The Use of Medical Simulation to Improve Patient Safety

2013 ◽  
pp. 155-172
Author(s):  
Stuart Marshall ◽  
Jennifer Hogan
Keyword(s):  
Patient Safety ◽  
Organizational Design ◽  
Simulation Training ◽  
Improve Patient Safety ◽  
Clinical Care ◽  
Clinical Work ◽  
Medical Simulation ◽  
Simulation Education ◽  
Strategic Approach ◽  
Future Direction

In healthcare, medical simulation describes a heterogeneous group of methods that aim to replicate some aspect of clinical care. This chapter discusses the extent to which simulation is being used to explore facets of patient safety from the design of specific devices that are being used in the context of clinical work, to the broader organizational design of systems. The most commonly associated aspect of medical simulation is the education of clinicians in relation to improving patient safety. Few studies have attempted to examine how simulation education can affect patient safety; however, there is an emerging body of evidence that simulation training, particularly with regard to the training of teams, can have a positive effect on patient safety outcomes. The barriers commonly incurred with the implementation of simulation training warrant exploration and discussion so that an informed and strategic approach is adopted to allow the future direction of medical simulation in healthcare to be educationally sound and financially sustainable.

scholarly journals Adverse Drug Event Reporting From Clinical Care: Mixed-Methods Analysis for a Minimum Required Dataset (Preprint)

2018 ◽  
Author(s):  
David Peddie ◽  
Serena S Small ◽  
Katherin Badke ◽  
Chantelle Bailey ◽  
Ellen Balka ◽  
...  
Keyword(s):  
Systematic Review ◽  
Patient Safety ◽  
Mixed Methods ◽  
Adverse Drug Event ◽  
Improve Patient Safety ◽  
Clinical Care ◽  
Drug Event ◽  
Care Providers ◽  
Event Reporting ◽  
Improve Patient

BACKGROUND Patients commonly transition between health care settings, requiring care providers to transfer medication utilization information. Yet, information sharing about adverse drug events (ADEs) remains nonstandardized. OBJECTIVE The objective of our study was to describe a minimum required dataset for clinicians to document and communicate ADEs to support clinical decision making and improve patient safety. METHODS We used mixed-methods analysis to design a minimum required dataset for ADE documentation and communication. First, we completed a systematic review of the existing ADE reporting systems. After synthesizing reporting concepts and data fields, we conducted fieldwork to inform the design of a preliminary reporting form. We presented this information to clinician end-user groups to establish a recommended dataset. Finally, we pilot-tested and refined the dataset in a paper-based format. RESULTS We evaluated a total of 1782 unique data fields identified in our systematic review that describe the reporter, patient, ADE, and suspect and concomitant drugs. Of these, clinicians requested that 26 data fields be integrated into the dataset. Avoiding the need to report information already available electronically, reliance on prospective rather than retrospective causality assessments, and omitting fields deemed irrelevant to clinical care were key considerations. CONCLUSIONS By attending to the information needs of clinicians, we developed a standardized dataset for adverse drug event reporting. This dataset can be used to support communication between care providers and integrated into electronic systems to improve patient safety. If anonymized, these standardized data may be used for enhanced pharmacovigilance and research activities.

scholarly journals Comparison of 3 Dilation and Evacuation Technical Skills Models

2013 ◽  
Vol 5 (4) ◽  
pp. 662-664 ◽  
Author(s):  
Maureen K. Baldwin ◽  
Julie Chor ◽  
Beatrice A. Chen ◽  
Alison B. Edelman ◽  
Jennefer Russo
Keyword(s):  
Patient Safety ◽  
Family Medicine ◽  
Simulation Training ◽  
Improve Patient Safety ◽  
Technical Skills ◽  
Training Model ◽  
Second Trimester ◽  
Fidelity Model ◽  
Improve Patient ◽  
And Training

Abstract Background Simulation training may improve patient safety, decrease trainer and trainee anxiety, and reduce the number of cases needed for competency. Complications associated with dilation and evacuation (D&E) have been directly related to provider skill level, yet no low-fidelity model has been formally described or evaluated in the literature for second-trimester D&E training. Objective We report physicians' assessments of the realism of 3 D&E models to establish a composite training model. Methods We surveyed experienced providers at 2 national conferences to evaluate 3 D&E models and rate each model's components on a Likert scale. Results Fifty-five obstetrics-gynecology and family medicine physicians completed the survey. Most respondents rated 4 components of 1 model as somewhat realistic or very realistic. The components rated highest were the fetal parts (82% [45 of 55]) and placenta (60% [30 of 50]). This model was rated as more likely to be used in training by 80% (43 of 54) of participants than the 2 other models, as rated by 28% (15 of 54) and 9% (5 of 54) of participants. Conclusions A model made from a plastic bottle containing a stuffed fabric form with detachable parts has tactile similarity to a D&E procedure and should be further developed for testing and training.

scholarly journals The Importance of Medication Errors Reporting in Improving the Quality of Clinical Care Services

2015 ◽  
Vol 8 (8) ◽  
pp. 243 ◽  
Author(s):  
Nesreen Mohamed Kamal Elden ◽  
Amira Ismail
Keyword(s):  
Patient Safety ◽  
Medication Errors ◽  
Error Detection ◽  
Clinical Pharmacist ◽  
Improve Patient Safety ◽  
Clinical Care ◽  
Error Rates ◽  
Active Management ◽  
Effective Interventions ◽  
Post Test

<p><strong>INTRODUCTION:</strong> Medication errors have significant implications on patient safety. Error detection through an active management and effective reporting system discloses medication errors and encourages safe practices.</p><p><strong>OBJECTIVES: </strong>To improve patient safety through determining and reducing the major causes of medication errors (MEs), after applying tailored preventive strategies.</p><p><strong>METHODOLOGY: </strong>A pre-test, post-test study was conducted on all inpatients at a 177 bed hospital where all medication procedures in each ward were monitored by a clinical pharmacist. The patient files were reviewed, as well. Error reports were submitted to a hospital multidisciplinary committee to identify major causes of errors. Accordingly, corrective interventions that consisted of targeted training programs for nurses and physicians were conducted.</p><p><strong>RESULTS: </strong>Medication errors were higher during ordering/prescription stage (38.1%), followed by administration phase (20.9%). About 45% of errors reached the patients: 43.5% were harmless and 1.4% harmful. 7.7% were potential errors and more than 47% could be prevented. After the intervention, error rates decreased from (6.7%) to (3.6%) (P≤0.001).</p><p><strong>CONCLUSION:</strong> The role of a ward based clinical pharmacist with a hospital multidisciplinary committee was effective in recognizing, designing and implementing tailored interventions for reduction of medication errors. A systematic approach is urgently needed to decrease organizational susceptibility to errors, through providing required resources to monitor, analyze and implement effective interventions.</p>

scholarly journals The patient safety practices of emergency medical teams in disaster zones: a systematic analysis

2019 ◽  
Vol 4 (6) ◽  
pp. e001889
Author(s):  
Ussamah El-khani ◽  
Hutan Ashrafian ◽  
Shahnawaz Rasheed ◽  
Harald Veen ◽  
Ammar Darwish ◽  
...  
Keyword(s):  
Patient Safety ◽  
Improve Patient Safety ◽  
Case Reports ◽  
Clinical Care ◽  
Grey Literature ◽  
Case Series ◽  
Quality Data ◽  
Safety Practices ◽  
Emergency Medical ◽  
Medical Teams

IntroductionDisaster zone medical relief has been criticised for poor quality care, lack of standardisation and accountability. Traditional patient safety practices of emergency medical teams (EMTs) in disaster zones were not well understood. Improving the quality of healthcare in disaster zones has gained importance within global health policy. Ascertaining patient safety practices of EMTs in disaster zones may identify areas of practice that can be improved.MethodsA systematic search of OvidSP, Embase and Medline databases; key journals of interest; key grey literature texts; the databases of the WHO, Médecins Sans Frontieres and the International Committee of the Red Cross; and Google Scholar was performed. Descriptive studies, case reports, case series, prospective trials and opinion pieces were included with no limitation on date or language of publication.ResultsThere were 9685 records, evenly distributed between the peer-reviewed and grey literature. Of these, 30 studies and 9 grey literature texts met the inclusion criteria and underwent qualitative synthesis. From these articles, 302 patient safety statements were extracted. Thematic analysis categorised these statements into 84 themes (total frequency 632). The most frequent themes were limb injury (9%), medical records (5.4%), surgery decision-making (4.6%), medicines safety (4.4%) and protocol (4.4%).ConclusionPatient safety practices of EMTs in disaster zones are weighted toward acute clinical care, particularly surgery. The management of non-communicable disease is under-represented. There is widespread recognition of the need to improve medical record-keeping. High-quality data and institutional level patient safety practices are lacking. There is no consensus on disaster zone-specific performance indicators. These deficiencies represent opportunities to improve patient safety in disaster zones.

Simulation training to improve patient safety

2012 ◽  
pp. 274-278 ◽  
Author(s):  
Valeriy Kozmenko ◽  
Judy G. Johnson ◽  
Melville Wyche ◽  
Alan D. Kaye
Keyword(s):  
Patient Safety ◽  
Simulation Training ◽  
Improve Patient Safety ◽  
Improve Patient
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