence a patient's engagement in safety, beliefs about involvement and actions taken are varied. Five conceptual themes emerged from their narratives: Personal Capacity, Experiential Knowledge, Personal Character, Relationships and Meaning of Safety. Discussion These results will be used to develop and test a pragmatic, accessible tool to enable providers a way to collaborate with patients for determining their personal level and type of safety involvement. Conclusion The most ethical and responsible approach to health‐care safety is to consider every potential way for improvement. This study provides fundamental insights into the complexity of patient engagement in safety.
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Affiliation(s)
- Lenora Duhn
- School of Nursing, Queen's University, Kingston, Ontario, Canada
| | - Jennifer Medves
- School of Nursing, Queen's University, Kingston, Ontario, Canada
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Howell AM, Burns EM, Hull L, Mayer E, Sevdalis N, Darzi A. International recommendations for national patient safety incident reporting systems: an expert Delphi consensus-building process. BMJ Qual Saf 2016; 26:150-163. [PMID: 26902254 DOI: 10.1136/bmjqs-2015-004456] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 01/10/2016] [Accepted: 01/24/2016] [Indexed: 11/03/2022]
Abstract
BACKGROUND Patient safety incident reporting systems (PSRS) have been established for over a decade, but uncertainty remains regarding the role that they can and ought to play in quantifying healthcare-related harm and improving care. OBJECTIVE To establish international, expert consensus on the purpose of PSRS regarding monitoring and learning from incidents and developing recommendations for their future role. METHODS After a scoping review of the literature, semi-structured interviews with experts in PSRS were conducted. Based on these findings, a survey-based questionnaire was developed and subsequently completed by a larger expert panel. Using a Delphi approach, consensus was reached regarding the ideal role of PSRSs. Recommendations for best practice were devised. RESULTS Forty recommendations emerged from the Delphi procedure on the role and use of PSRS. Experts agreed reporting system should not be used as an epidemiological tool to monitor the rate of harm over time or to appraise the relative safety of hospitals. They agreed reporting is a valuable mechanism for identifying organisational safety needs. The benefit of a national system was clear with respect to medication error, device failures, hospital-acquired infections and never events as these problems often require solutions at a national level. Experts recommended training for senior healthcare professionals in incident investigation. Consensus recommendation was for hospitals to take responsibility for creating safety solutions locally that could be shared nationally. CONCLUSIONS We obtained reasonable consensus among experts on aims and specifications of PSRS. This information can be used to reflect on existing and future PSRS, and their role within the wider patient safety landscape. The role of PSRS as instruments for learning needs to be elaborated and developed further internationally.
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Affiliation(s)
- Ann-Marie Howell
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Elaine M Burns
- Department of Biosurgery and Surgical Technology, Imperial College London, London, UK
| | - Louise Hull
- Division of Surgery, Imperial College London, London, UK
| | - Erik Mayer
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Nick Sevdalis
- Department of Surgery and Cancer, Imperial College London, London, UK.,Health Service and Population Research, Centre for Implementation Science, King's College, London, UK
| | - Ara Darzi
- Department of Surgery and Cancer, Imperial College London, London, UK
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Marchon SG, Mendes WV. Patient safety in primary health care: a systematic review. CAD SAUDE PUBLICA 2015; 30:1815-35. [PMID: 25317512 DOI: 10.1590/0102-311x00114113] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 07/10/2014] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to identify methodologies to evaluate incidents in primary health care, types of incidents, contributing factors, and solutions to make primary care safer. A systematic literature review was performed in the following databases: PubMed, Scopus, LILACS, SciELO, and Capes, from 2007 to 2012, in Portuguese, English, and Spanish. Thirty-three articles were selected: 26% on retrospective studies, 44% on prospective studies, including focus groups, questionnaires, and interviews, and 30% on cross-sectional studies. The most frequently used method was incident analysis from incident reporting systems (45%). The most frequent types of incidents in primary care were related to medication and diagnosis. The most relevant contributing factors were communication failures among member of the healthcare team. Research methods on patient safety in primary care are adequate and replicable, and they will likely be used more widely, thereby providing better knowledge on safety in this setting.
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Rhodes P, Campbell S, Sanders C. Trust, temporality and systems: how do patients understand patient safety in primary care? A qualitative study. Health Expect 2015; 19:253-63. [PMID: 25644998 PMCID: PMC5024004 DOI: 10.1111/hex.12342] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2014] [Indexed: 11/29/2022] Open
Abstract
Introduction Patient safety research has tended to focus on hospital settings, although most clinical encounters occur in primary care, and to emphasize practitioner errors, rather than patients' own understandings of safety. Objective To explore patients' understandings of safety in primary care. Methods Qualitative interviews were conducted with patients recruited from general practices in northwest England. Participants were asked basic socio‐demographic information; thereafter, topics were largely introduced by interviewees themselves. Transcripts were coded and analysed using NVivo10 (qualitative data software), following a process of constant comparison. Results Thirty‐eight people (14 men, 24 women) from 19 general practices in rural, small town and city locations were interviewed. Many of their concerns (about access, length of consultation, relationship continuity) have been discussed in terms of quality, but, in the interviews, were raised as matters of safety. Three broad themes were identified: (i) trust and psycho‐social aspects of professional–patient relationships; (ii) choice, continuity, access, and the temporal underpinnings of safety; and (iii) organizational and systems‐level tensions constraining safety. Discussion Conceptualizations of safety included common reliance on a bureaucratic framework of accreditation, accountability, procedural rules and regulation, but were also individual and context‐dependent. For patients, safety is not just a property of systems, but personal and contingent and is realized in the interaction between doctor and patient. However, it is the systems approach that has dominated safety thinking, and patients' individualistic and relational conceptualizations are poorly accommodated within current service organization.
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Affiliation(s)
- Penny Rhodes
- NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, Institute of Population Health, University of Manchester, Manchester, UK
| | - Stephen Campbell
- NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, Institute of Population Health, University of Manchester, Manchester, UK
| | - Caroline Sanders
- Centre for Primary Care, Institute of Population Health, University of Manchester, Manchester, UK
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Keriel-Gascou M, Brami J, Chanelière M, Haeringer-Cholet A, Larrieu C, Villebrun F, Robert T, Michel P. [Which definition and taxonomy of incident to use for a French reporting system in primary care settings?]. Rev Epidemiol Sante Publique 2014; 62:41-52. [PMID: 24439084 DOI: 10.1016/j.respe.2013.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Revised: 09/17/2013] [Accepted: 10/28/2013] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND There is no widely accepted definition of incident for primary care doctors in France and no taxonomic classification system for epidemiological use. In preparation for a future epidemiological study on primary care incidents in France (the ESPRIT study), this work was designed to identify the definitions and taxonomic classifications used internationally along with the usual methods and results in terms of frequency in the literature. The goal was to determine a French definition and taxonomy. DESIGN Systematic review of the literature and consensus methods. METHOD An exhaustive search of epidemiological surveys was performed. A structured grid was used. After having identified the definitions used in the literature, a definition was chosen using the focus groups method. Taxonomies identified in the literature were classified by relationship, architecture, code number, and number of studies published. Subsequently, a consensus among experts, who independently tested these taxonomies on six incidents, was reached for choosing the most appropriate for epidemiological data collection (little information on a large number of cases). RESULTS Twenty-four papers reporting 17 studies were selected among 139 articles. Five definitions and eight taxonomies were found. The chosen definition of incident was based on the WHO definition "A patient safety incident is an event or circumstance that could have resulted, or did result, in harm to a patient, and whose wish it is not repeated again". The test of incidents resulted in the choice of the TAPS version of the International Taxonomy of Medical Error in Primary Care for a reproducible and internationally recognized codification and the tempos method for its current use in French general practice. DISCUSSION The definitions, taxonomies, data collection characteristics and frequency of incidents results in the international literature on incidents in primary care are key components for the preparation of an epidemiological survey on incidents in primary care.
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Affiliation(s)
- M Keriel-Gascou
- Département de médecine générale, EA 4128 santé, individu, société, université Lyon I, 8, avenue Rockefeller, 69373 Lyon, France.
| | - J Brami
- Faculté de médecine Paris-Descartes, Haute Autorité de santé, 75005 Paris, France.
| | - M Chanelière
- Département de médecine générale, EA 4128 santé, individu, société, université Lyon I, 8, avenue Rockefeller, 69373 Lyon, France.
| | - A Haeringer-Cholet
- RéQua réseau qualité en Franche-Comté, 26, rue Proudhon, 25000 Besançon, France.
| | - C Larrieu
- Faculté de médecine Paris-Descartes, 75005 Paris, France.
| | - F Villebrun
- Département de médecine générale, université Paris Est Créteil, 94000 Créteil, France; Centres municipaux de santé, 93000 Saint-Denis, France.
| | - T Robert
- Comité de coordination de l'évaluation clinique et de la qualité en Aquitaine (CCECQA), 33604 Pessac, France.
| | - P Michel
- Comité de coordination de l'évaluation clinique et de la qualité en Aquitaine (CCECQA), 33604 Pessac, France.
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Abstract
Background Fishbone diagrams have been widely promoted as a systems-focused hazard analysis tool for use in root cause analysis, but they suffer from a number of structural weaknesses, including a unidirectional structure that only takes into account forces that promote an accident (ignoring those that make the accident less likely or less severe) and a means of displaying these forces that does not convey any difference in strength of influence. In a separate but related issue, many healthcare organizations suffer from a lack of change management expertise. Proposed solution To address these concerns, I present a novel technique, the Lovebug diagram, which draws from both Fishbone diagrams and force-field analysis (an approach to analyzing planned change). This new technique adds value to both its progenitor methods, while retaining their key strengths and ease of use. It can be used both prospectively, to assess planned changes, and retrospectively to assess unplanned (accidental) departures from the status quo. Discussion The Lovebug diagram is a more powerful analytical tool than its progenitor methods; however, overall adoption of systems-focused tools for root cause analysis remains suboptimal. Additional research is needed to determine how best to promote a truly systems-focused approach to healthcare root cause analysis. Beyond this retrospective use of the technique, it represents a simple tool to assist healthcare organizations with prospective change management.
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Affiliation(s)
- Alan J Card
- Evidence-Based Health Solutions, LLC, Notre Dame, USA
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Dunn AG, Ong MS, Westbrook JI, Magrabi F, Coiera E, Wobcke W. A simulation framework for mapping risks in clinical processes: the case of in-patient transfers. J Am Med Inform Assoc 2011; 18:259-66. [PMID: 21486883 PMCID: PMC3078660 DOI: 10.1136/amiajnl-2010-000075] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2010] [Accepted: 02/24/2011] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To model how individual violations in routine clinical processes cumulatively contribute to the risk of adverse events in hospital using an agent-based simulation framework. DESIGN An agent-based simulation was designed to model the cascade of common violations that contribute to the risk of adverse events in routine clinical processes. Clinicians and the information systems that support them were represented as a group of interacting agents using data from direct observations. The model was calibrated using data from 101 patient transfers observed in a hospital and results were validated for one of two scenarios (a misidentification scenario and an infection control scenario). Repeated simulations using the calibrated model were undertaken to create a distribution of possible process outcomes. The likelihood of end-of-chain risk is the main outcome measure, reported for each of the two scenarios. RESULTS The simulations demonstrate end-of-chain risks of 8% and 24% for the misidentification and infection control scenarios, respectively. Over 95% of the simulations in both scenarios are unique, indicating that the in-patient transfer process diverges from prescribed work practices in a variety of ways. CONCLUSIONS The simulation allowed us to model the risk of adverse events in a clinical process, by generating the variety of possible work subject to violations, a novel prospective risk analysis method. The in-patient transfer process has a high proportion of unique trajectories, implying that risk mitigation may benefit from focusing on reducing complexity rather than augmenting the process with further rule-based protocols.
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Affiliation(s)
- Adam G Dunn
- Centre for Health Informatics, Australian Institute of Health Innovation, University of New South Wales, Sydney, Australia.
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Defining near misses: Towards a sharpened definition based on empirical data about error handling processes. Soc Sci Med 2010; 70:1301-8. [DOI: 10.1016/j.socscimed.2010.01.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2008] [Revised: 12/17/2009] [Accepted: 01/11/2010] [Indexed: 11/17/2022]
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Abstract
Work in patient safety has focused on acute care, yet ambulatory patient safety, particularly for those with chronic diseases, demands more attention. A framework, provided in the context of the Chronic Care Model, outlines the multifaceted approach needed for ambulatory care.
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Schwappach DLB. Review: engaging patients as vigilant partners in safety: a systematic review. Med Care Res Rev 2009; 67:119-48. [PMID: 19671916 DOI: 10.1177/1077558709342254] [Citation(s) in RCA: 205] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Several initiatives promote patient involvement in error prevention, but little is known about its feasibility and effectiveness. A systematic review was conducted on the evidence of patients' attitudes toward engagement in error prevention and the effectiveness of efforts to increase patient participation. Database searches yielded 3,840 candidate articles, of which 21 studies fulfilled the inclusion criteria. Patients share a positive attitude about engaging in their safety at a general level, but their intentions and actual behaviors vary considerably. Studies applied theories of planned behavior and indicate that self-efficacy, preventability of incidents, and effectiveness of actions seem to be central to patients' intention to engage in error prevention. Rigorous evaluations of major educational campaigns are lacking. Interventions embedded within clinical settings have been effective to some extent. Evidence suggests that involvement in safety may be successful if interventions promote complex behavioral change and are sensitively implemented in health care settings.
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Elder NC, McEwen TR, Flach JM, Gallimore JJ. Management of test results in family medicine offices. Ann Fam Med 2009; 7:343-51. [PMID: 19597172 PMCID: PMC2713153 DOI: 10.1370/afm.961] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2008] [Revised: 10/08/2008] [Accepted: 10/13/2008] [Indexed: 11/09/2022] Open
Abstract
PURPOSE We wanted to explore test results management systems in family medicine offices and to delineate the components of quality in results management. METHODS Using a multimethod protocol, we intensively studied 4 purposefully chosen family medicine offices using observations, interviews, and surveys. Data analysis consisted of iterative qualitative analysis, descriptive frequencies, and individual case studies, followed by a comparative case analysis. We assessed the quality of results management at each practice by both the presence of and adherence to systemwide practices for each results management step, as well as outcomes from chart reviews, patient surveys, and interview and observation notes. RESULTS We found variability between offices in how they performed the tasks for each of the specific steps of results management. No office consistently had or adhered to office-wide results management practices, and only 2 offices had written protocols or procedures for any results management steps. Whereas most patients surveyed acknowledged receiving their test results (87% to 100%), a far smaller proportion of patient charts documented patient notification (58% to 85%), clinician response to the result (47% to 84%), and follow-up for abnormal results (28% to 55%). We found 2 themes that emerged as factors of importance in assessing test results management quality: safety awareness-a leadership focus and communication that occurs around quality and safety, teamwork in the office, and the presence of appropriate policies and procedures; and technological adoption-the presence of an electronic health record, digital connections between the office and testing facilities, use of technology to facilitate patient communication, and the presence of forcing functions (built-in safeguards and requirements). CONCLUSION Understanding the components of safety awareness and technological adoption can assist family medicine offices in evaluating their own results management processes and help them design systems that can lead to higher quality care.
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Affiliation(s)
- Nancy C Elder
- Department of Family Medicine, University of Cincinnati, Cincinnati, Ohio, USA.
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Elder NC, Hickner J, Graham D. Quality and safety in outpatient laboratory testing. Clin Lab Med 2008; 28:295-303, vii. [PMID: 18436072 DOI: 10.1016/j.cll.2007.12.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Interactions between the laboratory and outpatient physician are critical to ensure the appropriateness, accuracy, and utility of laboratory results. A recent Institute of Medicine report suggested that the consequences of medical errors in the outpatient setting-and the opportunities to improve-"may dwarf those in hospitals." This article focuses on the role of the physician's office in laboratory quality.
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Affiliation(s)
- Nancy C Elder
- Department of Family Medicine, University of Cincinnati, Cincinnati, OH 45267-0582, USA.
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