53 e-Letters

published between 2014 and 2017

  • Statistical Process Control and Interrupted Time Series
    Alan J Poots

    I read Fretheim and Tomic's article [1] with interest as I trained in frequentist stastistics and now work primarily with Stastistical Process Control (SPC) in quality improvement (QI) initiatives.

    I concur that there are missed opportunities for using Interrupted Time Series (ITS) in QI; however, I note cautions in doing so:

    Regression models applied in ITS often have the assumption of homoscedastici...

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  • Hand Washing is about Respect for Patients
    Daniel L Cohen

    The paper by Redelmeier and Shafir resonated strongly with me because I have always believed that there are important factors that motivate some physicians to wash their hands while others behave differently. I agree completely that this is a more complex issue than has been previously noted. I always wash my hands in front of patients and have done so for over 40 years. This has very little to do with the risks of healthc...

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  • What did Albert Einstein ever do?
    Robert L Wears

    Reed and Card's essay on the problem of valuing action over thought could not have come at a better time. For years, quality and safety mavens have been paraphrasing Goethe -- "Knowing is not enough ... we must do". But the resulting culture of 'do, do, do' has brought us quite a lot of doo-doo.

    To counter this, consider the question, "What did Einstein ever do?" He invented nothing, patented nothing, created n...

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  • Patient-centered bedside rounds-Exploring patient preferences before patient-centered care
    Naseema B Merchant

    Dear Editor,

    It was with great interest that we read the study of O'Leary et al published in the December issue of the journal and were quite surprised by their findings that patient centered- rounds had no impact on patients' perceptions of shared decision making, activation, and satisfaction with care.1

    Previous studies have shown that patients prefer their rounding team conduct rounds at the bedside...

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  • The problem with incident reporting
    Paresh Jobanputra

    Dear Sir or Madam

    I read with interest the editorial by Carl Macrae on incident reporting. I wonder if, in making a detailed comparison with the aviation and other industries, Macrae loses sight of one important reason why health services staff report incidents. My experience suggests that often the purpose of reports is not to learn from incidents but for staff to pre -emptively give their version of events in...

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  • Re:More information on safety culture in long-term care
    Martina Buljac-Samardzic

    We appreciate Dr. Singer's point about a more thorough discussion of the large literature on safety climate and tools for assessing it. Although we did include two of the articles she refers to; not all were included. While acknowledging and discussing other instruments for measuring Patient Safety Climate (PSC), would have made our article more complete, the findings and conclusions of the study would not have changed....

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  • More information on safety culture in long-term care
    Sara Singer

    To the Editor: I was a little surprised to see Buljac-Samardzic et al. in their recent article on safety culture in long-term care state that few tools are available to evaluate the effectiveness of initiatives to improve safety culture in nursing and residential homes. While there may be fewer tools available for nursing and residential homes than inpatient settings, there are several safety climate instruments that are...

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  • Statistical analysis of differences in turnover times among operating theatres
    Franklin Dexter

    Overdyk et al. used remote video auditing with real-time feedback in a surgical suite [1]. As part of their randomized trial clustered by theatre, they report less turnover times among "fast rooms," those generally including 3 or greater cases per day.

    Successive turnover times between scheduled cases within theatres on the same date tend to be correlated (e.g., caused by same surgeon, nurses, and anaesthetist)....

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  • Public website for interrupted time series and segmented regression
    Robert G Badgett

    We agree with the authors that interrupted time series should be used more often (1). We also agree that the statistics are difficult. We find segmented regression to be the preferable form of interrupted time series (ITS) as traditional ITS with the Davies tests only looks for a change in slope at the breakpoint. This works well if there is not a simultaneous change or shift in the level of the outcome at the breakpoint; howev...

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  • Response to 'Tall Man lettering and potential prescription errors: a time series analysis of 42 children's hospitals in the USA over 9 years' by Feudtner et al
    Zahra Kiani

    We were very interested to read the recent article by Feudtner et a,1 which has stated that Tall Man lettering has not changed the rate of look- alike sound-alike (LASA) related prescription or dispensing medication errors significantly in 42 children`s hospitals form 2004 to 2012. Feudtner et al`s study is a very valuable work because they performed an extensive statistical analysis on routine medication pairs of their h...

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