Training fellows and residents in paediatric cardiac critical care

2016 ◽  
Vol 26 (8) ◽  
pp. 1531-1536 ◽  
Author(s):  
Sarah Tabbutt ◽  
Nancy Ghanayem ◽  
Melvin C. Almodovar ◽  
John Charpie ◽  
Stephen J. Roth ◽  
...  
Keyword(s):  
Critical Care ◽  
Patient Safety ◽  
Cardiac Disease ◽  
Pediatric Patients ◽  
Multidisciplinary Care ◽  
Improve Quality ◽  
Training Curriculum ◽  
Specific Patient ◽  
Cardiac Critical Care

AbstractAs pediatric cardiac critical care becomes more sub-specialized it is reasonable to assume that dedicated units may provide a better infrastructure for improved multidisciplinary care, cardiac-specific patient safety initiatives, and dedicated training of fellows and residents. The knowledge base required to optimally manage pediatric patients with critical cardiac disease has evolved sufficiently to consider a standardized training curriculum and board certification for pediatric cardiac critical care. This strategy would potentially provide consistency of training and healthcare and improve quality of care and patient safety.

Nursing Turbulence in Critical Care: Relationships With Nursing Workload and Patient Safety

2020 ◽  
Vol 29 (3) ◽  
pp. 182-191
Author(s):  
Jennifer Browne ◽  
Carrie Jo Braden
Keyword(s):  
Critical Care ◽  
Patient Safety ◽  
Quality Of Care ◽  
Full Range ◽  
Operational Definition ◽  
Nursing Workload ◽  
Turbulence Scale ◽  
Safety Risk ◽  
Care Relationships

Background Increased nursing workload can be associated with decreased patient safety and quality of care. The associations between nursing workload, quality of care, and patient safety are not well understood. Objectives The concept of workload and its associated measures do not capture all nursing work activities, and tools used to assess healthy work environments do not identify these activities. The variable turbulence was created to capture nursing activities not represented by workload. The purpose of this research was to specify a definition and preliminary measure for turbulence. Methods A 2-phase exploratory sequential mixed-methods design was used to translate the proposed construct of turbulence into an operational definition and begin preliminary testing of a turbulence scale. Results A member survey of the American Association of Critical-Care Nurses resulted in the identification of 12 turbulence types. Turbulence was defined, and reliability of the turbulence scale was acceptable (α = .75). Turbulence was most strongly correlated with patient safety risk (r = 0.41, n = 293, P < .001). Workload had the weakest association with patient safety risk (r = 0.16, n = 294, P = .005). Conclusions Acknowledging the concepts of turbulence and workload separately best describes the full range of nursing demands. Improved measurement of nursing work is important to advance the science. A clearer understanding of nurses’ work will enhance our ability to target resources and improve patients’ outcomes.

Improving patient safety: Utilization of standardized radiation oncology simulation templates.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 259-259
Author(s):  
Ashlyn S. Everett ◽  
Ginna Blalock ◽  
Drexell Hunter Boggs
Keyword(s):  
Patient Safety ◽  
Quality Of Care ◽  
Radiation Oncology ◽  
Treatment Guidelines ◽  
Error Rates ◽  
Cancer Site ◽  
Improve Quality ◽  
Clinic Efficiency ◽  
Ct Simulation

259 Background: Increasing patient volume and treatment complexity in the field of radiation oncology has resulted in increased number of errors possibly affecting patient safety. Effective methods of mitigating these errors include automation, computerization, simplification, and standardization. To improve quality of care and patient safety, our institution established consensus standardized treatment guidelines for each cancer site. However, physician orders for computed tomography (CT) simulation for radiation treatment planning continued to have extreme variability, with error rates of 31%. Therefore, a team was assembled to devise standardized orders to reduce error, improve patient safety, and improve quality of care in the CT simulation order process. Methods: For this study, we investigated 3 commonly treated sites at our institution: breast (14%), prostate (7%), and brain metastases treated with radiosurgery (14%). A standardized template CT simulation order was defined for each disease site using the consensus treatment guidelines. These orders were integrated into the electronic medical record (EMR) on March 5, 2018. To evaluate the efficacy of the intervention, CT simulation order data were queried for the two-month period before and after implementation of standardized template orders. Orders with variation from the treatment guidelines were counted to calculate error rates with and without standardized simulation orders. Results: In the two-months prior to implementation of the standardized order templates, 48 of 151 (31%) CT simulation orders for the three selected sites had variation from the consensus standardized orders. After implementation of the EMR standardized template, 17 of 129 simulation orders (13%) in the three selected sites had variations from the standard during this two-month period. Standardization of CT simulation orders using an EMR template reduced error rates from 31% to 13% (18% absolute reduction; 42% relative reduction). Conclusions: Simplification and standardization of CT simulation orders decreased error rates by 42%, thereby improving clinic efficiency and appropriate patient treatment.

scholarly journals Prescription for antibiotics at drug shops and strategies to improve quality of care and patient safety: a cross-sectional survey in the private sector in Uganda

BMJ Open ◽  
2016 ◽  
Vol 6 (3) ◽  
pp. e010632 ◽  
Author(s):  
Anthony K Mbonye ◽  
Esther Buregyeya ◽  
Elizeus Rutebemberwa ◽  
Siân E Clarke ◽  
Sham Lal ◽  
...  
Keyword(s):  
Patient Safety ◽  
Quality Of Care ◽  
Private Sector ◽  
Improve Quality ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Drug Shops

scholarly journals Integrating Patient-Generated Health Data in an Electronic Medical Record: Stakeholders’ Perspectives

2020 ◽  
Author(s):  
Katherine Blondon ◽  
Frederic Ehrler
Keyword(s):  
Patient Safety ◽  
Quality Of Care ◽  
Focus Group ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Health Data ◽  
Improve Quality

Patient-generated health data (PGHD), when shared with the provider, provides potential as an approach to improve quality of care. Based on interviews and a focus group with stakeholders involved in PGHD integration in the electronic medical record (EMR), we explore the benefits, barriers and possible risks. We propose solutions to address liability concerns, such as clarifying patient and provider expectations for the analyses of PGHD and emphasize considerations for future steps, which include the need to screen PGHD for patient safety.

Sociotechnical Issues of Tele-ICU Technology

2011 ◽  
pp. 225-240 ◽  
Author(s):  
Peter Hoonakker ◽  
Kerry McGuire ◽  
Pascale Carayon
Keyword(s):  
Critical Care ◽  
Patient Safety ◽  
Quality Of Care ◽  
Virtual Teams ◽  
Life Quality ◽  
Quality Of Work Life ◽  
Icu Patients ◽  
Care Services ◽  
Video And Audio

Intensive care units (ICUs) are highly complex organizations where lives are hanging by a thread. Approximately 400,000 to 500,000 people die each year in American ICUs. The highly complex environment and large responsibilities put a burden on ICU staff including physicians and nurses. Research has shown that ICU physicians and nurses report high levels of workload and burnout that are related to lower quality of care provided to ICU patients and patient safety problems. Furthermore, there is a shortage of ICU personnel. In the past decades, the number of critical care beds has increased while the number of hospitals offering critical care services has decreased. Telemedicine may be one solution to deal with the shortage of ICU personnel. The tele-ICU technology represents the application of telemedicine in ICUs: ICU patients are monitored remotely by physicians and nurses trained in critical care. Recent estimates show that a nurse in the tele-ICU environment can monitor as many as 50 ICU patients in different ICUs, using the most recent telemedicine technology that provides access to patient information as well as video and audio links to patient rooms. The physicians and nurses in the tele-ICU collaborate with the physicians and nurses in the ICUs in what can be considered virtual teams. We know little about how the virtual team characteristics affect communication and trust between the participating members of the team. Furthermore, we know little about how the technological environment of the tele-ICU may affect the physicians and nurses’ workload and possibly burnout, and how this may affect quality of care and patient safety. In this chapter we describe the ICU and tele-ICU from a sociotechnical perspective, and examine how organizational factors may affect the jobs of nurses in the tele-ICU, and possible consequences for quality of work life, quality of care and patient safety.

The Impact of Information Technology across Small, Medium, and Large Hospitals

2011 ◽  
pp. 347-361
Author(s):  
Stacy Bourgeois ◽  
Edmund Prater ◽  
Craig Slinkman
Keyword(s):  
Information Technology ◽  
Patient Safety ◽  
Financial Performance ◽  
Hospital Performance ◽  
Performance Outcomes ◽  
Hospital Environment ◽  
Improve Quality ◽  
It Applications ◽  
The Impact

Hospitals invest in Information Technology to lower costs and to improve quality of care. However, it is unclear whether these expectations for Information Technology are being met. This study explores Information Technology (IT) in a hospital environment and investigates its relationship to mortality, patient safety, and financial performance across small, medium, and large hospitals. Breaking down IT into functional, technical, and integration components permits the assessment of different types of technologies’ impact on financial and operational outcomes. Findings indicate that both IT sophistication (access to IT applications) and IT sophistication’s relationship to hospital performance varies significantly between small, medium, and large hospitals. In addition, empirical investigation of quality, safety, and financial performance outcomes demonstrates that the observed impact of IT is contingent upon the category of IT employed.

Sociotechnical Issues of Tele-ICU Technology

2011 ◽  
pp. 1879-1895 ◽  
Author(s):  
Peter Hoonakker ◽  
Kerry McGuire ◽  
Pascale Carayon
Keyword(s):  
Critical Care ◽  
Patient Safety ◽  
Quality Of Care ◽  
Virtual Teams ◽  
Life Quality ◽  
Quality Of Work Life ◽  
Icu Patients ◽  
Care Services ◽  
Video And Audio

Intensive care units (ICUs) are highly complex organizations where lives are hanging by a thread. Approximately 400,000 to 500,000 people die each year in American ICUs. The highly complex environment and large responsibilities put a burden on ICU staff including physicians and nurses. Research has shown that ICU physicians and nurses report high levels of workload and burnout that are related to lower quality of care provided to ICU patients and patient safety problems. Furthermore, there is a shortage of ICU personnel. In the past decades, the number of critical care beds has increased while the number of hospitals offering critical care services has decreased. Telemedicine may be one solution to deal with the shortage of ICU personnel. The tele-ICU technology represents the application of telemedicine in ICUs: ICU patients are monitored remotely by physicians and nurses trained in critical care. Recent estimates show that a nurse in the tele-ICU environment can monitor as many as 50 ICU patients in different ICUs, using the most recent telemedicine technology that provides access to patient information as well as video and audio links to patient rooms. The physicians and nurses in the tele-ICU collaborate with the physicians and nurses in the ICUs in what can be considered virtual teams. We know little about how the virtual team characteristics affect communication and trust between the participating members of the team. Furthermore, we know little about how the technological environment of the tele-ICU may affect the physicians and nurses’ workload and possibly burnout, and how this may affect quality of care and patient safety. In this chapter we describe the ICU and tele-ICU from a sociotechnical perspective, and examine how organizational factors may affect the jobs of nurses in the tele-ICU, and possible consequences for quality of work life, quality of care and patient safety.

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