scholarly journals Improving Medical Handover: An SHO-Led Approach to Implementing A Formalized Handover System

2021 ◽  
Vol 3 (6) ◽  
pp. 28-30
Author(s):  
Rachel Hallam ◽  
Kurun Kumar ◽  
Susan Akintunde ◽  
Opeyemi Akinnawonu ◽  
Saba Mahmood ◽  
...  
Keyword(s):  
United Kingdom ◽  
Quality Improvement ◽  
High Risk ◽  
Continuity Of Care ◽  
Medical Errors ◽  
Medical Department ◽  
Smooth Handover

Handover is a high-risk exercise. As the number of doctors in hospitals vary between shifts, continuity of care must be secured from many professionals down to a few. Literature has repeatedly shown that handover time is when the greatest number of medical errors occur [1]. Tasks may be inefficiently handover over, mis-represented or forgotten entirely. We have shared perspectives from a quality improvement (QI) project undertaken at the William Harvey Hospital, Kent, United Kingdom towards ensuring safe and smooth handover of medical tasks between shifts at the acute medical department in this hospital.

Pooling Raw Shell Eggs: Salmonella Contamination and High Risk Practices in the United Kingdom Food Service Sector

2010 ◽  
Vol 73 (3) ◽  
pp. 574-578 ◽  
Author(s):  
F. J. GORMLEY ◽  
C. L. LITTLE ◽  
N. MURPHY ◽  
E. de PINNA ◽  
J. MCLAUCHLIN
Keyword(s):  
United Kingdom ◽  
Food Safety ◽  
High Risk ◽  
Service Sector ◽  
Safety Management ◽  
Food Service ◽  
Control Measures ◽  
Hygiene Practices ◽  
Risk Practices ◽  
Handling Practices

Salmonella contamination of pooled raw shelled egg mix (RSEM) used as an ingredient in lightly cooked or uncooked foods and high-risk kitchen hygiene practices in United Kingdom food service establishments using RSEM were investigated. Samples were collected from 934 premises. Salmonella was found in 1 (0.13%) of 764 RSEM samples, 2 (0.3%) of 726 samples from surfaces where ready-to-eat foods were prepared, and 7 (1.3%) of 550 cleaning cloths. Poor RSEM storage and handling practices were highlighted. Workers in 40% of the premises sampled failed to use designated utensils when RSEM was added to other ingredients, workers in 17% of the premises did not clean surfaces and utensils thoroughly after use with RSEM and before preparing other foods, only 42% of workers washed and dried their hands after handling eggs or RSEM, workers in 41% of the premises did not store RSEM at refrigeration temperature before use, and workers in 8% of the premises added RSEM to cooked rice at the end of cooking when preparing egg fried rice. Take-away premises, especially those serving Chinese cuisine, were least likely to have a documented food safety management system and awareness of the key food safety points concerning the use of RSEM compared with other food service premises (P < 0.0001). Food service businesses using RSEM must be aware of the continuing hazard from Salmonella, must adopt appropriate control measures, and must follow advice provided by national food agencies to reduce the risk of Salmonella infection.

scholarly journals SARS-CoV-2 testing and sequencing for international arrivals reveals significant cross border transmission of high risk variants into the United Kingdom

2021 ◽  
pp. 101021
Author(s):  
Gareth H Williams ◽  
Alexander Llewelyn ◽  
Ruben Brandao ◽  
Kaiya Chowdhary ◽  
Keeda-Marie Hardisty ◽  
...  
Keyword(s):  
United Kingdom ◽  
High Risk ◽  
Cross Border ◽  
The United Kingdom ◽  
Risk Variants

Doing More With Less: Pragmatic Implementation of Vancomycin Area-Under-the-Curve (AUC) Monitoring

2021 ◽  
pp. 089719002110272
Author(s):  
Joanne Huang ◽  
Jeannie D. Chan ◽  
Thu Nguyen ◽  
Rupali Jain ◽  
Zahra Kassamali Escobar
Keyword(s):  
Quality Improvement ◽  
High Risk ◽  
Therapeutic Drug Monitoring ◽  
Paradigm Shift ◽  
Area Under The Curve ◽  
Cost Effective ◽  
Practical Method ◽  
Therapeutic Drug ◽  
Short Term ◽  
Quality Improvement Process

Universal area-under-the-curve (AUC) guided vancomycin therapeutic drug monitoring (TDM) is resource-intensive, cost-prohibitive, and presents a paradigm shift that leaves institutions with the quandary of defining the preferred and most practical method for TDM. We report a step-by-step quality improvement process using 4 plan-do-study-act (PDSA) cycles to provide a framework for development of a hybrid model of trough and AUC-based vancomycin monitoring. We found trough-based monitoring a pragmatic strategy as a first-tier approach when anticipated use is short-term. AUC-guided monitoring was most impactful and cost-effective when reserved for patients with high-risk for nephrotoxicity. We encourage others to consider quality improvement tools to locally adopt AUC-based monitoring.

scholarly journals Implementation of midwifery continuity of care models for Indigenous women in Australia: Perspectives and reflections for the United Kingdom

Midwifery ◽  
2019 ◽  
Vol 69 ◽  
pp. 110-112 ◽  
Author(s):  
C. Fernandez Turienzo ◽  
Y. Roe ◽  
H. Rayment-Jones ◽  
A. Kennedy ◽  
D. Forster ◽  
...  
Keyword(s):  
United Kingdom ◽  
Continuity Of Care ◽  
Indigenous Women ◽  
The United Kingdom ◽  
Care Models

scholarly journals The impact of the incorporation of a feasible postoperative mortality model at the Post-Anaesthestic Care Unit (PACU) on postoperative clinical deterioration: A pragmatic trial with 5,353 patients

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0257941
Author(s):  
Claudia de Souza Gutierrez ◽  
Katia Bottega ◽  
Stela Maris de Jezus Castro ◽  
Gabriela Leal Gravina ◽  
Eduardo Kohls Toralles ◽  
...  
Keyword(s):  
Quality Improvement ◽  
High Risk ◽  
Clinical Deterioration ◽  
Surgical Patients ◽  
Predictive Tool ◽  
Postoperative Death ◽  
High Risk Patients ◽  
Death Probability ◽  
Risk Patients ◽  
The Impact

Background Practical use of risk predictive tools and the assessment of their impact on outcome reduction is still a challenge. This pragmatic study of quality improvement (QI) describes the preoperative adoption of a customised postoperative death probability model (SAMPE model) and the evaluation of the impact of a Postoperative Anaesthetic Care Unit (PACU) pathway on the clinical deterioration of high-risk surgical patients. Methods A prospective cohort of 2,533 surgical patients compared with 2,820 historical controls after the adoption of a quality improvement (QI) intervention. We carried out quick postoperative high-risk pathways at PACU when the probability of postoperative death exceeded 5%. As outcome measures, we used the number of rapid response team (RRT) calls within 7 and 30 postoperative days, in-hospital mortality, and non-planned Intensive Care Unit (ICU) admission. Results Not only did the QI succeed in the implementation of a customised risk stratification model, but it also diminished the postoperative deterioration evaluated by RRT calls on very high-risk patients within 30 postoperative days (from 23% before to 14% after the intervention, p = 0.05). We achieved no survival benefits or reduction of non-planned ICU. The small group of high-risk patients (13% of the total) accounted for the highest proportion of RRT calls and postoperative death. Conclusion Employing a risk predictive tool to guide immediate postoperative care may influence postoperative deterioration. It encouraged the design of pragmatic trials focused on feasible, low-technology, and long-term interventions that can be adapted to diverse health systems, especially those that demand more accurate decision making and ask for full engagement in the control of postoperative morbi-mortality.

scholarly journals Treatment Patterns With Lipid-Altering Drugs In High-Risk Vascular Disease In The United Kingdom

2014 ◽  
Vol 17 (3) ◽  
pp. A122
Author(s):  
Z. Zhao ◽  
Y. Zhu ◽  
J. Collins ◽  
R. Donaldson ◽  
W. Engelman ◽  
...  
Keyword(s):  
United Kingdom ◽  
High Risk ◽  
Vascular Disease ◽  
Treatment Patterns ◽  
The United Kingdom

Research Methods, Statistics, Patient Safety, and Quality Improvement

2020 ◽  
pp. 521-530
Author(s):  
Carlos Lerner
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
Adverse Events ◽  
Research Methods ◽  
Confidence Intervals ◽  
Medical Errors ◽  
Likelihood Ratios ◽  
Predictive Values ◽  
Analysis Of Variation ◽  
Answer Format

The chapter on research methods, statistics, patient safety, and quality improvement (QI) uses a question-and-answer format to make concepts in these areas relevant and accessible to general pediatricians. Research topics covered include study design and study types, validity, sources of bias, types of errors, sensitivity and specificity, positive and negative predictive values, likelihood ratios, incidence and prevalence, p values and confidence intervals. The patient safety questions focus on medical errors and adverse events, including their categorization, detection, prevention, and disclosure. Finally, the QI questions address key QI principles and methods, including tools to understand systems (e.g. fishbone diagrams and Pareto charts), analysis of variation, and the Langley Model for Improvement.

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