Methodological guidance for rapid reviews in healthcare: a scoping review

OBJECTIVE

The aim of the present work was to identify published methodological guidance for rapid reviews (RRs) and to analyze the recommendations with regard to time-saving measures.

STUDY DESIGN AND SETTING

A literature search was performed in PubMed and EMBASE in November 2020. In addition, a search based on Google Scholar and websites of governmental and non-governmental organizations was conducted. Literature screening was carried out by two researchers independently.

RESULTS

A total of 34 publications were included. These describe 38 distinct RR types. The timeframe to complete the identified RR types ranges from 24 hours to six months (mean time 2.2 months). For most RR types a specific research question (n=21) and a prioritizing search (n=25; preference for e.g. systematic reviews, meta-analyses) is employed. Different approaches such as reduced personnel in literature screening (n=21) and data extraction (n=21) are recommended. The majority of RR types include a bias assessment (n=28) and suggest a narrative report focusing on safety and efficacy.

CONCLUSION

The included RR types are heterogeneous in terms of completion time, considered domains and strategies to alter the standard systematic review methods. A rationale for the recommended shortcuts is rarely presented. This article is protected by copyright. All rights reserved.

A Decade of Preventing Harm

Medical errors are a significant source of morbidity and mortality, and while focused efforts to prevent harm have been made, sustaining reductions across multiple categories of patient harm remains a challenge. In 2008 BJC HealthCare initiated a systemwide program to eliminate all major causes of preventable harm and mortality over a five-year period with a goal of sustaining these reductions over the subsequent five years.

METHODS

Areas of focus included pressure ulcers, adverse drug events, falls with injury, health care-associated infections, and venous thromboembolism. Initial efforts involved building system-level multidisciplinary teams, utilizing standardized project management methods, and establishing standard surveillance methods. Evidence-based interventions were deployed across the system; core standards were established while allowing for flexibility in local implementation. Improvements were tracked using actual numbers of events rather than rates to increase meaning and interpretability by patients and frontline staff.

RESULTS

Over the course of the five-year intervention period, total harm events were reduced by 51.6% (10,371 events in 2009 to 5,018 events in 2012). Continued improvement efforts over the subsequent five years led to additional harm reduction (2,605 events in 2017; a 74.9% reduction since 2009).

CONCLUSION

A combination of project management discipline, rigorous surveillance, and focused interventions, along with system-level support of local hospital improvement efforts, led to dramatic reductions in preventable harm and long-term sustainment of progress.