(Oak Brook Ill.) Joint Commission Resources announces the January 2013 issue of the The Joint Commission Journal on Quality and Patient Safety. In the lead article for the January 2013 issue, “A Mixed-Methods Analysis of Patient Reviews of Hospital Care in England: Implications for Public Reporting of Health Care Quality Data in the United States,” Tara Lagu and colleagues at Baystate Medical Center, Springfield, Massachusetts, report on their analysis of data collected from hospital patients by the United Kingdom’s National Health Service (NHS) program NHS Choices. They also discuss the lesson that NHS Choices provides on how to increase patient engagement and awareness of information about health care quality in the United States. The January issue also includes an introduction to the nine new members of the Journal’s Editorial Advisory Board.
The Joint Commission Journal on Quality and Patient Safety, published monthly by Joint Commission Resources, is a peer-reviewed journal, available by subscription, and serves as a forum for practical approaches to improving quality and safety in health care.
Editorial: Patients as Reviewers of Quality and Safety
Gerry Armitage, Ph.D., R.N.; Jane Ward, Ph.D.; Yvonne Birks,
According to the authors, the need for a reasonably rapid response to patient reviews of their care experiences and the ability to analyze, extrapolate, and examine trends in the data will be a significant challenge for many health care systems.
A Mixed-Methods Analysis of Patient Reviews of Hospital Care in England: Implications for Public Reporting of Health Care Quality Data in the United States
Tara Lagu, M.D., M.PH.; Sarah L. Goff, M.D.; Nicholas S. Hannon, B.S.; Amy Shatz, M.P.H.; Peter K. Lindenauer, M.D., M.Sc.
NHS Choices, a quality-reporting website begun by the National Health Service in England in 2007, enables patients to provide narrative feedback about hospital care. Reviews can provide useful and complementary information to consumers (patients) and hospitals, particularly when combined with systematically collected patient experience data.
Cost Reductions Associated with a Quality Improvement Initiative for Patients with ST-Elevation Myocardial Infarction
Chad E. Darling, M.D.; Craig S. Smith, M.D.; Jiaoyuan E. Sun, B.A.; Christian G. Klaucke, B.A.; Joshua Lerner, M.D.; Jay Cyr, R.N., M.S., M.B.A.; Peter G. Paige, M.D., M.M.M., FACEP; Paula Paige, R.N.; Steven B. Bird, M.D.
In a follow-up study to a Cardiac Alert Team initiative, which reduced door-to-balloon times, significant reductions in inpatient care costs – from $14,634 in fiscal years 2005-2006 to $13,308 (2008-2009) and $13,567 (2010-2011) – were also found. The greatest decrease in costs was related to cardiac catheterization, which was likely a result of standardization of care and identification of practice inefficiencies.
National Patient Safety Goals
Anticoagulation Education: Do Patients Understand Potential Medication-Related Emergencies?
Christopher J. Moreland, M.D., M.P.H.; Richard L. Kravitz, M.D., M.S.P.H.; Debora A. Paterniti, Ph.D.; Chin-Shang Li, Ph.D.; Tzu-Chun Lin, Ph.D.; Richard H. White, M.D.
The Joint Commission Venous Thromboembolism (VTE) National Hospital Inpatient Quality Measure VTE-5 outlines four criteria for discharge education of patients starting anticoagulation (usually, warfarin) therapy. Patients showed fair warfarin-related factual knowledge but, when exposed to clinical scenarios, did not appear to recognize well the clinical severity of warfarin-associated scenarios, such as those involving stroke symptoms or medication mismanagement.
Risk and Event Assessment
A Cross-Sectional Study on the Relationship Between Utilization of Root Cause Analysis and Patient Safety at 139 Department of Veterans Affairs Medical Centers
Katherine B. Percarpio, M.S.; B. Vince Watts, M.D., M.P.H.
In a cross-sectional study, root cause analysis (RCA) data were collected for the 139 Department of Veteran Affairs medical centers (VAMCs) in the National Center for Patient Safety database from 2004 through 2006. Large, high-spending VAMCs conducted more RCAs per year than smaller, low-spending facilities, and VAMCs that performed more RCAs developed more corrective actions. VAMCs that completed fewer than four RCAs per year had higher rates of postoperative complications.
The Changing Nature of ICU Charge Nurses’ Decision Making: From Supervision of Care Delivery to Unit Resource Management
Anne Miller, Ph.D.; Peter I. Buerhaus, Ph.D., R.N., FAAN
Recent evidence that variations in nursing workload may affect inpatient outcomes highlight findings from the need for insight into one of the lesser-explored team roles in health care – that of the charge nurse (CN). Observational data for eight CNs, each at one of eight ICUs, suggest that the role of CNs appears to be continuing to evolve, now encompassing unit resource management in addition to supervision of care delivery.
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