24 e-Letters

published between 2011 and 2014

  • 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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  • Any value of Early Warning Systems must rely on the prevalence of the conditions being sought
    Susan Bewley

    Mackintosh et al. have made a useful contribution to the literature about pregnant and parturient's safety (1). The purpose of an Early Warning System (EWS) is to take action before deterioration that may require multiorgan support in intensive care. The ethnographic technique revealed many perceived benefits of a simple, graphic monitoring tool that empowered escalation of concerns. The research team highlighted incons...

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  • Separating fact from opinion - A response to 'The science of human factors: Separating fact from fiction'
    Melissa T. Baysari

    In their paper 'The science of human factors: separating fact from fiction', Russ et al present a description of the human factors (HF) discipline, and discuss several cases where the science of HF has been misapplied in healthcare [1].

    On examining some of the examples of misapplication they provide, it became apparent that in most cases the term 'human factors' was used to describe factors relating to human...

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  • We need to teach leadership and quality improvement to all doctors, not just a select few.
    Rob M. Bethune

    We read with interest and agreement the editorial by Claire Lemur and Fiona Moss(1). We very much concur with the point that we have to engage the next generation of clinicians in quality improvement to ensure the future of healthcare. In the article several leadership programmes are mentioned and in addition we would add the NHS Medical Directors Clinical Fellow Scheme(2). However all of these schemes involve a small...

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  • Re: Harnessing the cloud of patient experience: using social media to detect poor quality healthcare
    Courtney R. Lyles

    January 31, 2013

    To the editors:

    We were pleased to read the recent article by Greaves et al.1 outlining new methodological techniques to analyze patients' online ratings of care. We agree with the authors that social media websites represent a wealth of first-hand patient experiences with health and healthcare, but have largely remained untapped by biomedical researchers - especially to gain new insi...

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  • Engaging junior doctors in patient safety: Don't forget the basics
    Maria Ahmed

    We read the study by Durani et al (1) and the accompanying editorial (2) with great interest. Aspiring to engage junior doctors in the safety and quality movement is a noble aim but in doing so it is essential to consider the influences of both the formal (explicit) curriculum and the informal ('hidden') curriculum on doctors in training. We feel that whilst Durani et al's questionnaire may be useful to chart temporal tre...

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  • 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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