Publications
276 results found
Brown K, Fraser G, Ramsay M, et al., 2011, Attitudinal and demographic predictors of measles-mumps-rubella vaccine (MMR) uptake during the UK catch-up campaign 2008-09: cross-sectional survey, PLOS One, Vol: 6, ISSN: 1932-6203
Background and ObjectiveContinued suboptimal measles-mumps-rubella (MMR) vaccine uptake has re-established measles epidemic risk, prompting a UK catch-up campaign in 2008–09 for children who missed MMR doses at scheduled age. Predictors of vaccine uptake during catch-ups are poorly understood, however evidence from routine schedule uptake suggests demographics and attitudes may be central. This work explored this hypothesis using a robust evidence-based measure.DesignCross-sectional self-administered questionnaire with objective behavioural outcome.Setting and Participants365 UK parents, whose children were aged 5–18 years and had received <2 MMR doses before the 2008–09 UK catch-up started.Main Outcome MeasuresParents' attitudes and demographics, parent-reported receipt of invitation to receive catch-up MMR dose(s), and catch-up MMR uptake according to child's medical record (receipt of MMR doses during year 1 of the catch-up).ResultsPerceived social desirability/benefit of MMR uptake (OR = 1.76, 95% CI = 1.09–2.87) and younger child age (OR = 0.78, 95% CI = 0.68–0.89) were the only independent predictors of catch-up MMR uptake in the sample overall. Uptake predictors differed by whether the child had received 0 MMR doses or 1 MMR dose before the catch-up. Receipt of catch-up invitation predicted uptake only in the 0 dose group (OR = 3.45, 95% CI = 1.18–10.05), whilst perceived social desirability/benefit of MMR uptake predicted uptake only in the 1 dose group (OR = 9.61, 95% CI = 2.57–35.97). Attitudes and demographics explained only 28% of MMR uptake in the 0 dose group compared with 61% in the 1 dose group.ConclusionsCatch-up MMR invitations may effectively move children from 0 to 1 MMR doses (unimmunised to partially immunised), whilst attitudinal interventions highlighting social benefits of MMR may effectively move children from 1 to 2 MMR doses (partially to fully immunised). Older children may be best targeted th
Symons NRA, Wong HWL, Sevdalis N, et al., 2011, Non-technical skills in surgical shift handover: it's not just the content that matters, International Surgical Congress of the Association-of-Surgeons-of-Great-Britain-and-Ireland, Publisher: WILEY-BLACKWELL, Pages: 32-32, ISSN: 0007-1323
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- Citations: 1
Symons NRA, Almoudaris A, Nagpal K, et al., 2011, Preventable failures in post-operative care: a potential target for quality improvement, International Surgical Congress of the Association-of-Surgeons-of-Great-Britain-and-Ireland, Publisher: WILEY-BLACKWELL, Pages: 4-4, ISSN: 0007-1323
Anderson O, West J, Davey G, et al., 2011, Designing Out Medical Error/The Care Station (practical demonstration), Clinical Human Factors Group Seminar. Imperial College London, UK
Vincent C, Batalden P, Davidoff F, 2011, Multidisciplinary centres for safety and quality improvement: learning from climate change science, BMJ QUALITY & SAFETY, Vol: 20, Pages: I73-I78, ISSN: 2044-5415
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- Citations: 14
Nagpal K, Abboudi M, Fischler L, et al., 2011, Evaluation of Postoperative Handover Using a Tool to Assess Information Transfer and Teamwork, ANNALS OF SURGERY, Vol: 253, Pages: 831-837, ISSN: 0003-4932
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- Citations: 80
Pinto A, Benn J, Burnett S, et al., 2011, Predictors of the perceived impact of a patient safety collaborative: an exploratory study, International Journal for Quality in Health Care, Vol: 23, Pages: 173-181
Objective The aim of this study was to evaluate the influence of various factors on the perceived impact of a patient safety improvement collaborative in the UK, the Safer Patients Initiative (SPI).Study design A cross-sectional survey design was used.Study setting Twenty National Health Service organizations from the UK that participated in the main phase of the SPI programme, which ran from September 2007 to 2008.Participants Senior executive leads, clinical operational leads in the four clinical areas targeted by the programme, programme coordinators and any other staff involved in the SPI (n= 635).Intervention The SPI is a patient safety improvement intervention based on the Breakthrough Series Collaborative model (Institute of Healthcare Improvement, 2004) aimed at improving patient safety in four clinical areas (general ward care, intensive care, perioperative care and pharmacy) through implementing a number of evidence-based clinical practices and a focus on organizational leadership.Outcome measures Participant perceptions of the impact of the programme on their organizations.Results Exploratory regression analysis showed that programme management, the value assigned to programme methodology and length of data collection contributed the largest variance in perceived impact of the SPI followed by perceived support from junior doctors, inter-professional collaboration, difference of the programme from existing safety improvement practices and organizational readiness.Conclusions The resulting model suggests hierarchical importance for a range of variables to support future research concerning the mechanisms by which large-scale organizational programmes, such as the SPI, impact on the care systems they are designed to influence.
Lamb BW, Brown KF, Nagpal K, et al., 2011, Quality of care management decisions by multidisciplinary cancer teams: A systematic review, Annals of Surgical Oncology
Background: Factors that affect the quality of clinical decisions of multidisciplinary cancer teams (MDTs) are not well understood. We reviewed and synthesised the evidence on clinical, social, and technological factors that affect the quality of MDT clinical decision-making. Methods: Electronic databases were searched in May 2009. Eligible studies reported original data, quantitative or qualitative. Data were extracted and tabulated by two blinded reviewers, and study quality formally evaluated. Results: Thirty-seven studies were included. Study quality was low to medium. Studies assessed quality of care decisions via the effect of MDTs on care management. MDTs changed cancer management by individual physicians in 2-52% of cases. Failure to reach a decision at MDT discussion was found in 27-52% of cases. Decisions could not be implemented in 1-16% of cases. Team decisions are made by physicians, using clinical information. Nursing personnel do not have an active role and patient preferences are not discussed. Time pressure, excessive caseload, low attendance, poor teamworking and lack of leadership lead to lack of information and deterioration of decision-making. Telemedicine is increasingly used in developed countries, with no detriment to quality of MDT decisions. Conclusions: Team/social factors affect management decisions by cancer MDTs. Inclusion of time to prepare for MDTs into team-members job plans, making team and leadership skills training available to team-members, and systematic input from nursing personnel would address some of the current shortcomings. These improvements ought to be considered at national policy level, with the ultimate aim of improving cancer care.
Healey AN, Nagpal K, Moorthy K, et al., 2011, Engineering the system of communication for safer surgery, COGNITION TECHNOLOGY & WORK, Vol: 13, Pages: 1-10, ISSN: 1435-5558
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- Citations: 9
Brown KF, Shanley R, Cowley NAL, et al., 2011, Attitudinal and demographic predictors of measles, mumps and rubella (MMR) vaccine acceptance: Development and validation of an evidence-based measurement instrument, VACCINE, Vol: 29, Pages: 1700-1709, ISSN: 0264-410X
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- Citations: 31
Davis RE, Sevdalis N, Vincent CA, 2011, Patient involvement in patient safety: How willing are patients to participate?, BMJ Qual Saf, Vol: 20, Pages: 108-114
BACKGROUND: Despite growing recognition internationally that patients can help to promote their own safety, little evidence exists on how willing patients are to take on an active role. OBJECTIVES: To investigate medical and surgical patients' perceived willingness to participate in different safety-related behaviours and the potential impact of doctors'/nurses' encouragement on patients' willingness levels. DESIGN: Cross-sectional exploratory study using a survey that addressed willingness to participate in different behaviours recommended by current patient safety initiatives. Interactional behaviours (asking factual or challenging questions, notifying doctors or nurses of errors or problems) and non-interactional behaviours (choosing a hospital based on the safety record, bringing medicines and a list of allergies into hospital, and reporting an error to a national reporting system) were assessed. PARTICIPANTS: 80 medical and surgical patients from an inner city London teaching hospital. Findings Patients' perceived willingness to participate was affected (p<0.05) by the action required by the patient and (for interactional behaviours) whether the patient was engaging in the specific action with a doctor or nurse. Patients were less willing to participate in challenging behaviours. Doctors' and nurses' encouragement appeared to increase patient-reported willingness to ask challenging questions, but no other consistent findings were observed. CONCLUSION: Patients do not view involvement in a range of safety-related behaviours uniformly. Particular efforts are needed to encourage patients to participate in novel or challenging behaviours as these are behaviours where patients appear less inclined to take on an active role.
Davis RE, Vincent CA, Murphy MF, 2011, Blood transfusion safety: the potential role of the patient., Transfus Med Rev, Vol: 25, Pages: 12-23
UNLABELLED: There are many initiatives to reduce transfusion-related errors. However, one important intervention that remains largely unexplored is that of patient involvement. This article considers the patients' role in ensuring safe care along the transfusion trajectory. STUDY DESIGN AND METHODS: Empirical data on patients' attitudes to, and involvement in, transfusion-related behaviors were systematically reviewed. Opportunities for patient involvement in transfusion processes were identified by extant national guidelines and expert consultation. RESULTS: A number of transfusion-related behaviors in which patients can participate were highlighted, but to date, little is known about patients' preferences for taking on an active role. Many patients have no recollection of consenting to a blood transfusion, and some are not even aware they have been transfused. Information provided to patients about transfusion is often poorly understood. Patients have a number of misconceptions about the safety of blood transfusion, and the way in which information is presented to patients can significantly affect their level of confidence and subsequent acceptance in receiving a blood transfusion. SUMMARY: One important intervention that could help to improve the quality and safety of the blood transfusion process is involvement of the patient themselves. This article considers the patients' role in ensuring safe care at different stages of the transfusion trajectory. The literature on patients' attitudes to, and involvement in, transfusion-related behaviors was systematically reviewed and opportunities for patient involvement were identified. The evidence suggests that although there is considerable potential for patients to be involved in different blood transfusion processes, it is very unclear at present how able and willing patients would be to take on an active role in this aspect of their health care management. Research in this area is paramount in helping to inform the d
Davis R, Vincent C, Henley A, et al., 2011, Exploring the care experience of patients undergoing spinal surgery: A qualitative study, Journal of Evaluation and Clinical Practice
Davis R, Sevdalis N, Pinto A, et al., 2011, Patients’ attitudes towards patient safety interventions: Results of two exploratory studies, Health Expectations
Almoudaris AM, Burns EM, Mamidanna R, et al., 2011, Value of failure to rescue as a marker of the standard of care following reoperation for complications after colorectal resection, The British journal of surgery, Vol: 98, Pages: 1775-1783, ISSN: 1365-2168
BACKGROUND: Complication management appears to be of vital importance to differences in survival following surgery between surgical units. Failure-to-rescue (FTR) rates have not yet distinguished surgical from general medical complications. The aim of this study was to assess whether variability exists in FTR rates after reoperation for serious surgical complications following colorectal cancer resections in England. METHODS: The Hospital Episode Statistics (HES) database was used to identify patients undergoing primary resection for colorectal cancer between 2000 and 2008 in English National Health Service (NHS) trusts. Units were ranked into quintiles according to overall risk-adjusted mortality. Highest and lowest mortality quintiles were compared with respect to reoperation rates and FTR-surgical (FTR-S) rates. FTR-S was defined as the proportion of patients with an unplanned reoperation who died within the same admission. RESULTS: Some 144 542 patients undergoing resection for colorectal cancer in 150 English NHS trusts were included. On ranking according to risk-adjusted mortality, rates varied significantly between lowest and highest mortality quintiles (5.4 and 9.3 per cent respectively; P = 0.029). Lowest and highest mortality quintiles had equivalent adjusted reoperation rates (both 4.8 per cent; P = 0.211). FTR-S rates were significantly higher at units within the worst mortality quintile (16.8 versus 11.1 per cent; P = 0.002). CONCLUSION: FTR-S rates differed significantly between English colorectal units, highlighting variability in ability to prevent death in this high-risk group. This variability may represent differences in serious surgical complication management. FTR-S represents a readily collectable marker of surgical complication management that is likely to be applicable to other surgical specialties. Copyright (c) 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Pinto A, Burnett S, Benn J, et al., 2011, Improving reliability of clinical care practices for ventilated patients in the context of a patient safety improvement initiative, Journal of evaluation in clinical practice, Vol: 17, Pages: 180-187, ISSN: 1365-2753
Almoudaris AM, Clark S, Vincent C, et al., 2011, Establishing quality in colorectal surgery, Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, Vol: 13, Pages: 961-973, ISSN: 1463-1318
AIM: The review aimed to offer a contemporary perspective of the quality of current colorectal surgery. METHOD: A literature search was undertaken to identify relevant indicators. Citations were included if they related to quality in colorectal surgery. The search terms used included the Medical Subject Heading terms and Boolean characters: 'colon' OR 'colorectal', OR 'rectal' OR 'rectum' AND 'Quality Indicators', OR 'Quality Assurance', OR 'Quality of healthcare', OR 'Reference Standards', OR 'Quality' plus a variable floating term. A two-person independent review was undertaken from resulting citations and their consequent reference lists. The search was limited to citations from 2000 to 2010 in humans and to the English language. RESULTS: Metrics identified as potential quality indicators in colorectal surgery are discussed according to the structure, process and outcome framework. CONCLUSION: A clear appreciation of the scope of individual metrics for quality appraisal purposes is necessary if they are to be used meaningfully for performance benchmarking.
Anderson O, Norris B, West J, et al., 2011, Using the systems approach to design out medical error (abstract)., London, Publisher: Taylor & Francis Group, ISBN: 9780415684132
Lamb BW, Sevdalis N, Vincent C, et al., 2011, Development and evaluation of a checklist to support decision-making in cancer multidisciplinary team meetings: MDT-QuIC, Ann Surg Oncol
Sevdalis N, Jacklin R, Arora S, et al., 2010, Diagnostic error in a national incident reporting system in the UK, JOURNAL OF EVALUATION IN CLINICAL PRACTICE, Vol: 16, Pages: 1276-1281, ISSN: 1356-1294
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- Citations: 32
Anderson O, West J, Davey G, et al., 2010, Identifying and prioritizing high-risk processes in elective general surgery wards (poster - winner of prize for best research poster), 3rd North British Patient Safety Research Symposium, Bradford, UK
Anderson O, West J, Davey G, et al., 2010, Designing out preventable patient harm on general surgery wards (oral presentation - winner of prize for most innovative patient safety research project), 3rd North British Patient Safety Research Symposium, Bradford, UK
Anderson O, Brodie A, Vincent CA, et al., 2010, An analysis of risk on general surgery wards: failure mode and effects analysis of six high-risk processes (poster), International Society of Quality and Safety in Healthcare (ISQua), Paris, France
Fox J, Glasspool D, Patkar V, et al., 2010, Delivering clinical decision support services: There is nothing as practical as a good theory, JOURNAL OF BIOMEDICAL INFORMATICS, Vol: 43, Pages: 831-843, ISSN: 1532-0464
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- Citations: 38
Parand A, Burnett S, Benn J, et al., 2010, Medical engagement in organisation-wide safety and quality-improvement programmes: experience in the UK Safer Patients Initiative, QUALITY & SAFETY IN HEALTH CARE, Vol: 19, ISSN: 1475-3898
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- Citations: 19
Wears RL, Woloshynowych M, Brown R, et al., 2010, Reflective analysis of safety research in the hospital accident & emergency departments, APPLIED ERGONOMICS, Vol: 41, Pages: 695-700, ISSN: 0003-6870
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- Citations: 36
Walker S, Lambden S, Mckay A, et al., 2010, UNANNOUNCED IN SITU SIMULATION REPRESENTS A REALISTIC METHOD FOR TEACHING THE TECHNICAL AND NON-TECHNICAL SKILLS REQUIRED FOR RESUSCITATION, 23rd Annual Meeting of the European-Society-of-Intensive-Care-Medicine, Publisher: SPRINGER, Pages: S267-S267, ISSN: 0342-4642
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- Citations: 1
Walker S, Lambden S, Mckay A, et al., 2010, DEVELOPMENT, RELIABILITY, AND CONTENT VALIDATION OF THE OBSERVATIONAL SKILL-BASED CLINICAL ASSESSMENT FOR RESUSCITATION (OSCAR), 23rd Annual Meeting of the European-Society-of-Intensive-Care-Medicine, Publisher: SPRINGER, Pages: S328-S328, ISSN: 0342-4642
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- Citations: 1
de Saint Maurice G, Auroy Y, Vincent C, et al., 2010, The natural lifespan of a safety policy: violations and system migration in anaesthesia, QUALITY & SAFETY IN HEALTH CARE, Vol: 19, Pages: 327-331, ISSN: 1475-3898
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- Citations: 17
Nagpal K, Vats A, Lamb B, et al., 2010, Information Transfer and Communication in Surgery <i>A Systematic Review</i>, ANNALS OF SURGERY, Vol: 252, Pages: 225-239, ISSN: 0003-4932
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- Citations: 144
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