The Journal of Patient Safety最新文献

Resident Working Hour Restrictions Increased the Workload of the Medical Emergency Team: A Retrospective Observational Study. 住院医生工作时间限制增加了医疗急救小组的工作量:一项回顾性观察研究。

The Journal of Patient Safety Pub Date : 2019-12-01 DOI: 10.1097/PTS.0000000000000629

K. M. Moon, J. Huh, Shinhee Park, Sang-Bum Hong, C. Lim, Y. Koh

{"title":"Resident Working Hour Restrictions Increased the Workload of the Medical Emergency Team: A Retrospective Observational Study.","authors":"K. M. Moon, J. Huh, Shinhee Park, Sang-Bum Hong, C. Lim, Y. Koh","doi":"10.1097/PTS.0000000000000629","DOIUrl":"https://doi.org/10.1097/PTS.0000000000000629","url":null,"abstract":"BACKGROUND\u0000Restrictions to residents' working hours have been shown to increase the workload of other medical resources; few studies have measured the effects on medical emergency teams (METs).\u0000\u0000\u0000OBJECTIVES\u0000This study evaluated how limiting residents' working hours affected the workload of MET in a pulmonology unit.\u0000\u0000\u0000METHODS\u0000This retrospective observational study analyzed MET activity during periods before and after we limited the working hours of residents in our pulmonary unit to 88 h/wk: Period 1, March 2014 to February 2015; and Period 2, March 2015 to February 2016. Medical emergency team activities, dose (activations/1000 admissions), intensive care unit transfers, and mortality were compared between the two periods for weekdays and for weekends and holidays.\u0000\u0000\u0000RESULTS\u0000There were no significant differences between the two periods in MET dose (85.0 in Period 1 versus 91.3 in Period 2, P = 0.675), intensive care unit transfers (P = 0.828), 30-day mortality (P = 0.701), and 60-day mortality (P = 0.531). However, some activities increased significantly or near significantly in Period 2, including portable echocardiography (P < 0.001), arterial line insertion (P = 0.034), mechanical ventilation (P = 0.063), and fluid therapy (P = 0.220). These increases were greater for weekends and holidays than for weekdays.\u0000\u0000\u0000CONCLUSIONS\u0000Since December 2017, a specific law for improving the training environment and status of residents has been implemented and applied at all hospitals in Korea. This legal restriction to working hours raises concerns regarding other medical personnel and system improvements to ensure patient safety and care continuity.","PeriodicalId":206245,"journal":{"name":"The Journal of Patient Safety","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121941602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Prioritizing Patient Safety Efforts in Office Practice Settings. 优先考虑患者安全工作在办公室实践设置。

The Journal of Patient Safety Pub Date : 2019-12-01 DOI: 10.1097/PTS.0000000000000652

S. Kravet, Melissa Bhatnagar, M. Dwyer, K. Kjaer, J. Evanko, Hardeep Singh

{"title":"Prioritizing Patient Safety Efforts in Office Practice Settings.","authors":"S. Kravet, Melissa Bhatnagar, M. Dwyer, K. Kjaer, J. Evanko, Hardeep Singh","doi":"10.1097/PTS.0000000000000652","DOIUrl":"https://doi.org/10.1097/PTS.0000000000000652","url":null,"abstract":"OBJECTIVES\u0000Outpatient care settings face unique risks of adverse events and medico-legal liability, often worsened by inconsistent processes and fragmented care. Health systems are increasingly providing integrated care that includes outpatient care, but models of how to systematically target medico-legal risk in office practices are largely absent. Innovative and scalable efforts are needed to guide large health systems in their approach to outpatient safety.\u0000\u0000\u0000METHODS\u0000A malpractice consortium consisting of five large health care delivery systems identified that its ambulatory care cases (including office practices, outpatient hospital settings, and emergency departments) account for 30% to 35% of annual medical malpractice costs, and missed or delayed diagnoses account for approximately 50% of office practice liability risk. To further understand risks and opportunities in office-based practices, a team of patient safety and loss prevention professionals conducted site visits to seven outpatient-affiliated sites of the five health systems from January to March 2016 and interviewed several key informant members of physician, nursing, and administrative leadership.\u0000\u0000\u0000RESULTS\u0000We identified eight common patient safety risk domains based on analysis of eight sets of group interviews. Risk domains were then prioritized by members of the consortium leadership using scoring criteria that we developed based on existing risk assessment and prioritization approaches. The method helped identify communication and follow-up of diagnostic test results in the outpatient setting as the single most important risk area to target improvement efforts.\u0000\u0000\u0000CONCLUSIONS\u0000A targeted approach to identify a single high-risk area led to development of dedicated teams to conduct local patient safety improvement projects at the affiliated health systems and for sharing lessons learned. Similar efforts elsewhere could lead to safety improvements in office practices at other large health systems.","PeriodicalId":206245,"journal":{"name":"The Journal of Patient Safety","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117069514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Urethral Catheterization Is Not Necessary During Nononcological Laparoscopic Pelvic Surgery. 非肿瘤性腹腔镜盆腔手术不需要导尿。

The Journal of Patient Safety Pub Date : 2019-12-01 DOI: 10.1097/PTS.0000000000000612

E. Nevins, Elizabeth G Nevins, P. Moori, C. Strong, Samim Al-Zubaidi, J. Wayman, D. Karat

{"title":"Urethral Catheterization Is Not Necessary During Nononcological Laparoscopic Pelvic Surgery.","authors":"E. Nevins, Elizabeth G Nevins, P. Moori, C. Strong, Samim Al-Zubaidi, J. Wayman, D. Karat","doi":"10.1097/PTS.0000000000000612","DOIUrl":"https://doi.org/10.1097/PTS.0000000000000612","url":null,"abstract":"OBJECTIVES\u0000Expert opinion remains divided regarding whether routine urethral catheterization is required before nononcological laparoscopic pelvic surgery. Catheterization is thought to reduce the incidence of bladder injury when inserting a suprapubic laparoscopic port and prevent obstruction of the view of the pelvis because of bladder filling. However, catheterization comes with a risk of nosocomial infection and harbors financial cost. Moreover, indwelling catheters inhibit early mobilization and increase postoperative discomfort.\u0000\u0000\u0000METHODS\u0000A systematic review was undertaken using the Meta-Analysis of Observational Studies guidelines to identify eligible publications. End points included bladder injury, positive postoperative urinary microbiology, and postoperative urinary symptoms.\u0000\u0000\u0000RESULTS\u0000The reported incidence rates of laparoscopic bladder injury in included publications ranges from 0% to 1.3%. Importantly, bladder injury has occurred during both catheterized and noncatheterized operations. Our meta-analysis also shows that patients who are catheterized have a 2.33 times relative risk of developing postoperative positive microbiology in their urine (P = 0.01) and a 2.41 times relative risk of postoperative urinary symptoms (P = 0.005), when compared with noncatheterized patients.\u0000\u0000\u0000CONCLUSIONS\u0000This meta-analysis indicates that omitting a catheter in emergency and elective nononcological laparoscopic pelvic surgery may be a safe option. Catheterization does not remove the risk of bladder injury but results in more urinary tract infections and symptoms. It may be reasonable to ask a patient to void immediately before anesthesia, after which an on-table bladder scan should be performed. If there is minimal residual volume, a urinary catheter may not be necessary, unless operative time is estimated to be greater than 90 minutes.","PeriodicalId":206245,"journal":{"name":"The Journal of Patient Safety","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124168694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cell Phone Calls in the Operating Theater and Staff Distractions: An Observational Study. 手术室中使用手机和员工分心:一项观察性研究。

The Journal of Patient Safety Pub Date : 2017-01-09 DOI: 10.1097/PTS.0000000000000351

A. Avidan, Galel Yacobi, C. Weissman, P. Levin

{"title":"Cell Phone Calls in the Operating Theater and Staff Distractions: An Observational Study.","authors":"A. Avidan, Galel Yacobi, C. Weissman, P. Levin","doi":"10.1097/PTS.0000000000000351","DOIUrl":"https://doi.org/10.1097/PTS.0000000000000351","url":null,"abstract":"OBJECTIVES\u0000Cell phones are the primary communication tool in our institution. There are no restrictions on their use in the operating rooms. The goal of this study was to evaluate the extent of cell phone use in the operating rooms during elective surgery and to evaluate whether they cause staff distractions.\u0000\u0000\u0000METHODS\u0000The following data on cell phone use were recorded anonymously: number of incoming and outgoing cell phone calls, duration of cell phone calls and their content (patient related, work related, private), who was distracted by the cell phone calls, and duration of distractions.\u0000\u0000\u0000RESULTS\u0000We made observations during 52 surgeries. There were 205 cell phone calls, 197 (96.1%; median, 3 per surgery; interquartile range, 2-5) incoming and 8 (3.9%) outgoing. Incoming calls were answered on 110 (55.8%) of 197 (median, 2; interquartile range, 1-3) occasions. The mean duration of incoming calls (64 ± 40 seconds) was shorter than those of the outgoing calls (137 ± 242 seconds, P < 0.001). During 29 (14.7%) of 197 incoming calls, 30 staff distractions occurred. Distractions were caused mainly for surgeons talking on their cell phones (24/30, 80.0%). The mean duration of the distractions was 43.6 ± 22.3 seconds. During all 8 outgoing calls, no other staff members were distracted.\u0000\u0000\u0000CONCLUSION\u0000The number of cell phone calls in the operating rooms during elective surgery was lower than expected and caused short-lived distractions mainly to the operating surgeons. We recommend that operating surgeons turn off their cell phones before surgery.","PeriodicalId":206245,"journal":{"name":"The Journal of Patient Safety","volume":"186 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116145830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 18

Rock, Paper, Scissors. 石头，剪刀，布。

The Journal of Patient Safety Pub Date : 2016-11-01 DOI: 10.1097/PTS.0000000000000285

J. Adashek

引用次数: 0

Physician Perspectives on Interhospital Transfers. 医生对医院间转院的看法。

The Journal of Patient Safety Pub Date : 2016-11-01 DOI: 10.1097/PTS.0000000000000312

Stephanie K. Mueller, J. Schnipper

{"title":"Physician Perspectives on Interhospital Transfers.","authors":"Stephanie K. Mueller, J. Schnipper","doi":"10.1097/PTS.0000000000000312","DOIUrl":"https://doi.org/10.1097/PTS.0000000000000312","url":null,"abstract":"OBJECTIVE\u0000The transfer of patients between acute care hospitals (interhospital transfer [IHT]) is a common but nonstandardized process leading to variable quality and safety. The goal of this study was to survey accepting physicians regarding problems encountered in the transfer process.\u0000\u0000\u0000METHODS\u0000A cross-sectional survey of residents and inpatient attendings from internal medicine, neurology, and surgery services at a large tertiary care referral hospital was undertaken to identify problematic aspects of the IHT process as perceived by accepting frontline providers. The frequency that specific scenarios were encountered in caring for transferred patients and whether these processes impacted patient safety were determined using 5- and 3-point Likert scales, respectively. The frequency of responses to each question were measured using proportions.\u0000\u0000\u0000RESULTS\u0000Approximately 51% of the 284 physicians surveyed responded. Pertinent findings included the following: physician subject surveys found that transferred patients sometimes, frequently, or always arrived without requiring specialized care in 56% of responses, arrived with unrealistic expectations of care in 77.2% of responses, arrived more than 24 hours after accepted for transfer in 80.1% of responses, and arrived without necessary transfer records in 86.9% of responses. Most respondents felt that lack of availability of transfer records and the time of day of arrival frequently posed a risk to transferred patients (57.2% and 53.1%, respectively). Response variation was noted between resident and attending physician respondents.\u0000\u0000\u0000CONCLUSIONS\u0000Expectations of care, delays and timing of transfer, and information exchange at time of transfer were identified as all too common problems in IHT, which creates a risk for patient safety. These areas are important targets for investigation and the development of interventions to improve patient safety.","PeriodicalId":206245,"journal":{"name":"The Journal of Patient Safety","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115486715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 12

Human Factors and Quality Improvement in the Emergency Department: Reducing Potential Errors in Blood Collection. 急诊科的人为因素与质量改进:减少采血的潜在错误。

The Journal of Patient Safety Pub Date : 2016-02-18 DOI: 10.1097/PTS.0000000000000237

O. Bashkin, Sigalit Caspi, Assaf Swissa, Amitai Amedi, Shai Zornano, R. Stalnikowicz

{"title":"Human Factors and Quality Improvement in the Emergency Department: Reducing Potential Errors in Blood Collection.","authors":"O. Bashkin, Sigalit Caspi, Assaf Swissa, Amitai Amedi, Shai Zornano, R. Stalnikowicz","doi":"10.1097/PTS.0000000000000237","DOIUrl":"https://doi.org/10.1097/PTS.0000000000000237","url":null,"abstract":"OBJECTIVES\u0000Adverse events in blood collection procedures such as mismatched or unlabeled samples may have critical implications on patient safety (such as wrong diagnosis and treatments). The current study examined blood collection procedures in an emergency department before and after the application of a human factors approach for improving performance quality and preventing adverse events.\u0000\u0000\u0000METHODS\u0000In the emergency department of a community care hospital, 190 blood collection events were observed in 2 phases: preintervention and postintervention. Two quality measures were tested as follows: quality measure 1, performing all 7 stages in the procedure of blood collection according to protocol, and quality measure 2, performing the stages of the procedure in the correct sequence according to the protocol. In addition, medical staff anonymously answered questionnaires about their procedure for collecting blood.\u0000\u0000\u0000RESULTS\u0000Analyses of data collected before the intervention revealed only 2 events in which all 7 stages in the protocol of the procedure were performed and only 1 event in which the 7 stages of the procedure were performed in the correct sequence. In 91% of the events, the patient was not fully identified. Based on these findings, we developed an intervention using a human factors approach to improve the quality of performance. Analyses of data collected after the intervention revealed significant differences (t188 = -14.9, ρ < 0.01) in quality measure 1 before (mean [SD], 4.8 [0.6]) and after (mean [SD], 6.4 [0.8]) the intervention was initiated, which implies improvement on efficiency subsequent to the implementation of the intervention. Improvement also appeared in quality measure 2.\u0000\u0000\u0000CONCLUSIONS\u0000This study illustrates the nature of potential errors in blood collection performance, offering a proactive approach to improve the rate of proper performance.","PeriodicalId":206245,"journal":{"name":"The Journal of Patient Safety","volume":"99 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116073273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Sustaining Innovations in Complex Health Care Environments: A Multiple-Case Study of Rapid Response Teams. 复杂卫生保健环境中的持续创新:快速反应小组的多案例研究。

The Journal of Patient Safety Pub Date : 2016-01-11 DOI: 10.1097/PTS.0000000000000239

D. Stolldorf, D. Havens, Cheryl B. Jones

{"title":"Sustaining Innovations in Complex Health Care Environments: A Multiple-Case Study of Rapid Response Teams.","authors":"D. Stolldorf, D. Havens, Cheryl B. Jones","doi":"10.1097/PTS.0000000000000239","DOIUrl":"https://doi.org/10.1097/PTS.0000000000000239","url":null,"abstract":"OBJECTIVES\u0000Rapid response teams (RRTs) are one innovation previously deployed in U.S. hospitals with the goal to improve the quality of care. Sustaining RRTs is important to achieve the desired implementation outcomes, reduce the risk of program investment losses, and prevent employee disillusionment and dissatisfaction. This study sought to examine factors that do and do not support the sustainability of RRTs.\u0000\u0000\u0000METHODS\u0000The study was conceptually guided by an adapted version of the Planning Model of Sustainability. A multiple-case study was conducted using a purposive sample of 2 hospitals with high RRT sustainability scores and 2 hospitals with low RRT sustainability scores. Data collection methods included (a) a hospital questionnaire that was completed by a nurse administrator at each hospital; (b) semistructured interviews with leaders, RRT members, and those activating RRT calls; and (c) a review of internal documents. Quantitative data were analyzed using descriptive statistics; qualitative data were analyzed using content analysis.\u0000\u0000\u0000RESULTS\u0000Few descriptive differences were found between hospitals. However, there were notable differences in the operationalization of certain factors between high- and low-sustainability hospitals. Additional sustainability factors other than those captured by the Planning Model of Sustainability were also identified.\u0000\u0000\u0000CONCLUSIONS\u0000The sustainability of RRTs is optimized through effective operationalization of organizational and project design and implementation factors. Two additional factors-individual and team characteristics-should be included in the Planning Model of Sustainability and considered as potential facilitators (or inhibitors) of RRT sustainability.","PeriodicalId":206245,"journal":{"name":"The Journal of Patient Safety","volume":"20 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128633587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 7

Two Cultures in Modern Science and Technology: For Safety and Validity Does Medicine Have to Update? 现代科技中的两种文化:为了安全与有效性，医学必须更新吗?

The Journal of Patient Safety Pub Date : 2016-01-11 DOI: 10.1097/PTS.0000000000000260

R. Becker

{"title":"Two Cultures in Modern Science and Technology: For Safety and Validity Does Medicine Have to Update?","authors":"R. Becker","doi":"10.1097/PTS.0000000000000260","DOIUrl":"https://doi.org/10.1097/PTS.0000000000000260","url":null,"abstract":"Two different scientific cultures go unreconciled in modern medicine. Each culture accepts that scientific knowledge and technologies are vulnerable to and easily invalidated by methods and conditions of acquisition, interpretation, and application. How these vulnerabilities are addressed separates the 2 cultures and potentially explains medicine's difficulties eradicating errors. A traditional culture, dominant in medicine, leaves error control in the hands of individual and group investigators and practitioners. A competing modern scientific culture accepts errors as inevitable, pernicious, and pervasive sources of adverse events throughout medical research and patient care too malignant for individuals or groups to control. Error risks to the validity of scientific knowledge and safety in patient care require systemwide programming able to support a culture in medicine grounded in tested, continually updated, widely promulgated, and uniformly implemented standards of practice for research and patient care. Experiences from successes in other sciences and industries strongly support the need for leadership from the Institute of Medicine's recommended Center for Patient Safely within the Federal Executive branch of government.","PeriodicalId":206245,"journal":{"name":"The Journal of Patient Safety","volume":"201 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131568523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Factors Influencing Time-Dependent Quality Indicators for Patients With Suspected Acute Coronary Syndrome. 影响疑似急性冠脉综合征患者时间依赖性质量指标的因素。

The Journal of Patient Safety Pub Date : 2016-01-11 DOI: 10.1097/PTS.0000000000000242

D. France, S. Levin, R. Ding, R. Hemphill, Jin Han, Stephan E. Russ, D. Aronsky, M. Weinger

{"title":"Factors Influencing Time-Dependent Quality Indicators for Patients With Suspected Acute Coronary Syndrome.","authors":"D. France, S. Levin, R. Ding, R. Hemphill, Jin Han, Stephan E. Russ, D. Aronsky, M. Weinger","doi":"10.1097/PTS.0000000000000242","DOIUrl":"https://doi.org/10.1097/PTS.0000000000000242","url":null,"abstract":"OBJECTIVES\u0000Rapid risk stratification and timely treatment are critical to favorable outcomes for patients with acute coronary syndrome (ACS). Our objective was to identify patient and system factors that influence time-dependent quality indicators (QIs) for patients with unstable angina/non-ST elevation myocardial infarction (NSTEMI) in the emergency department (ED).\u0000\u0000\u0000METHODS\u0000A retrospective, cohort study was conducted during a 42-month period of all patients 24 years or older suspected of having ACS as defined by receiving an electrocardiogram and at least 1 cardiac biomarker test. Cox regression was used to model the effects of patient characteristics, ancillary service use, staffing provisions, equipment availability, and ED and hospital crowding on ACS QIs.\u0000\u0000\u0000RESULTS\u0000Emergency department adherence rates to national standards for electrocardiogram readout time and biomarker turnaround time were 42% and 37%, respectively. Cox regression models revealed that chief complaints without chest pain and the timing of stress testing and medication administration were associated with the most significant delays.\u0000\u0000\u0000CONCLUSIONS\u0000Patient and system factors both significantly influenced QI times in this cohort with unstable angina/NSTEMI. These results illustrate both the complexity of diagnosing patients with NSTEMI and the competing effects of clinical and system factors on patient flow through the ED.","PeriodicalId":206245,"journal":{"name":"The Journal of Patient Safety","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133460615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 6