eLetters

102 e-Letters

  • Worthless Statistics in search of Meaningful Conclusion
    Louise B Andrew

    It appears that these authors believe that variability in the disciplinary rates between states is something that indicates a lack of quality and/or a lack of uniformity of safety measures.

    Nothing could be further from the truth.

    There are many more reasons affecting a state's disciplinary rates than those controlled for in the study. For just one glaringly obvious example, in certain states and i...

    Show More
  • Why do we love to hate ourselves?
    Robert L Wears

    Dhaliwal's comment [1] on Zwaan et al [2] nicely refutes what has been called "the hypothesis of special cause" [3] - the notion that when things turn out wrong, the cognitive processes leading to that outcome must have been fundamentally different (ie, error-prone) from when they turn out right. Dhaliwal's argument recapitulates thinking that is over 100 years old; one of the early contributors to psychology, Ernst Mach, wr...

    Show More
  • Statistical Process Control and Interrupted Time Series
    Alan J Poots

    I read Fretheim and Tomic's article [1] with interest as I trained in frequentist stastistics and now work primarily with Stastistical Process Control (SPC) in quality improvement (QI) initiatives.

    I concur that there are missed opportunities for using Interrupted Time Series (ITS) in QI; however, I note cautions in doing so:

    Regression models applied in ITS often have the assumption of homoscedastici...

    Show More
  • Hand Washing is about Respect for Patients
    Daniel L Cohen

    The paper by Redelmeier and Shafir resonated strongly with me because I have always believed that there are important factors that motivate some physicians to wash their hands while others behave differently. I agree completely that this is a more complex issue than has been previously noted. I always wash my hands in front of patients and have done so for over 40 years. This has very little to do with the risks of healthc...

    Show More
  • What did Albert Einstein ever do?
    Robert L Wears

    Reed and Card's essay on the problem of valuing action over thought could not have come at a better time. For years, quality and safety mavens have been paraphrasing Goethe -- "Knowing is not enough ... we must do". But the resulting culture of 'do, do, do' has brought us quite a lot of doo-doo.

    To counter this, consider the question, "What did Einstein ever do?" He invented nothing, patented nothing, created n...

    Show More
  • Patient-centered bedside rounds-Exploring patient preferences before patient-centered care
    Naseema B Merchant

    Dear Editor,

    It was with great interest that we read the study of O'Leary et al published in the December issue of the journal and were quite surprised by their findings that patient centered- rounds had no impact on patients' perceptions of shared decision making, activation, and satisfaction with care.1

    Previous studies have shown that patients prefer their rounding team conduct rounds at the bedside...

    Show More
  • The problem with incident reporting
    Paresh Jobanputra

    Dear Sir or Madam

    I read with interest the editorial by Carl Macrae on incident reporting. I wonder if, in making a detailed comparison with the aviation and other industries, Macrae loses sight of one important reason why health services staff report incidents. My experience suggests that often the purpose of reports is not to learn from incidents but for staff to pre -emptively give their version of events in...

    Show More
  • Re:More information on safety culture in long-term care
    Martina Buljac-Samardzic

    We appreciate Dr. Singer's point about a more thorough discussion of the large literature on safety climate and tools for assessing it. Although we did include two of the articles she refers to; not all were included. While acknowledging and discussing other instruments for measuring Patient Safety Climate (PSC), would have made our article more complete, the findings and conclusions of the study would not have changed....

    Show More
  • More information on safety culture in long-term care
    Sara Singer

    To the Editor: I was a little surprised to see Buljac-Samardzic et al. in their recent article on safety culture in long-term care state that few tools are available to evaluate the effectiveness of initiatives to improve safety culture in nursing and residential homes. While there may be fewer tools available for nursing and residential homes than inpatient settings, there are several safety climate instruments that are...

    Show More
  • Statistical analysis of differences in turnover times among operating theatres
    Franklin Dexter

    Overdyk et al. used remote video auditing with real-time feedback in a surgical suite [1]. As part of their randomized trial clustered by theatre, they report less turnover times among "fast rooms," those generally including 3 or greater cases per day.

    Successive turnover times between scheduled cases within theatres on the same date tend to be correlated (e.g., caused by same surgeon, nurses, and anaesthetist)....

    Show More

Pages