eLetters

9 e-Letters

published between 2006 and 2009

  • Reducing Complications of Central Venous Catheter Insertion
    Ros MacLeod

    Most Intensive Care Units (ICU) collect comprehensive data relating to patient demographics, diagnoses and complications and some use this information to benchmark and guide quality improvement activities aimed at improving patient outcomes and reducing iatrogenic complications. Ayas et. al. are to be commended for using routine information they collect in an attempt to identify trends and possible contributing factors t...

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  • Empowering the patients in patient safety program
    Rizaldy Pinzon

    It has been well recognized internationally that hospitals are not as safe as they should be. In order to redress this situation, health care services around the world have turned their attention to strategically implementing robust patient safety and quality care program to identify circumstances that put patients at risk of harm and then acting to prevent or control those risks In my hospital the patient safety program h...

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  • Randomized trials are necessary in quality improvement
    Per Winkel

    Recently Neuhauser and Dias raised an important question [1]: are randomised clinical trials (RCT) necessary in quality improvement?

    They conclude that “RCTs need to be embedded in generalized replicatable theory. Otherwise it is a scientific house without foundation” and argue that RCTs comparing drugs cannot be replicated for two reasons: (1) after a decade or two the control arm has changed and (2) replicati...

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  • Authors' response
    Hardeep Singh

    Dear Editor,

    We thank Dr. McCarthy for his thoughtful insights on the application of situational awareness (SA) in medicine. We agree that physicians begin with a limited amount of SA and often fail to maximize their SA using a team approach. Because of the increasing complexity and acuity of care in the outpatient setting, the risk of outpatient medical errors has increased during the past several years.[1] Thus, t...

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  • Situational Awareness in medicine
    Geoffrey W McCarthy

    Dear Editor,

    As a retired USAF pilot-physician, I commend Singh et al. for their excellent use of aviation Situational Awareness as an analysis tool. I wish only to add a subtle dimension to their illustration of situational awareness: "LSA" - loss of situational awareness – began as a universally recognized NATO acronym. But…one can not lose what one never had. SA in military and air carrier aviation universally b...

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  • Changing social relationships
    Nick J Fox

    Dear Editor,

    In his review of our paper on pro-anorexia Internet communities (Quality and Safety in Health Care 2006;15:220-222), Dr Smith introduced one inaccuracy into an otherwise concise summary. He mistakenly attributed a quotation from a participant in the Internet forum to our researcher. Angela (a pseudonym) had commented that she was intending to leave the group because she did not approve of some of t...

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  • Patients Agencies and complaints in Italy
    Roberto Natangelo

    Dear Editor,

    According to MM Bismark et Al (1) complaints that are brought to a Commissioner in NZ offer a potentially valuable “window” on serious threats to patient safety. In Italy, the consultative and conciliatory commissions (“Commissioni miste conciliative”) and the ombudsmen (second level organisations) supply unsatisfactory results or are not even established (2). Furthermore, epidemiological data lik...

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  • Benefits of improving and disseminating evidence on quality improvement projects
    Mano Selvan

    Dear Editor,

    It was a great pleasure to read the article by F. Davidoff and P. Batalden published in October 2005 issue of the journal Quality and Safety in Health Care, pages 807–814. The article clearly pictures how failing to publish quality improvement (QI) may have several adverse implications hindering the overall medical quality improvement expected by consumers, accrediting agencies, federal agencies and...

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  • Making the case for more necropsies to improve patient care
    Megan A Bohensky

    Dear Editor,

    In their recent study, Shojana et al highlight the importance of necropsy to clinical care by demonstrating how diagnostic sensitivity for three conditions is overestimated without necropsy results.[1] This study prompted an editorial by Guly calling for more research to demonstrate that increasing necropsy rates can improve patient care.[2]

    Clearly, the evidence establishing the value of necr...

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