Publications
125 results found
Johnston MJ, King D, Arora S, et al., 2015, Smartphones let surgeons know WhatsApp: an analysis of communication in emergency surgical teams, American Journal of Surgery, Vol: 209, Pages: 45-51, ISSN: 0002-9610
BackgroundOutdated communication technologies in healthcare can place patient safety at risk. This study aimed to evaluate implementation of the WhatsApp messaging service within emergency surgical teams.MethodsA prospective mixed-methods study was conducted in a London hospital. All emergency surgery team members (n = 40) used WhatsApp for communication for 19 weeks. The initiator and receiver of communication were compared for response times and communication types. Safety events were reported using direct quotations.ResultsMore than 1,100 hours of communication pertaining to 636 patients were recorded, generating 1,495 communication events. The attending initiated the most instruction-giving communication, whereas interns asked the most clinical questions (P < .001). The resident was the speediest responder to communication compared to the intern and attending (P < .001). The participants felt that WhatsApp helped flatten the hierarchy within the team.ConclusionsWhatsApp represents a safe, efficient communication technology. This study lays the foundations for quality improvement innovations delivered over smartphones.
Johnston M, Arora S, King D, et al., 2015, Can a Human Factors Intervention Improve Institutional Safety Culture and Outcomes For Surgical Patients?, International Surgical Congress of the Association-of-Surgeons-of-Great-Britain-and-Ireland (ASGBI), Publisher: WILEY-BLACKWELL, Pages: 86-87, ISSN: 0007-1323
Johnston M, King D, Arora S, et al., 2015, Communication and Supervision of Juniors in Emergency Surgery can be Improved by Smartphone Messaging Services, International Surgical Congress of the Association-of-Surgeons-of-Great-Britain-and-Ireland (ASGBI), Publisher: WILEY-BLACKWELL, Pages: 112-112, ISSN: 0007-1323
Paige JT, Arora S, Fernandez G, et al., 2015, Debriefing 101: training faculty to promote learning in simulation-based training, AMERICAN JOURNAL OF SURGERY, Vol: 209, Pages: 126-131, ISSN: 0002-9610
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- Citations: 41
Johnston M, Arora S, Anderson O, et al., 2015, Uncovering Failures in the Recognition and Management of Post-Operative Complications: a Systematic Risk Assessment of a Safety-Critical Process, International Surgical Congress of the Association-of-Surgeons-of-Great-Britain-and-Ireland (ASGBI), Publisher: WILEY-BLACKWELL, Pages: 87-87, ISSN: 0007-1323
Ahmed M, Arora S, McKay J, et al., 2014, Patient safety skills in primary care: a national survey of GP educators, BMC Family Practice, Vol: 15, ISSN: 1471-2296
BackgroundClinicians have a vital role in promoting patient safety that goes beyond their technical competence. The qualities and attributes of the safe hospital doctor have been explored but similar work within primary care is lacking. Exploring the skills and attributes of a safe GP may help to inform the development of training programmes to promote patient safety within primary care.This study aimed to determine the views of General Practice Educational Supervisors (GPES) regarding the qualities and attributes of a safe General Practitioner (GP) and the perceived trainability of these ‘safety skills’ and to compare selected results with those generated by a previous study of hospital doctors.MethodsThis was a two-stage study comprising content validation of a safety skills questionnaire (originally developed for hospital doctors) (Stage 1) and a prospective survey of all GPES in Scotland (n = 691) (Stage 2).ResultsStage 1: The content-validated questionnaire comprised 66 safety skills/attributes across 17 broad categories with an overall content validation index of 0.92.Stage 2: 348 (50%) GPES completed the survey. GPES felt the skills/attributes most important to being a safe GP were honesty (93%), technical clinical skills (89%) and conscientiousness (89%). That deemed least important/relevant to being a safe GP was leadership (36%). This contrasts sharply with the views of hospital doctors in the previous study. GPES felt the most trainable safety skills/attributes were technical skills (93%), situation awareness (75%) and anticipation/preparedness (71%). The least trainable were honesty (35%), humility (33%) and patient awareness/empathy (30%). Additional safety skills identified as relevant to primary care included patient advocacy, negotiation skills, accountability/ownership and clinical intuition (‘listening to that worrying little inner voice’).ConclusionsGPES believe a broad range of skills and attributes contribut
Ahmed M, Arora S, Tiew S, et al., 2014, Building a safer foundation: the Lessons Learnt patient safety training programme, BMJ QUALITY & SAFETY, Vol: 23, Pages: 78-86, ISSN: 2044-5415
Runnacles J, Thomas L, Sevdalis N, et al., 2014, Development of a tool to improve performance debriefing and learning: the paediatric Objective Structured Assessment of Debriefing (OSAD) tool, POSTGRADUATE MEDICAL JOURNAL, Vol: 90, Pages: 613-621, ISSN: 0032-5473
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- Citations: 19
Shah S, Arora S, Atkin G, et al., 2014, Decision-making in Colorectal Cancer Tumor Board meetings: Results of a prospective observational assessment, SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol: 28, Pages: 2783-2788, ISSN: 0930-2794
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- Citations: 30
Chana P, Johnston MJ, Pullyblank AM, et al., 2014, Identifying Organizational Failures in Emergency General Surgical Admissions in the United Kingdom: A Healthcare Failure Mode Effect Analysis, Annual Clinical Congress of the American-College-of-Surgeons, Publisher: ELSEVIER SCIENCE INC, Pages: S92-S92, ISSN: 1072-7515
Johnston MJ, King D, Arora S, et al., 2014, Requirements of a new communication technology for handover and the escalation of patient care: a multi-stakeholder analysis, Journal of Evaluation in Clinical Practice, Vol: 20, Pages: 486-497, ISSN: 1356-1294
Rationale, aims and objectivesIn order to enable safe and efficient information transfer between health care professionals during clinical handover and escalation of care, existing communication technologies must be updated. This study aimed to provide a user‐informed guide for the development of an application‐based communication system (ABCS), tailored for use in patient handover and escalation of care.MethodsCurrent methods of inter‐professional communication in health care along with information system needs for communication technology were identified through literature review. A focus group study was then conducted according to a topic guide developed by health innovation and safety researchers. Fifteen doctors and 11 nurses from three London hospitals participated in a mixture of homogeneous and heterogeneous sessions. The sessions were recorded and transcribed verbatim before being subjected to thematic analysis.ResultsSeventeen information system needs were identified from the literature review. Participants identified six themes detailing user perceptions of current communication technology, attitudes to smartphone technology and anticipated requirements of an application produced for handover and escalation of care. Participants were in favour of an ABCS over current methods and expressed enthusiasm for a system with integrated patient information and group‐messaging functions.ConclusionDespite concerns regarding confidentiality and information governance a robust guide for development and implementation of an ABCS was produced, taking input from multiple stakeholders into account. Handover and escalation of care are vital processes for patient safety and communication within these must be optimized. An ABCS for health care professionals would be a welcome innovation and may lead to improvements in patient safety.
Bhaludin BN, Shelmerdine SC, Arora S, et al., 2014, Delays and errors in abnormal chest radiograph follow-up: a systems approach to promoting patient safety in radiology, JOURNAL OF EVALUATION IN CLINICAL PRACTICE, Vol: 20, Pages: 453-459, ISSN: 1356-1294
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- Citations: 3
Arora S, Cox C, Davies S, et al., 2014, Towards the Next Frontier for Simulation-Based Training <i>Full-Hospital Simulation Across the Entire Patient Pathway</i>, ANNALS OF SURGERY, Vol: 260, Pages: 252-258, ISSN: 0003-4932
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- Citations: 22
Johnston M, Arora S, King D, et al., 2014, Escalation of care and failure to rescue: a multicenter, multiprofessional qualitative study, Surgery, Vol: 155, Pages: 989-994, ISSN: 0039-6060
BackgroundThe escalation of care process has not been explored in surgery, despite the role of communication failures in adverse events. This study aimed to develop a conceptual framework of the influences on escalation of care in surgery allowing solutions to facilitate management of sick patients to be developed.MethodsA multicenter qualitative study was conducted in three hospitals in London, UK. A total of 41 participants were recruited, including 16 surgeons, 11 surgical PGY1s, six surgical nurses, four intensivists, and four critical care outreach team members. Participants were submitted to semistructured interviews that were analyzed using grounded theory methodology.ResultsA decision to escalate was based upon five key themes: patient, individual, team, environmental, and organizational factors. Most participants felt that supervision and escalation of care were problematic in their hospital, with unclear escalation protocols and poor availability of senior surgical staff the most common concerns. Mobile phones and direct conversation were identified to be more effective when escalating care than hospital pager systems. Transparent escalation protocols, increased senior clinician supervision, and communication skills training were highlighted as strategies to improve escalation of care.ConclusionThis is the first study to describe escalation of care in surgery, a key process for protecting the safety of deteriorating surgical patients. Factors affecting the decision to escalate are complex, involving clinical and professional aspects of care. An understanding of this process could pave the way for interventions to facilitate escalation in order to improve patient outcome.
Sarkar S, Arora S, Soukup T, et al., 2014, Variability in the quality of decision-making processes in urology multidisciplinary teams compared to other cancer specialties, Annual Scientific Meeting of the British-Association-of-Urological-Surgeons (BAUS), Publisher: WILEY-BLACKWELL, Pages: 31-32, ISSN: 1464-4096
Morar P, Read J, Arora S, et al., 2014, SETTING STANDARDS BY DEFINING THE AIMS AND OPTIMAL DESIGN OF THE INFLAMMATORY BOWEL DISEASE (IBD) MULTIDISCIPLINARY TEAM (MDT) MEETING, GUT, Vol: 63, Pages: A165-A165, ISSN: 0017-5749
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- Citations: 1
Mitchell EL, Arora S, Moneta GL, et al., 2014, A systematic review of assessment of skill acquisition and operative competency in vascular surgical training, JOURNAL OF VASCULAR SURGERY, Vol: 59, Pages: 1440-1455, ISSN: 0741-5214
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- Citations: 49
Sarkar S, Arora S, Lamb BW, et al., 2014, Urology MDTs : multi-disciplinary or multi-dysfunctional?, Annual Meeting of the Society-of-Academic-and-Research-Surgery, Publisher: WILEY-BLACKWELL, Pages: 65-66, ISSN: 0007-1323
Hull L, Birnbach D, Arora S, et al., 2014, Improving Surgical Ward Care, ANNALS OF SURGERY, Vol: 259, Pages: 904-909, ISSN: 0003-4932
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- Citations: 14
Sarkar S, Arora S, Lamb BW, et al., 2014, Urology MDTs: multi-disciplinary or multi-dysfunctional?, Conference on Changing Paradigms in Urology (UROFAIR), Publisher: WILEY-BLACKWELL, Pages: 28-28, ISSN: 1464-4096
Sarkar S, Arora S, Soukup T, et al., 2014, Variability in the quality of decision-making processes in urology multidisciplinary teams compared to other cancer specialties, Conference on Changing Paradigms in Urology (UROFAIR), Publisher: WILEY-BLACKWELL, Pages: 27-28, ISSN: 1464-4096
Singh P, Aggarwal R, Pucher PH, et al., 2013, Defining quality in surgical training: perceptions of the profession, 99th Annual Clinical Congress of the American-College-of-Surgeons / 68th Annual Sessions of the Owen H Wangensteen Surgical Forum on Fundamental Surgical Problems, Publisher: ELSEVIER SCIENCE INC, Pages: S119-S119, ISSN: 1072-7515
Johnston M, Arora S, King D, et al., 2013, Preventing failure to rescue by improving the escalation of care process: an intervention study, 99th Annual Clinical Congress of the American-College-of-Surgeons / 68th Annual Sessions of the Owen H Wangensteen Surgical Forum on Fundamental Surgical Problems, Publisher: ELSEVIER SCIENCE INC, Pages: S124-S125, ISSN: 1072-7515
Bharathan R, Arora S, Varma A, et al., 2013, Mental practice restores surgical performance after sleep deprivation: a RCT, International Surgical Congress of the Association-of-Surgeons-of-Great-Britain-and-Ireland (ASGBI), Publisher: WILEY-BLACKWELL, Pages: 22-22, ISSN: 0007-1323
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- Citations: 1
Hull L, Arora S, Symons NRA, et al., 2013, Training Faculty in Nontechnical Skill Assessment <i>National Guidelines on Program Requirements</i>, ANNALS OF SURGERY, Vol: 258, Pages: 370-375, ISSN: 0003-4932
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- Citations: 67
Chatrchyan S, Khachatryan V, Sirunyan AM, et al., 2013, search for new physics in events with same-sign dileptons and b jets in pp collisions at √<i>s</i> = 8 TeV (vol 3, pg 037, 2013), JOURNAL OF HIGH ENERGY PHYSICS, ISSN: 1029-8479
Korndorffer JR, Arora S, Sevdalis N, et al., 2013, The American College of Surgeons/Association of Program Directors in Surgery National Skills Curriculum: Adoption rate, challenges and strategies for effective implementation into surgical residency programs, 5th Annual Meeting of the Consortium-of-ACS-Accredited-Education-Institutes, Publisher: MOSBY-ELSEVIER, Pages: 13-20, ISSN: 0039-6060
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- Citations: 40
Mitchell EL, Lee DY, Arora S, et al., 2013, Improving the Quality of the Surgical Morbidity and Mortality Conference: A Prospective Intervention Study, ACADEMIC MEDICINE, Vol: 88, Pages: 824-830, ISSN: 1040-2446
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- Citations: 50
Bharathan R, Arora S, Darzi A, et al., 2013, Call-associated Acute Fatigue in Surgical Residents-Subjective Perception or Objective Fact? A Cross-sectional Observational Study to Examine the Influence of Fatigue on Surgical Performance, WORLD JOURNAL OF SURGERY, Vol: 37, Pages: 1176-1177, ISSN: 0364-2313
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- Citations: 1
Sevdalis N, Moran A, Arora S, 2013, Methodological issues surrounding 'The mind's scalpel in surgical education: a randomised controlled trial of mental imagery', BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Vol: 120, Pages: 775-776, ISSN: 1470-0328
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- Citations: 5
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