eLetters

27 e-Letters

published between 2001 and 2004

  • 'Sceptics or realists' - Authors' response
    Rose Gollop

    Dear Editor

    We note Dr Checkland’s comments on our paper on scepticism with interest.[1] In response, we do not believe that the paper argues that it is not legitimate for staff to be sceptical; indeed, we acknowledge the fact that scepticism can be useful in highlighting gaps and flaws in improvement initiatives. Nevertheless, the study – based on interviews that centred on listening to the opinions of others...

    Show More
  • Sceptics or realists
    Kath H Checkland

    Dear Editor

    The article by Gollop et al.[1] raises an interesting question: does labelling a programme of change an "improvement" programme mean that such a programme will automatically deliver improvements?

    I am disturbed by the implication that simply because something is "a key component of the government's strategy to modernise the NHS and make it more accessible to patients" it is therefor...

    Show More
  • Organizational trust: the responsibility of the leadership
    Nicole J Tweddle

    Dear Editor

    Firth-Cozens article explores the effect of trust and the ways in which it can be developed in health care organizations to enhance patient safety.[1] Leadership attributes of ability, benevolence and integrity most certainly contribute to the establishment of trust in a leader however, these attributes alone are not enough to overcome the barriers to open disclosure of errors.

    Organizational...

    Show More
  • A whole healthcare record
    Susan M Dovey

    Dear Editor

    At the Linnaeus Collaboration meeting in Canberra, Australia last week (sponsored by the Australian Primary Health Care Research Institute and the US Agency for Healthcare Research and Quality), primary care researchers from Australia, Canada, England, Germany, New Zealand, and the United States met to consider further research aimed at improving patient safety in primary health care. We discussed the...

    Show More
  • Initiatives for promoting the quality of guidelines: The Electronic G-I-N Guideline Library
    Guenter Ollenschlaeger

    Dear Editor

    We fully agree with Hasenfeld and Shekelle that many published guidelines fall short of the internationally consented quality criteria for their production and use, although the principles for the development of sound evidence–based guidelines are well established. In response several national and international initiatives have been working on programmes for the promotion of quality in guideline developm...

    Show More
  • What is a 'safety culture'?
    Martin N Marshall

    Dear Editor

    We welcome Singer and colleague’s contribution to developing the concept of a safety culture.[1] Policy-makers, managers and clinicians are slowly realising that patient safety will not be improved solely by counting adverse events or by introducing technical innovations. History tells us that when these initiatives are evaluated the results will probably show a marginal impact on patient safety, and one...

    Show More
  • General practice accreditation is only a small part of a comprehensive quality improvement strategy
    Laurence A Malcolm

    Dear Editor

    Buetow and Wellingham present a comprehensive overview of accreditation of general practices in New Zealand, and elsewhere, in this well-written article.[1] They make the very significant point about the limitations of quality assurance as compared with the more important performance outcome orientation of continuous quality improvement.

    However I am puzzled that they make no reference to the...

    Show More
  • Re Article: Qual Saf Health Care 2003; 12 : 112-118
    Nesamani K.S.Vengadasalam

    Dear Editor

    Congratulations to the authors for this wonderful comprehensive survey undertaken across 15 hospitals regarding safety cultures. The results of an overall response rate of only 47.4%, was largely due to the poor response for physicians (33%) . Efforts need to be taken to increase the response rate for a more reliable study result. The majority of participants in the survey responded in ways which in...

    Show More
  • Postmarketing surveillance for adverse drug effects
    Richard A. Deyo

    Dear Editor

    Doctors Santiago, Debanne, and Neuhauser correctly point out the frequent deficiencies in post-marketing surveillance of newly marketed drugs.[1] Because of aggressive marketing to physicians and direct-to- consumer advertising in the US, a new drug can now have very rapid dissemination, exposing large populations in a short time. Passive surveillance with ambiguous definitions of adverse effects may ofte...

    Show More
  • The junior doctor's perspective
    Waheeda Rahman

    Dear Editor

    In response to the recent article in QSHC by A Coulter,[1] as a junior ophthalmic surgeon in training it worries me to see such views expressed as it has seriously detrimental consequences on our training.

    It seems that Ms Coulter is suggesting that only Consultants or very senior, experienced surgeons should be operating on patients and any "junior" member operating would put a patient at ser...

    Show More

Pages