Themed issue on Quality & Safety plus HSJ roundup.<\/strong><\/span><\/p>\n Considering chance in quality and safety performance measures: an analysis of performance reports by boards in English NHS trusts – BMJ Quality & Safety. Schmidtke, K. A., Poots, A. J., Carpio, J., Vlaev, I., Kandala, N.-B., Lilford, R. J.<\/strong> How might health services capture patient-reported safety concerns in a hospital setting? An exploratory pilot study of three mechanisms – BMJ Quality & Safety, \u00a0O’Hara, J. K., Armitage, G., Reynolds, C., Coulson, C., Thorp, L., Din, I., Watt, I., Wright, J.<\/strong> Self-care after hospital discharge: knowledge is not enough – BMJ Quality & Safety,\u00a0Horwitz, L. I.<\/strong> Turning the page on hospital communications slowly – BMJ Quality & Safety, Wu, R.<\/strong> Closing the loop: a process evaluation of inpatient care team communication – BMJ Quality & Safety, Kummerow Broman, K., Kensinger, C., Hart, H., Mathisen, J., Kripalani, S.<\/strong> Understanding patient-centred readmission factors: a multi-site, mixed-methods studytags: Editor’s choice – BMJ Quality & Safety,\u00a0Greysen, S. R., Harrison, J. D., Kripalani, S., Vasilevskis, E., Robinson, E., Metlay, J., Schnipper, J. L., Meltzer, D., Sehgal, N., Ruhnke, G. W., Williams, M. V., Auerbach, A. D.<\/strong> The role of embedded research in quality improvement: a narrative review\u00a0 – BMJ Quality & Safety Vindrola-Padros, C., Pape, T., Utley, M., Fulop, N. J.<\/strong>
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\nHospital board members are asked to consider large amounts of quality and safety data with a duty to act on signals of poor performance. However, in order to do so it is necessary to distinguish signals from noise (chance). This article investigates whether data in English National Health Service (NHS) acute care hospital board papers are presented in a way that helps board members consider the role of chance in their decisions.<\/a><\/p>\n
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\nEmergent evidence suggests that patients can identify and report safety issues while in hospital. However, little is known about the best method for collecting information from patients about safety concerns. This study presents an exploratory pilot of three mechanisms for collecting data on safety concerns from patients during their hospital stay. Interviewing at the patient’s bedside is likely to be the most effective means of gathering safety concerns<\/a> from inpatients, potentially providing an opportunity for health services to gather patient feedback about safety from their perspective.<\/p>\n
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\nIn this issue of BMJ Quality and Safety, Greysen and colleagues present results of a large, multi-institutional interview study of readmitted patients\u2019 perspectives of post-discharge care<\/a>. Investigators interviewed over 1000 patients while they were readmitted to one of 12 academic medical centres and asked them a variety of questions about barriers to recovery after their previous discharge. More than half of patients reported difficulty carrying out the care plan given to them when they were first discharged from the hospital, even though the vast majority reported no difficulties understanding what they were supposed to do.<\/p>\n
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\nIn hospitals, breakdowns in communication has been found to be a major source of errors<\/a>. Communication between clinicians can occur at scheduled times or rounds, through face-to-face meetings or may be facilitated through the use of communication tools such as pagers. For the latter, often urgent communication between clinicians about a patient is required. Problems in communication can result in a failure to rescue or result in poor coordination of care.<\/p>\n
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\nInterprofessional communication is a core component of healthcare delivery in inpatient settings and a key contributor to safe and efficient inpatient care<\/a>. Communication is implicated in two-thirds of medical errors and accounts for a significant proportion of nurse and clinician time. Inpatient teams rely on multiple communication methods ranging from paging and stationary telephones to wireless mobile devices, but comparative evaluations of communication systems are largely limited to qualitative outcomes. With respect to safety and efficiency, key measures of communication system performance include frequency of task disruption and reliability of \u2018closed loop\u2019 communication, meaning the sender receives a sufficient response to address the communication need. We sought to understand communication processes in two different patient care areas of a single hospital using traditional (non-mobile) versus mobile phones…<\/p>\n
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\nPatient concerns at or before discharge inform many transitional care interventions; few studies examine patients\u2019 perceptions of self-care and other factors related to readmission. Patients readmitted within 30 days reported understanding their discharge plans, but frequent difficulties in self-care <\/a>and low anticipatory guidance for resolving these issues after discharge.<\/p>\n
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\nThe use of research evidence to facilitate improvements <\/a>in healthcare quality continues to be a topic widely debated by scholars and practitioners. The concept of \u2018knowledge mobilisation\u2019 has been developed, with strategies to help bridge this gap. These strategies include the development of “a culture of partnership between academic researchers and decision-makers to assist in strengthening the development of policy, practice and social innovation, or the co-production of knowledge”. It is based on the premise that knowledge that is collected and created \u2018on the ground\u2019, through daily interaction and negotiation with practitioners, managers and service users, will provide better insight into the issues affecting these stakeholders, be more relevant to the local context and will, therefore, be more easily incorporated into changes in practice.<\/p>\n
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