Journal ArticleDOI
Does Systems Thinking Improve the Perception of Safety Culture and Patient Safety
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TLDR
The STEP intervention strengthened understanding of systems thinking and revealed the importance of addressing the nurse as a second victim of medication errors, which is likely to be central to safety culture for nurses.About:
This article is published in Journal of Nursing Regulation.The article was published on 2017-07-01. It has received 18 citations till now. The article focuses on the topics: Patient safety & Workaround.read more
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Journal ArticleDOI
Systems approach to health service design, delivery and improvement: a systematic review and meta-analysis.
Alexander Komashie,James Ward,Tom Bashford,T. Dickerson,Gulsum Kubra Kaya,Yuanyuan Liu,Isla Kuhn,Aslι Günay,Katharina Kohler,Nicholas Boddy,Eugenia O'Kelly,Joseph Masters,John Dean,Catherine Meads,P. John Clarkson +14 more
Abstract: Objectives To systematically review the evidence base for a systems approach to healthcare design, delivery or improvement. Design Systematic review with meta-analyses. Methods Included were studies in any patients, in any healthcare setting where a systems approach was compared with usual care which reported quantitative results for any outcomes for both groups. We searched Medline, Embase, HMIC, Health Business Elite, Web of Science, Scopus, PsycINFO and CINAHL from inception to 28 May 2019 for relevant studies. These were screened, and data extracted independently and in duplicate. Study outcomes were stratified by study design and whether they reported patient and/or service outcomes. Meta-analysis was conducted with Revman software V.5.3 using ORs—heterogeneity was assessed using I2 statistics. Results Of 11 405 records 35 studies were included, of which 28 (80%) were before-and-after design only, five were both before-and-after and concurrent design, and two were randomised controlled trials (RCTs). There was heterogeneity of interventions and wide variation in reported outcome types. Almost all results showed health improvement where systems approaches were used. Study quality varied widely. Exploratory meta-analysis of these suggested favourable effects on both patient outcomes (n=14, OR=0.52 (95% CI 0.38 to 0.71) I2=91%), and service outcomes (n=18, OR=0.40 (95% CI 0.31 to 0.52) I2=97%). Conclusions This study suggests that a systems approaches to healthcare design and delivery results in a statistically significant improvement to both patient and service outcomes. However, better quality studies, particularly RCTs are needed. PROSPERO registration number CRD42017065920.
Journal ArticleDOI
Systems thinking and CMM for continuous improvement in the construction industry
TL;DR: In this article, a capability maturity model (CMM) was developed to implement continuous improvement in small and medium scale construction companies (SMSCC) in Nigeria, by exploring possible relationships between the variables established.
Journal ArticleDOI
Huddles and their effectiveness at the frontlines of clinical care: a scoping review.
Camilla B. Pimentel,A. Lynn Snow,A. Lynn Snow,Sarah L Carnes,Nishant R. Shah,Julia Loup,Julia Loup,Tatiana M Vallejo-Luces,Caroline Madrigal,Christine W. Hartmann +9 more
TL;DR: In this paper, a comprehensive overview of huddles used in diverse health care settings, examines the empirical support for huddle effectiveness, and identifies knowledge gaps and opportunities for future research.
Journal ArticleDOI
Systems Analysis of Vulnerability to Hydrometeorological Threats: An Exploratory Study of Vulnerability Drivers in Northern Zimbabwe
TL;DR: In this paper, the authors used literature review, interviews, transect walks, and focus groups to gather data from selected samples involving smallholder farmers with in-depth knowledge about community vulnerability.
Journal ArticleDOI
Development and Validation of the Systems Thinking Scale
TL;DR: The 20-item systems thinking scale (STS) has the potential to advance the science and education of quality improvement in two main ways: increase understanding of a critical mechanism by which quality improvement processes achieve results, and evaluate the effectiveness of the education to improve systems thinking.
References
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BookDOI
To Err Is Human Building a Safer Health System
TL;DR: Boken presenterer en helhetlig strategi for hvordan myndigheter, helsepersonell, industri og forbrukere kan redusere medisinske feil.
Journal ArticleDOI
Human error: models and management
TL;DR: The longstanding and widespread tradition of the person approach focuses on the unsafe acts—errors and procedural violations—of people at the sharp end: nurses, physicians, surgeons, anaesthetists, pharmacists, and the like.
Journal ArticleDOI
The Safety Attitudes Questionnaire: psychometric properties, benchmarking data, and emerging research
John B. Sexton,Robert L. Helmreich,Torsten B. Neilands,Kathy Rowan,Keryn Vella,James Boyden,Peter R. Roberts,Eric J. Thomas +7 more
TL;DR: The Safety Attitudes Questionnaire demonstrated good psychometric properties and healthcare organizations can use the survey to measure caregiver attitudes about six patient safety-related domains, to compare themselves with other organizations, to prompt interventions to improve safety attitudes and to measure the effectiveness of these interventions.
Journal ArticleDOI
Workarounds to barcode medication administration systems: their occurrences, causes, and threats to patient safety.
TL;DR: A typology of clinicians' workarounds when using barcoded medication administration (BCMA) systems is developed, finding nurses overrode BCMA alerts for 4.2% of patients charted and for 10.3% of medications charted.
Journal ArticleDOI
Effect of Bar-Code Technology on the Safety of Medication Administration
Eric G. Poon,Carol A. Keohane,Catherine Yoon,Matthew Ditmore,Anne Bane,Osnat Levtzion-Korach,Thomas T. Moniz,Jeffrey M. Rothschild,Allen Kachalia,Judy Hayes,William W. Churchill,Stuart R. Lipsitz,Anthony D. Whittemore,David W. Bates,Tejal K. Gandhi +14 more
TL;DR: The use of bar-code e-marms has been shown to substantially reduce the rate of errors in order transcription and medication administration as discussed by the authors, although it did not eliminate all timing errors.