7 e-Letters

published between 2009 and 2012

  • Extension of Emergency Care Summary availability in Secondary Care
    Libby Morris

    The authors of the article 'Perceived Causes of Prescribing Errors by Junior Doctors in Hospitals' published in the BMJ Quality & Safety on 30 October 2012 report that "the main task factor identified was poor availability of drug information on admission (often out of hours)" and "Systems which should aid prescribers were not always available (e.g. the Emergency Care Summary was available, but the doctor did not have...

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  • Mandating of the RRS protocol to improve patient care, could this be the next step?
    Frances K. L. Ng

    I appreciated Shearer et al's recent article in BMJQS[1], it brings to light the debilitating effects of ill-placed social and cultural influences, and the professional hierarchies evident in all hospitals. The issues identified from the research further validate the necessity for a systems approach when dealing with clinical risk management[2]. That said, mandating rapid response systems (RRS) as part of hospital protocol...

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  • Innovative Ways to improve quality of discharge summaries
    Narveshwar Sinha

    We read the article on discharge summaries by Mohta et al with interest. We passionately believe that we must keep trying innovative methods to improve the quality of this most important handover document of care. Earlier this month, our audit to evaluate the extent to which contents of all fields in the electronic discharge summary template are completed with relevant information, revealed that the trainees had failed to...

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  • ANOM Chart: A Chart Worth Getting to Know
    Karen Homa

    I appreciated seeing an introduction of analysis of means (ANOM) by Mohammed and Holder. As stated in their article, the technique is not well known, but nonetheless I would like to encourage people to learn this useful graphical display to compare groups. I have been using this method in healthcare improvement work (1,2) and would like to share a couple of lessons learned over the years. The proportion ANOM chart should...

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  • Translating technical improvements into behavioural ones the sustainability challenge
    Sarah W. Fraser

    There is a paucity of papers focused on the sustainability of improvement projects. In addition, the authors and the VA are to be congratulated on sharing what are less-than-positive results so we can all learn.

    The quality improvement collaborative (QIC) process is excellent in raising awareness of issues, training staff in QI techniques and in mobilising action to improve. With all methods there are some gain...

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  • Behavioural theory is not new to Patient Safety Practices (PSPs)
    John G Wakefield

    Dear Editor,

    We welcome the recent Original Viewpoint paper by Foy et al1, titled The role of theory in research to develop and evaluate the implementation of patient safety practices. We strongly support the recommendations in this paper, and in particular, the application of behavioural change theory in the design, implementation and evaluation of Patient Safety Practices (PSPs).

    However, on rea...

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  • The Systems Approach, Disasters, Errors and Patient Safety: Some Comments on Travalgia et al., (2010)
    Patrick E. Waterson

    Travaglia et al's recent paper in BMJQS[1] alongside their earlier work[2] provides some valuable insights into research which has been carried out on large-scale disasters and accidents. This type of work has the potential to move patient safety away from a focus on individual error and towards the adoption of a wider and more inclusive perspective on the failure of whole health care systems such as hospital.[3] That sa...

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