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"Quality is everyone's responsibility."
W. Edwards Deming


Rapid response team’s effect on hospital mortality

In a French teaching hospital, the "implementation of an intensivist-led RRT along with educational modules, publicity and bedside simulation-based training was associated with a significant decrease in unexpected and overall mortality of inpatients."

Source: Intensive Care Medicine 2016; 42(4): 494-504

Further reading

The April 2016 issue of Intensive Care Medicine contains 3 additional editorial articles on rapid response teams (RRT) and their impacts. The various authors who include Austin authors Daryl Jones & Rinaldo Bellomo, offer a range of perspectives on whether RRTs improve patient outcomes and (collectively) call for research to determine ideal RRT staffing, factors that contribute to the need for an RRT, and how rapid response affects the safety of patients.
Source: Intensive Care Medicine 2016; 42(4)


Junior doctors’ prescribing errors

Authors use a mixed-methods evaluation to identify how prescribing errors are occurring in a large UK teaching hospital. This quality improvement project was to reduce errors which had been established as occurring in up to 15% of medication orders written for UK hospital inpatients, resulting in harm to an estimated 1%-2%.

Source: BMJ Quality & Safety 2016; online first 4 April


Optimising severe maternity care incident reviews

This study calls for improvement of hospital's local reviews of reporting on the care of women with several maternal morbidity. "Very few reviews involved patients, despite recent initiatives to improve transparency in examining the quality of care". Authors provide evidence that improvement will come if a multidisciplinary approach is adopted locally, and "ideally this would be managed as a separate process to those that include individual disciplinary procedures."

Source: BMJ Quality & Safety 2016; online first 24 March


Electronic health record adoption & adverse events

This study was a retrospective analysis of patient discharges (using data from US acute care hospitals) covering adult patients hospitalised with either: acute cardiovascular disease; pneumonia, or conditions requiring surgery. Primary outcomes were the occurrence rates of the 21 in-hospital adverse events grouped into: hospital-acquired infections, adverse drug events, general events (such as falls and pressure ulcers) and post-procedural events for which patients were at risk during their hospitalisation. Among all study patients, the occurrence rate of adverse events was 2.3 % (7,820 adverse events). However, as the authors report, "patients exposed to fully electronic health records, however, had 17-30 % lower odds of any adverse event."

Source: Journal of Patient Safety 2016; online first 31 March

Further reading

Safety in e-health – ACSQHC
E-Health programs have the aim of improving the quality of health care. The main elements of Commission's Safety in E-Health program are:

  • Optimising safety and quality within the rollouts of clinical systems, with an initial focus on discharge summary and hospital medications management programs
  • Using E-Health initiatives to improve the safety and quality of health care

Source: Safety in E-Health. Australian Commission on Safety and Quality in Health Care


Private hospital rising faster than public hospital admissions

"In 2014-15, there were about 10.2 million separations (episodes of care) in Australia's public and private hospitals: about 6.0 million of these occurred in public hospitals; 94% of separations were for acute care and 4% for rehabilitation care. Between 2010-11 and 2014-15: the number of separations increased overall by 3.5% on average each year; by 3.2% for public hospitals and by 4.0% for private hospitals; private health insurance funded separations increased by an average of 5.9% each year and; public patient separations increased by 2.7% each year."

Source: Admitted patient care 2014-15: Australian hospital statistics. Australian Institute of Health and Welfare, 2016


Austin Health Research Online - recent submissions

Rapid response teams improve outcomes: we are not sure. Wendon J, Hodgson C, Bellomo R. Intensive Care Medicine 2016; 42(4): 599-601

Rapid response teams improve outcomes: yes. Jones D, Rubulotta F, Welch J. Intensive Care Medicine 2016; 42(4): 593-595

Australian patterns of prostate cancer care: are they evolving?. Lo J, Papa N, Bolton DM. Prostate International 2016; 4(1): 20-24

Me and my neurological illness: weightlifter's headache. Simpson M. Practical Neurology 2016; online first: 16 March

A targeted resequencing gene panel for focal epilepsy. Hildebrand M, Myers C, Carvill G, Regan B, Damiano J, Mullen S, Newton M, Nair U, Gazina E, Milligan C, Reid C, Petrou S, Scheffer I, Berkovic S, Mefford H. Neurology 2016; online first: 30 March

Colonoscopic localization accuracy for colorectal resections in the laparoscopic era. Yap R, Ianno D, Burgess A. The American Journal of Surgery 2016; online first: 22 February

Correlation of visceral adipose tissue measured by Lunar Prodigy dual x-ray absorptiometry with MRI and CT in older men. Cheung AS, de Rooy C, Hoermann R, Gianatti EJ, Hamilton EJ, Roff G, Zajac JD, Grossmann M. International Journal of Obesity 2016; online first: 22 March
Full text available for Austin & MHW Heidelberg staff via document delivery

Glaucarubinone combined with gemcitabine improves pancreatic cancer survival in an immunocompetent orthotopic murine model. Yeo D, Huynh N, Beutler J, Baldwin G, He H, Nikfarjam M. Journal of Investigative Surgery 2016; online first: 30 March

See more at AHRO, Austin Health Research Online


eBooks spotlight

Remington and Klein's infectious diseases of the fetus and newborn infant / edited by CB Wilson, V. Nizbet, YA Maldonado - 8th ed. - Elsevier Saunders, 2016.
An up-to-date guidance on infections found in utero during delivery and in the neonatal period in both premature and term infants.

Stroke : pathophysiology, diagnosis and management / edited by James C. Grotta et al. - 6th ed. - Elsevier, 2016.
This new edition highlights new information on genetic risk factors, primary prevention of stroke, infectious diseases and stroke; recovery interventions such as robotics, brain stimulation, and telerehabilitation.

New books on display

Textbook of Post-ICU medicine : the legacy of critical care / edited by Robert D Stevens, N. Hart, MS Herridge - Oxford University Press, 2014.
This book discusses the science of the recovery process and the approaches helping ICU survivors regain function as they heal following trauma or disease.

Oxford textbook of palliative nursing / edited by Betty R. Ferrell, Nessa Coyle, Judith A. Paice - 4th ed. - Oxford University Press, 2015.
This new edition includes chapters on topics such as the National Consensus Project for Quality Palliative Care Guidelines, palliative care for veterans, and palliative care in rural settings.


Journals spotlight

These links provide access to the current table of contents:

American Journal of Infection Control

American Journal of Respiratory and Critical Care Medicine

British Journal of Clinical Pharmacology

Cancer Immunology, Immunotherapy

Family Process

Journal for ImmunoTherapy of Cancer

The Journal of Maternal - Fetal & Neonatal Medicine

Journal of Palliative Medicine

Journal of the National Cancer Institute

Journal of Substance Abuse Treatment

Lancet Neurology

Quality of Life Research

Worldviews on Evidence-Based Nursing

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