37 e-Letters

published between 2012 and 2015

  • '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...

    Show More
    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...

    Show More
  • 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...

    Show More
  • 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...

    Show More
  • 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...

    Show More
  • 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...

    Show More
  • 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...

    Show More
  • 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...

    Show More
  • 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...

    Show More
  • 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...

    Show More