eLetters

106 e-Letters

  • Moving from Safety I to Safety II, but what about the media?
    Nick Woodier

    To the Editor

    I have recently returned from the Association of Simulated Practice in Healthcare 2014 conference in Nottingham and whilst there was privileged to hear and meet Professor Erik Hollnagel. He presented eloquently on his work relating to “From Safety I to Safety II” [1] which provided an excellent opening for the conference’s theme of “Changing Behaviours.” His work sparked much debate and reflection, part...

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  • Measuring the true impact of an electronic physiological surveillance system (EPSS)
    Dominick Shaw
    Dear Sir, We read with interest the article by Schmidt et al. We applaud the authors for undertaking this large and complex study and for highlighting the great potential of newer technologies to improve patient care. We hoped the authors could clarify some key issues. Firstly only one year's mortality data are used as a baseline comparator. Mortality fluctuates by year as this paper highlights, and can be affected by a large...
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  • WHO Safer Surgery Checklist not Immune to Human Errors
    Christian Schopflin

    We wish to congratulate Russ SJ et al. (1) for their excellent survey investigating patients' views of the WHO safer surgery checklist.

    The authors point out that the UK wide implementation of the checklist has encountered some difficulties. Specifically, barriers including checklist fatigue and difficulties in assembling the theatre team are mentioned. Whilst we certainly agree with this, we wish to amend the a...

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  • 'Between the flags': implementing a rapid response system at scale - A reply
    Sanjay Sharma

    The authors (1) have raised a very important issue relating to recognition and management of a deteriorating patient. Over the years, cases have been reported where outcome may have been better if deterioration was recognized in time. Once recognized, an urgent response by a qualified team could instigate immediate investigations and management as warranted, possibly averting a poor outcome.

    Code blue calls or...

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  • SURGERY AND CHECKLISTS: WHAT A PILOT WOULD LIKE TO KNOW
    Fabrizio Dal Moro

    Dear Editor, we would like to congratulate Russ et al. on their paper on the patients' views of surgical checklists (SC). In their elegant work, the above authors underlined that assessing the fidelity of the SC remains a challenge, but demonstrated a high level of patient support for use of checklists. They found that patients were surprised that SC was only a recent introduction to surgical care. Moreover, the authors...

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  • Evidence-based E-Health Policy - Vitally Important but not a New Call
    Michael J. Rigby

    The editorial from Sheikh, Atun, and Bates is welcome in flagging up a key issue in the context of England and the US. However, it is not a new issue, and it is disappointing that they do not acknowledge prior and concurrent work.

    The need for, and challenges impeding, evaluation of health information systems have been flagged up much earlier, e.g. Rigby 1999; 2001. Both the European Federation for Medical In...

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  • Paperlite patient record, are we ready.
    Zarshed Khan

    Stephanie et al has produced some very interesting observations about the impact of electronic medical records on patient-doctor communication. Recent investigations into the social care system in the light of child abuse enquiries depicted that professionals spend far too much time on making records rather than face to face meetings with families and children. More trusts in the NHS are adapting paper light patient recor...

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  • Identifying system failures by incident reporting systems
    Gerald Sendlhofer

    With respect to the scientific article of Franklin et al. (BMJ Qual Saf 2014;0:1-8.doi:10.1136/bmjqs-2013-002572) I would like to address two further issues concerning the learning and reporting system in general as well as defense strategies in order to prevent errors in administration of intrathecal chemotherapy.

    The amount of nine million incident reports in NHS is very impressive when compared to other repor...

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  • Adaptation in French oncology practice guidelines to patients: patient versions and patient involvement in the development process of guidelines
    Julien Carretier

    While Clinical Practice Guidelines (CPGs) have gained momentum to inform evidence-based practices, less investment has been made to use CPGs to support evidence-informed patient choice. The qualitative study by van der Weijden et al. shows a consensual vision of the need for and benefice of adapting CPGs into relevant patient versions to integrate patients' preferences in clinical decision-making. While we agree with the...

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  • Re:Any value of Early Warning Systems must rely on the prevalence of the conditions being sought
    Nicola Mackintosh

    In reply to Bewley's response to our paper, we acknowledge that a number of studies have assessed the extent of major obstetric complications as higher than that cited in the RCOG publication [1-5]. Definitions as well as rate estimation of maternal morbidity vary widely across studies [1]. However, the premise of our paper was not to minimise the scale and severity of the problem of maternal morbidity, but to explore t...

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