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Quality & safety in the literature
Quality and Safety in the Literature: January 2022
  1. Paul Caseley1,
  2. Nathan Houchens1,2,
  3. Ashwin Gupta1,2
  1. 1 Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
  2. 2 Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
  1. Correspondence to Dr Paul Caseley, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, 48109, Michigan, USA; caseley{at}med.umich.edu

https://doi.org/10.1136/bmjqs-2021-014410

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    Healthcare quality and safety span multiple topics across the spectrum of academic and clinical disciplines. Keeping abreast of the rapidly growing body of work can be challenging. In this series, we provide succinct summaries of selected relevant studies published in the last several months. Some articles will focus on a particular theme, whereas others will highlight unique publications from high-impact medical journals.

    Key points

    • A multicentre randomised controlled trial seeking to improve outcomes in heart failure (HF) care using both a hospital-based and a postdischarge transition of care intervention failed to show improvements in both a composite score of time to first HF readmission or all-cause mortality and a composite score for HF quality, when compared with usual care. JAMA 27 July 2021.

    • A significant number of non-indicated preprocedural urinalyses are performed by US surgeons, in many cases leading to inappropriate use of antibiotics, placing a significant avoidable cost burden on the healthcare system and potentially leading to negative downstream effects on patients. JAMA Intern Med 2 August 2021.

    • A novel computer-based, patient-centred intervention leads to higher rates of advance care planning in the ambulatory care setting. Ann Intern Med 31 August 2021.

    Effect of a hospital and postdischarge quality improvement intervention on clinical outcomes and quality of care for patients with heart failure with reduced ejection fraction: the CONNECT-HF randomized clinical trial

    JAMA 27 July 2021

    Of the 126.9 million Americans with cardiovascular disease, an estimated 6 million have heart failure (HF), a condition increasing in prevalence over time.1 The burden of disease for these patients is high: up to 40% of patients with HF have a history of hospitalisation, and the 5-year all-cause readmission rate is approximately 80%.2 According to the National Hospital Discharge Survey 2000–2010, there was no reduction in admissions for HF during this time3 despite a significant increase in the number of effective pharmacological agents for management of HF.4 In addition to poorly optimised medical management, factors such as lack of patient understanding …

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    Footnotes

    • Twitter @nate_houchens, @ashwin_b_gupta

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.