Quality Patient Safety Research Articles

General Practitioners' Experiences With Potentials and Pitfalls of Video Consultations in Norway During the COVID-19 Lockdown: Qualitative Analysis of Free-Text Survey Answers.

The use of video consultations (VCs) in Norwegian general practice rapidly increased during the COVID-19 pandemic. During societal lockdowns, VCs were used for nearly all types of clinical problems, as in-person consultations were kept to a minimum. This study aimed to explore general practitioners' (GPs') experiences of potentials and pitfalls associated with the use of VCs during the first pandemic lockdown. Between April 14 and May 3, 2020, all regular Norwegian GPs (N=4858) were invited to answer a web-based survey, which included open-ended questions about their experiences with the advantages and pitfalls of VCs. A total of 2558 free-text answers were provided by 657 of the 1237 GPs who participated in the survey. The material was subjected to reflexive thematic analysis. Four main themes were identified. First, VCs are described as being particularly convenient, informative, and effective for consultations with previously known patients. Second, strategically planned VCs may facilitate effective tailoring of clinical trajectories that optimize clinical workflow. VCs allow for an initial overview of the problem (triage), follow-up evaluation after an in-person consultation, provision of advice and information concerning test results and discharge notes, extension of sick leaves, and delivery of other medical certificates. VCs may, in certain situations, enhance the GPs' insight in their patients' relational and socioeconomical resources and vulnerabilities, and even facilitate relationship-building with patients in need of care who might otherwise be reluctant to seek help. Third, VCs are characterized by a demarcated communication style and the "one problem approach," which may entail effectiveness in the short run. However, the web-based communication climate implies degradation of valuable nonverbal signals that are more evidently present in in-person consultations. Finally, overreliance on VCs may, in a longer perspective, undermine the establishment and maintenance of relational trust, with a negative impact on the quality of care and patient safety. Compensatory mechanisms include clarifying with the patient what the next step is, answering any questions and giving further advice on treatment if conditions do not improve or there is a need for follow-up. Participation of family members can also be helpful to improve reciprocal understanding and safety. The findings have relevance for future implementation of VCs and deserve further exploration under less stressful circumstances.

Effectiveness of ASWAJA An Nahdliyah-based caring training on caring behavior, performance in patient safety and service quality

Objective: To analyze the effectiveness of ASWAJA An Nahdliyah-based caring training on caring behavior, performance in patient safety goals, and service quality. Methods: Quasi-experimental research design. The population was nurses and patients in the internal medicine and surgery rooms at the Surabaya Islamic Hospital A. Yani and Jemursari. Samples were taken from all practicing nurses working in the Az Zahrah 1 room at the Jemursari Islamic Hospital as the intervention group (n=19) and nurses working in the Shofa and Marwa rooms at the Surabaya Islamic Hospital A. Yani Islamic Hospital (n=19) were taken as the control group. The sample size for each group of patients was 38 people. Sampling was purposive sampling. The research instrument used a questionnaire.

Pozasądowe prawne modele kompensacji szkód medycznych – analiza prawno-porównawcza

The article addresses the topic of alternative legal models for pursuing out-of-court claims for medical damages, taking as its starting thesis the inefficiency of the Polish model stemming from its faulty legal construction. The purpose of the article is to conduct a legal analysis of the Polish alternative model of medical damage compensation, with particular attention to de lege ferenda postulates presented in the legal doctrine. In addition, in order to show the possible directions of legislative changes, the article presents the characteristics of selected foreign alternative models of medical damage compensation, including the model operating in New Zealand, which is an example of a model that can be classified as ‘no-fault’, the German model and the French model. The article culminates with an analysis of the draft of the Law on Quality in Health Care and Patient Safety to the extent that the draft provides for a new legal regulation of the alternative model for the out-of-court settlement of medical damage claims. The purpose of this analysis was to see whether the legislator has recognized the demands for change articulated in the legal doctrine, and whether the draft law on quality in health care and patient safety is inspired by solutions adopted in foreign legislation in terms of the legal construction of the alternative model of compensation for medical damages. The analysis here confirms the initial thesis of the work and leads to the conclusion that the draft law on quality in health care and patient safety takes into account many proposals constructed in the legal doctrine in connection with regulating an alternative model for the compensation of medical damages. It is also clear that the proposed model is inspired by some solutions that have been successful in other countries. Nevertheless, the article distinguishes proposed regulations that may still raise doubts and reservations.

A Unique Model of Performance-Based Premium Pay System in the Radiology Departments

Pay-for-performance (P4P) programs offer financial incentives to healthcare providers to improve the quality of care and patient safety. Various modifications of P4P approaches have been thrust into almost all medical specialities, including radiology, despite being a referral speciality. This article introduces a performance-based premium pay system for radiology personnel implemented in the radiology departments of a private health group in Turkey. The main purpose of the system is to enable the radiology personnel (i.e. technicians, rapporteurs and supporting staff) to earn more in parallel with the increase in their workload, to eliminate the imbalance between wages, to increase the institutional loyalty and commitment of radiology personnel, to ensure ownership of their tasks and equipment, to build up a team awareness, to encourage further training and specialization, and consequently, to improve the overall quality of radiology services.

A Novel Quality Improvement and Patient Safety Curriculum for Emergency Medicine Residents

Quality improvement training during residency is a crucial component of post-graduate medical education and is one of the Association of American Medical Colleges Cross-Continuum Competencies and the six Accreditation Council for Graduate Medical Education domains of clinical competency. No national standard curriculum exists when it comes to training emergency medicine residents. A novel residency-focused QI curriculum was implemented to help emergency medicine residents develop foundational skills in QI and to translate these skills into practical projects that span multiple disciplines. The curriculum was effective, is readily adaptable to the resident physician and medical student levels, and supports the national trend toward implementing education in QI earlier in physician training.

State of affairs and future challenges in laboratory medicine in Spain: an analysis of the Spanish Society of Laboratory Medicine (SEQCML).

Laboratory Medicine is a crucial discipline that contributes to the diagnosis, management and monitoring of patients. This branch of medicine faces two major challenges: New technologies and increased demand. Thereis limited information available of the state of affairs in Laboratory Medicine in Spain. This study provides a picture of clinical laboratories and clinical laboratory professionals. The Spanish Society of Laboratory Medicine distributed a questionnaire among the 250 most representative centers (the ones with the largest volume of determinations and training programs), of which 174 (69.6%) returned the questionnaire providing data for 2019. Laboratories were classified according to the number of determinations. In total, 37% identified themselves as small (<1 million determinations per year); 40%considered themselves medium-sized (1-5 million determinations per year) and 23% considered they were large laboratories (>5 million determinations). The level of specialization of laboratory physicians and laboratory performance were higher in large laboratories. Most requests (87%) and determinations (93%) corresponded to biochemistry and hematology. As many as 63% of physicians had an indefinite contract, and 23% were older than 60years. Laboratory medicine is a consolidated discipline that is gaining relevance in Spain. It adds value to the diagnosis, prognosis and follow-up of diseases, and to treatment response monitoring. The results of this study will help us address challenges such as the need for specialized training for laboratory professionals; the emergence of technological innovations; exploitation of Big Data; optimization of quality management systems and patient safety.

Cerrahi Kliniklerde Çalışan Hemşirelerin Sağlık Kalitesi Algıları ile Hasta Güvenliği Kültürleri Arasındaki İlişki

Objective: The study was carried out to determine the effect of health quality perceptions of nurses working in surgical clinics on patient safety culture. Materials and Methods: The research is descriptive type and correlational. The sample of the research consisted of 237 nurses. Personal Information Form created by the researchers, Patient Safety Culture Scale (PSCS), and Quality Perception Scale (QPS) were used as data collection tools in the study. Data were collected between January 2021 and February 2022. Results: The total mean score obtained from PSCS was found to be 3.36±0.21 in the study. In the study, it was found that the total mean score obtained from the QPS was 82.15±6.80. A positive, moderate correlation was found between the total score of PSCS and the total score of QPS (r= 0.407, p&amp;lt;0.01). Conclusions: It was determined that the increase in the quality perceptions of the nurses working in the surgical clinics increased the patient safety culture. It was observed that nurses who care for surgical patients attach importance to patient safety culture, especially in terms of patient benefit. It is recommended to organize in-service training programs to increase both quality perceptions and patient safety culture of healthcare professionals.

Outcomes in quality improvement and patient safety training: moving from in-person to synchronous distance education

BackgroundThe COVID-19 pandemic necessitated increased synchronous distance education (SDE) in graduate medical education, presenting challenges for Quality Improvement and Patient Safety (QIPS) best practices, which call for integration with daily...

Creating healthy workplaces in healthcare: Are we delaying progress by focusing on what we can do rather than what we should do?

All the available evidence points to the fact that healthcare is under considerable stress, and while change is urgently needed there is no quick fix; systemic and sustained changes in organizational cultures within healthcare are required. Moreover, the fragility of healthcare systems globally has been starkly exposed by the Coronavirus 2019 pandemic. We have gathered enough evidence to know what is driving poor wellbeing, and how these processes impact on quality of care and patient safety. Indeed, we have a good idea of what we need to do to improve the situation. Therefore, this begs a simpler question; If we know how to create healthy workplaces, why is it so difficult to achieve this in healthcare? In the following perspective paper, we will argue that we can do better if we address the following three issues: (1) we are ignoring the real problems, (2) limited successes that we are achieving are moving us further from tackling the real problems, (3) culture change is accepted as crucial, but we are not accepting what the evidence is telling us about healthcare culture. Tackling burnout is useful and necessary, but we must increase dignity among healthcare employees. Moreover, we need to train line managers to recognize and facilitate the need of employees to feel competent and be appreciated by others, while helping them set wellbeing boundaries.

The Effect of Empowerment And Self-Efficacy On Employees’ Perceptions Of Quality Of Care

Background: Empowerment in work palace denotes to better decision making power which enable the worker to have greater control of their jobs. In conventional organizational structures, functioning of the organization revolve around the designing of the set rules and methods. It was though that if organization makes employees obligatory to follow such structures the effectiveness and efficiency may improve. However, later, researchers found out that by fitting employees to the specific job structures, organizations lose their potential as well as performance because employees creativity and innovation got restricted. Therefore, conventional practices may not be suitable for operating in complex and dynamic healthcare environment. To achieve organizational goals with more efficiently, employee empowerment to some extent is in need because independence that comes with empowerment encourages employees to voice their opinions that benefit healthcare organizations in uplifting the patient safety and quality of care they offer. Therefore, study intends to assess the state of employees’ empowerment in public hospitals located in Al Qassim region, Saudi Arabia. Moreover, the study intends to explore the effect on employee’s empowerment has on employee’s perceptions of quality of care and patient safety. Methods Using a cross-sectional research design, the study collected data from 119 employees working in different public hospitals of Al Qassim region. The online questionnaire consists of 30 questionnaire items, was developed using Google Doc to address the research questions of the study. Results The healthcare employees responded to their demographic characteristics, empowerment, self-efficacy, and quality of care have been improvising in the facility. This finding showed that the respondents are empowered to make decisions and are better at performing their given jobs. Furthermore, the outcome of the study exhibited that employee empowerment is associated with respondents’ perceptions of quality care and patient safety. The results from the study may also help healthcare administrators and policy makers to understand the current level of employee empowerment and self-efficacy. The findings can immensely help healthcare administrators and policymakers to design policies and strategies to improve the quality of care in Saudi health organizations Conclusion The study explores the issue of empowerment in the context of Saudi public healthcare hospitals. It shows that in healthcare workers of Saudi Hospitals located in Al Qassim region believe that they possess certain decision-making authority to perform their jobs. The study also shows that the respondents think that their organizations deliver quality of care and are concerned about patient safety.

Survey of fellowship program directors in minimally invasive gynecologic surgery: fellow participation in quality improvement and patient safety initiatives

Survey of fellowship program directors in minimally invasive gynecologic surgery: fellow participation in quality improvement and patient safety initiatives

Evaluation of National Patient Safety Implementation Framework in Selected Public Healthcare Facilities of Tamil Nadu: An Operational Research.

The Ministry of Health and Family Welfare has introduced the "National Patient Safety Implementation Framework" to ensure the patient safety at different levels of healthcare delivery system. However, there is limited effort made in evaluating the implementation status of this framework. Hence, we have performed the process evaluation of National Patient Safety Implementation Framework across the public healthcare facilities in Tamil Nadu. This was a facility-level survey conducted by research assistants who visited 18 public health facilities across 6 districts of Tamil Nadu, India, for the purpose of documenting the presence of structural support systems and strategies to promote patient safety. We developed a tool for data collection based on the framework. It comprised a total of 100 indicators under the following domains and subdomains: structural support, systems for reporting, workforce, infection prevention and control, biomedical waste management, sterile supplies, blood safety, injection safety, surgical safety, antimicrobial safety, and COVID-19 safety. Only one facility (subdistrict hospital) belonged to the high-performing category with a score of 79.5 on the implementation of patient safety practices. About 11 facilities (4 medical colleges and 7 Government Hospitals) belonging to medium-performing category. The best-performing medical college had a score of 61.5 for patient safety practices. Six facilities (2 medical colleges, 4 Government Hospitals) belonged to low-performing category in terms of patient safety. The least-performing facilities (both subdistrict hospitals) had scores of 29.5 and 26 for patient safety practices, respectively. Because of COVID-19, there was a positive effect on biomedical waste management and infectious disease safety across all facilities. Most performed poor in the domain with structural systems to support quality and efficiency of healthcare and patient safety. The study concludes that based on the current situation of patient safety practices in public health facilities, it will be difficult to perform full-fledged implementation of patient safety framework by the year 2025.

Strategies to Overcome Language Barriers Between Immigrant Patients and Hospital Staff- Health Services in India &amp; USA

Language obstacles impair the satisfaction of medical professionals and patients and the provision of high-quality care and patient safety. Several large healthcare organizations offer translator services to improve patient happiness and communication. Miscommunication in the medical industry has the potential to be lethal. With an increasing number of migrant patients and staff who have received foreign training, communication errors between healthcare practitioners and patients are becoming increasingly common. This article aims to investigate the impact of language barriers on healthcare and to provide solutions. Language difficulties have a negative impact on medical practitioner and patient satisfaction and the overall quality of healthcare and patient safety. However, there has been little systematic research on this subject. A major objective of our research is to investigate language barriers and miscommunication between patients and healthcare practitioners, particularly when one or both speakers are conversant in a second language. By writing this essay, the author hopes to raise public awareness about the magnitude of the difficulty involved in delivering health services to a community with significant ethno linguistic diversity.

Urgent hospital transfers – The experiences and required skills of paramedics

IntroductionGlobal changes in the health and social care sector have centralized the treatment of emergency patients, leading to an increase of urgent hospital transfers. The aim of this study is to describe paramedics’ experiences gained while working in prehospital emergency care, regarding urgent hospital transfers and the skills that performing urgent hospital transfers requires. MethodsTwenty paramedics with experience in urgent hospital transfers participated in this qualitative study. The data collected via individual interviews were analyzed using inductive content analysis. ResultsParamedics’ experiences of urgent hospital transfers resulted in two upper categories: Factors related to paramedics, and factors related to transfer, conditions, and technology. The upper categories were grouped from six subcategories. Paramedics’ experiences of skills required in urgent hospital transfers resulted in two upper categories: Professional competence, and interpersonal skills. The upper categories were grouped from six subcategories. ConclusionsOrganizations should support and promote training related to urgent hospital transfers to enhance the quality of care and patient safety. Paramedics play a key role in successful transfer and collaboration, and thus the required professional competences and interpersonal skills should be addressed in their education. Furthermore, developing standardized procedures is recommended to enhance patient safety.

Persepsi Perawat Terhadap Implementasi Budaya Keselamatan Pasien Di Ruang Rawat Inap Terpadu Rumah Sakit H.Adam Malik Medan

&lt;p&gt;&lt;em&gt;Patient safety is a hospital service system that provides safer patient care. WHO (World Health Organization) publications report patient safety incidents that medical errors occur in 8% to 12% of inpatient rooms at H.Adam Malik Hospital Medan. Patient safety incidents that occur include nosocomial infections, patient falls, and medication errors. Each of these incidents exceeded the established standards. The purpose of this study was to evaluate nurses' perceptions of the implementation of patient safety culture at H.Adam Malik Hospital Medan&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt;The research design used was qualitative research. The characteristics of the key informants are the head of the nursing field, the head of the room, the head of pharmacy, the nursing committee and the head of the Quality Improvement and Patient Safety (PMKP) section, while the main informants are nurses. Qualitative data collection techniques using the Triangulation method. Data analysis using qualitative descriptive with data source triangulation stages&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt;The results showed that patient identification, effective communication, drug safety and risk of infection had gone well, while site marking and the risk of falling patients had not gone well.&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt;The conclusion of this study is that patient identification, effective communication, drug safety and risk of infection have gone well, while site marking and the risk of patients falling have not gone well. It is hoped that this can be an illustration of the application of patient safety to improve the quality of health services through the achievement of hospital achievements so that it can be used as the basis for taking a further policy and increasing the satisfaction of each patient who comes.&lt;/em&gt;&lt;/p&gt;

Evaluating the Impact of ACGME Resident Duty Hour Restrictions on Patient Outcomes for Bilateral Breast Reductions.

Bilateral breast reductions performed in the 3 years before and after each reform were collected from the National Inpatient Sample database: pre-duty hours (2000-2002), duty hours (2006-2008), and extended duty hours (2012-2014). Multivariable logistic regression models were constructed to investigate the association between ACGME duty hour restrictions on medical and surgical complications. Overall, 19,423 bilateral breast reductions were identified. Medical and surgical complication rates in these patients increased with each successive iteration of duty hour restrictions (P < 0.001). The 2003 duty-hour restriction independently associated with increased surgical (OR = 1.51, P < 0.001) and medical complications (OR = 1.85, P < 0.001). The 2011 extended duty-hour restriction was independently associated with increased surgical complications (OR = 1.39, P < 0.001). ACGME duty-hour restrictions do not seem associated with better patient outcomes for bilateral breast reduction although there are multiple factors involved. These considerations and consequences should be considered in decisions that affect resident quality of life, education, and patient safety.

Assessment of Impact of Structured Education Regarding Medication Errors among Selected Nursing Colleges of Kalaburagi

Purpose: Patient safety is a significant challenge facing healthcare systems today. It is the nurse’s role to provide the best possible quality of care and patient safety. They can play an important role in identification, prevention and reporting of MEs. The study was to assess the knowledge of MEs among nursing students, to improve the knowledge of ME among nursing students and to improve the medication error reporting skills of nursing students.&#x0D; Subjects and Methods: It was a Prospective Eduational study conducted among 186 nursing students of 3 different nursing colleges of KALABURAGI city. Data collection form including self-structured questionnaire were used. Pre-test followed by power point presentation on all aspects of ME education was done. After a gap of 2 weeks post test was conducted. Following evaluation, data was tempted into the Microsoft Excel Sheet and analyzed using IBM SPSS 20.0 and paired student’s T – test and ANOVA was applied for interpreting data .&#x0D; Results: Mean age of participants was 20.6 years and 96 of the students were males.100 students were from 3rd year and 86 were from 2nd year BSc nursing. Students had good knowledge and attitude towards ME and its reporting but poor practice.3rd year students had a better knowledge compared to 2nd year. In pretest mean knowledge score was 9.21.There was a statistically very highly significant difference in mean knowledge scores between pre and post-test (P&lt;0.001). A positive change in student’s perception and practice towards ME reporting was observed in posttest.&#x0D; Conclusions: Despite sufficient knowledge and favorable attitude towards medication error reporting there is still an under reporting of medication error when it comes to practice.

Level of Patient Safety Culture Awareness Among Healthcare Workers.

Patient safety is a major concern at all levels of the healthcare system, with the primary objective of reducing patient hazards when providing care. The Kingdom of Saudi Arabia has made great progress in improving the health of its citizens over the last few decades, particularly in terms of patient safety. Currently, many health-care institutions throughout the world are interested in implementing a safety culture to lower the risk of harm and the number of accidents associated with routine treatment. This study aims to assess the level of awareness concerning patient safety culture among health-care providers in hospitals in Riyadh, Saudi Arabia. This is a descriptive cross-sectional quantitative study that used the Agency for Healthcare Research and Quality's patient safety culture questionnaire. The survey was conducted online and was completed by 204 health-care employees from three distinct hospital settings in Riyadh, Saudi Arabia: government, quasi-government, and private hospitals. The results showed a low level of patient safety culture awareness among health-care workers in the 10 dimensions of patient safety. The mean score was 2.24 out of 5 and the standard deviation was 0.50. Participants assigned the highest mean scores to Organisational Learning and Continuous Improvement (Mean: 2.48, Standard deviation: 0.66), Communication About Error (Mean: 2.44, Standard deviation: 0.70), and Teamwork (Mean: 2.40, Standard deviation: 0.64). Interestingly, the scores for hospital supervisor and managerial positions are significant compared to other clinical positions (p-value = 0.047). Moreover, the patient safety rating and the number of reported events were significantly related to the overall level of awareness (p-value <0.001), (p-value = 0.042), respectively. In Riyadh hospitals, overall patient safety awareness is low, necessitating adequate attention and effective solutions such as encouraging reporting errors, implementing safety huddles and leadership walkarounds, and establishing a patient safety culture. Health-care executives and managers are encouraged to develop safety cultures that promote trust and justice, allowing employees to be candid about their mistakes and failings without retaliation. Moreover, this safety culture should be defined by the following qualities: a just culture, a learning culture, and a reporting culture.

National statutory reporting: not even ticking the boxes? The quality of ‘Learning from Deaths’ reporting in quality accounts within the NHS in England 2017–2020

IntroductionRegulation through statutory reporting is used in healthcare internationally to improve accountability, quality of care and patient safety. Since 2017, within the National Health Service (NHS) in England, NHS Secondary...

The perspective of pharmacist on pharmacovigilance and adverse drug reaction reporting in Asir region, Saudi Arabia.

Adverse drug reactions (ADRs) are widespread worldwide, and their intervention is critical to patient safety and healthcare quality. Pharmacists are essential in monitoring and reporting ADRs, directly influencing patient care. This study aimed to examine the prevalence of ADRs among pharmacists and their knowledge regarding ADRs, including the factors affecting ADR reporting. From September 2021 to November 2021, a cross-sectional survey among pharmacists in the Asir area of Saudi Arabia was planned. This study involved contacting 97 pharmacists using a cluster sampling method. The study's goals were met using a 25-item self-administered questionnaire. Data analysis was done using SPSS version 25 (IBM Corp., Armonk, NY, USA). Ninety-seven pharmacists (male 53.6% and female 46.4%) completed the survey. More than three-fourths of the participants (78.4%) know the ADR reporting system. The survey was completed by 97 pharmacists (male 53.6% and female 46.4%). More than three-quarters of the participants (78.4%) were aware of the ADR reporting system, and the majority (70.8%) were aware that it is done using an online system. Still, only 56.7% knew that the Saudi FDA is the regulatory agency collecting ADR data in Saudi Arabia. Furthermore, 73.2% cited stress in the workplace as a critical deterrent to reporting. Most respondents (76.3%) had an unfavorable attitude about reporting ADRs. Pharmacists understand ADR reporting, but most lack the mentality to report the incidents. As a result, comprehensive and ongoing training for pharmacists is required to raise awareness of the need for ADR reporting.