The problem with Plan-Do-Study-Act cycles - BMJ Quality & Safety
Quality improvement (QI) methods have been introduced to healthcare to support the delivery of care that is safe, timely, effective, efficient, equitable and cost effective. Of the many QI tools and methods, the Plan-Do-Study-Act (PDSA) cycle is one of the few that focuses on the crux of change, the translation of ideas and intentions into action. As …
Patient work self-managing medicines: a skilled job at the sharp …
Finally, for healthcare to be sustainable, particularly in settings where resources are stretched, there is a drive to situate acute or postsurgical care in the patient’s own home where appropriate, and for patients to take more responsibility for tools, tasks and technologies, for example, home monitoring of vital signs and app usage on postsurgical virtual wards.20 Managing medicines is ...
Contextual factors that influence adoption and sustainment of self ...
Background Self-management support (SMS) is a recommended component of cancer survivorship care that improves health-related quality of life and reduces healthcare utilisation. However, widespread implementation has been difficult to achieve, with a gap in the literature on system-wide implementation efforts. This study examines contextual factors perceived to influence SMS adoption and ...
Patient-activated escalation in hospital: patients and their families ...
Patient-activated rapid response systems are in operation in a number of health systems across the globe,4 including the USA,5 most parts of Australia6 and New Zealand.7 Mechanisms of escalation vary, but while many rapid response systems for healthcare professionals use defined physiological triggers for escalation, a ‘worry and concern’ is …
Models of the medical consultation ... - BMJ Quality & Safety
The medical consultation is best understood as a two-way social interaction involving interactive decision making. Game theory—a theory based on assumptions of rational choice and focusing on interactive decision making—has the potential to provide models of the consultation that can be used to generate empirically testable predictions about the …
The problem with ‘5 whys’ | BMJ Quality & Safety
‘The Problem with…’ series covers controversial topics related to efforts to improve healthcare quality, including widely recommended but deceptively difficult strategies for improvement and pervasive problems that seem to resist solution. The ‘5 whys’ technique is one of the most widely taught approaches to root-cause analysis (RCA) in healthcare. Its use is …
Understanding the enablers and barriers to implementing a …
Background The management of acute deterioration following surgery remains highly variable. Patients and families can play an important role in identifying early signs of deterioration but effective contribution to escalation of care can be practically difficult to achieve. This paper reports the enablers and barriers to the implementation of patient-led escalation systems found during a ...
A primer on PDSA: executing plan–do–study–act cycles in practice, …
Plan-do–study–act (PDSA) cycles are the building blocks of iterative healthcare improvement.1 Although frequently regarded as separate from research,2 this quality improvement method remains rooted in the scientific method. The P in PDSA usually stands for ‘plan’ but could just as easily refer to ‘predict’. Each cycle combines prediction with a …
Economic analysis of the prevalence and clinical and economic …
Objectives To provide national estimates of the number and clinical and economic burden of medication errors in the National Health Service (NHS) in England. Methods We used UK-based prevalence of medication errors (in prescribing, dispensing, administration and monitoring) in primary care, secondary care and care home settings, and associated healthcare resource use, to estimate annual number ...
Assessing patient work system factors for medication …
Objective To develop and evaluate measures of patient work system factors in medication management that may be modifiable for improvement during the care transition from hospital to home among older adults. Design, settings and participants Measures were developed and evaluated in a multisite prospective observational study of older adults (≥65 years) discharged home from medical units of ...