BMJ Open Quality最新文献

{"title":"Improving access to psychiatric outpatient care through feedback-informed treatment: a study on waiting times and therapy duration in Sweden.","authors":"Magnus Nilsson, Martin Rydberg, Johanna Clausen-Ekefjärd, Sofie Westling","doi":"10.1136/bmjoq-2026-004233","DOIUrl":"10.1136/bmjoq-2026-004233","url":null,"abstract":"<p><strong>Background: </strong>General adult psychiatry in Sweden faces significant challenges with rising patient volumes and limited therapeutic capacity, leading to prolonged waiting times and restricted access to care. Feedback-informed treatment (FIT) has shown promise in improving access to mental health services by enhancing treatment efficiency and patient outcomes.</p><p><strong>Aim: </strong>This study aimed to evaluate whether the implementation of FIT in an adult psychiatric outpatient clinic in Region Skåne, Sweden, was associated with changes in therapy duration and waiting times compared with a control clinic without FIT.</p><p><strong>Methods: </strong>A retrospective, observational design was employed to compare therapy length and waiting times between a clinic implementing FIT (n=139) and a control clinic (n=74) from 2022 to 2024. Data were extracted from patient records, including demographics and patient-reported outcomes (Outcome Rating Scale scores). Linear regression analyses were conducted to assess trends over time, and the steady-state assumption was evaluated to ensure the validity of the findings.</p><p><strong>Results: </strong>The FIT clinic exhibited a significant reduction in therapy duration over time (B=-0.019, p<0.001), while no significant trend was observed in the control clinic. Waiting times remained stable at the FIT clinic but increased non-significantly at the control clinic. The interaction effect for waiting times was significant (B=0.120, p=0.028), indicating a more favourable trajectory at the FIT clinic. Patient-reported outcomes did not differ significantly between the two periods (2021-2022 vs 2023-2024).</p><p><strong>Conclusions: </strong>The implementation of FIT in adult psychiatric outpatient care was associated with shorter therapy durations and more favourable waiting time trajectories, without deteriorating patient-reported outcomes, although these data were descriptive and not available for the control clinic. Given the observational, non-randomised design and modest effects, the findings should be interpreted as exploratory evidence that feedback-informed practice may be relevant to efforts to improve access and resource use in routine psychiatric care.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":"15 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13448619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148696957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Go Decaf!: implementing 'decaf by default' as a quality improvement intervention to reduce toileting-related falls and improve care environments in acute hospital settings.","authors":"Elaine Francis, Clare Collins","doi":"10.1136/bmjoq-2026-004291","DOIUrl":"10.1136/bmjoq-2026-004291","url":null,"abstract":"<p><strong>Background: </strong>Caffeinated hot drinks are routinely offered as the default in hospitals despite guidance recommending caffeine reduction for urinary urgency. Caffeine may increase urinary frequency, disrupt sleep and contribute to toileting-related falls, particularly among older adults living with frailty.</p><p><strong>Local problem: </strong>Routinely collected incident reporting data at an National Health Service (NHS) Foundation Trust identified that around one quarter of inpatient falls were toileting-related. Staff recognised caffeine as a potential contributor but reported limited ability to influence drink provision within existing ward routines.</p><p><strong>Methods: </strong>A registered quality improvement initiative used two sequential Plan-Do-Study-Act cycles to implement a 'decaf by default' approach across acute and community wards, an emergency department and a care home, followed by evaluation after organisation-wide rollout. Routine incident reporting monitored toileting-related falls, while staff and manager experience was assessed using structured questionnaires.</p><p><strong>Intervention: </strong>Decaffeinated hot drinks were offered as the default, with caffeinated drinks available on request. Implementation was supported by staff education, shared decision-making materials, face-to-face clinical support and a patient-facing 'Taste the Difference' activity.</p><p><strong>Results: </strong>Across pilot sites, toileting-related falls as a proportion of all inpatient falls reduced from 19%-21% to 11%-15%. Toileting-related falls reduced by approximately 11% in Cycle 1 and 20% in Cycle 2, with seven wards achieving reductions greater than 50%. Following organisation-wide rollout, the proportion of inpatient falls that were toileting-related reduced from 33.2% to 25.9%. Managers reported calmer ward environments, improved sleep, reduced agitation and fewer urgency-driven toileting attempts. Patient and relative feedback was predominantly positive or neutral.</p><p><strong>Conclusions: </strong>Changing default drink provision to decaffeinated options is a feasible, low-cost intervention associated with fewer toileting-related falls and improved ward environments while preserving patient choice. Sustained improvements following organisation-wide rollout suggest the approach is scalable using existing clinical infrastructure.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":"15 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13448601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence on the links between patient experience and safety: a systematic review.","authors":"Jenny King, Esther Ainley, Molly Hopson, Amy Tallett, Cara Witwicki, Bernardine Jappah, Adèle Bouyer, Chris Graham","doi":"10.1136/bmjoq-2026-004150","DOIUrl":"10.1136/bmjoq-2026-004150","url":null,"abstract":"<p><strong>Background: </strong>Patient experience and safety are central to healthcare quality, yet their relationship remains underexplored. While earlier evidence suggests a positive association, policy and practice are continually developing around the world. This review systematically examines the literature to better understand how patient experience and safety are linked.</p><p><strong>Methods: </strong>Searches were conducted via PubMed (2000-2023) using predefined terms on patient experience and safety. Articles were uploaded to Rayyan, duplicates removed and titles and abstracts screened for relevance. Full articles were reviewed and 30 eligible studies were included. A narrative synthesis was performed, with quality and evidence strength assessed using the Mixed Methods Appraisal Tool and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework.</p><p><strong>Results: </strong>Evidence regarding the relationship between patient experience and safety was heterogeneous. Seven studies demonstrated consistent positive associations, 6 reported no association and 17 yielded mixed findings across different safety metrics. Among these 17 studies, 7 tended to support a positive association, 5 suggested no association and 5 reported results that varied according to the analytical approach.</p><p><strong>Discussion: </strong>This review found mixed evidence on the relationship between patient experience and safety, and causality remains unknown. While some research identified clear associations, others showed considerable variation, often influenced by the specific measures used. Studies focused on secondary care, leaving gaps in primary and mental health settings. Notably, no research examined links between safety and the Picker Principles of 'fast access to healthcare advice' or 'family and carer involvement'-domains considered vital to safety.The review suggests that future research should explore domain-specific links and include experimental designs to strengthen causal understanding of the granular elements of safety and experience. Further investigation across care settings and population subgroups would help to fully understand how patient experience influences safety and vice versa.Overall, this review provides evidence that patient experience and safety are related but distinct concepts that should be addressed together in quality improvement efforts.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":"15 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13436084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing medical equipment downtime using Lean Six Sigma: a quality improvement project at Suhul Hospital, Shire.","authors":"Hawelti Messele Gebremariyam","doi":"10.1136/bmjoq-2026-004253","DOIUrl":"10.1136/bmjoq-2026-004253","url":null,"abstract":"<p><p>Medical equipment downtime is a major challenge in healthcare facilities, often driven by mechanical and electrical failures, delayed fault reporting and the absence of structured preventive maintenance. At Suhul Hospital, Shire, these issues were compounded by human error, outdated maintenance practices, limited standards and shortages of spare parts, leading to prolonged equipment unavailability and disrupted patient care.This project applied a Lean Six Sigma (LSS) approach to address these inefficiencies. Key tools included 5S practices, detailed process mapping, corrective maintenance standardisation and a structured preventive maintenance plan. A mixed-methods design was used, combining document review with semi-structured interviews involving 18 purposively selected professionals with at least a diploma and 4 years of relevant experience. Quantitative measures focused on downtime, defects and process capability, while qualitative data explored root causes and waste within the maintenance workflow.Implementation of Lean Six Sigma produced substantial improvements in medical equipment maintenance performance. Total equipment downtime decreased from 89,735 minutes to 292 minutes, while recorded defects decreased from 842 to 43. Overall, downtime decreased by 99.67%, defects by 94.89% and the Sigma level improved from 2.74 to 3.62, indicating a shift from low to moderate process reliability.These findings demonstrate that structured quality improvement methods can significantly enhance the efficiency and reliability of medical equipment maintenance in resource-constrained settings. While the intervention was successful, the project was limited to a single hospital, and further multi-site studies are recommended to strengthen generalisability.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":"15 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13435996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inclusion of sex and gender in clinical practice guidelines: an umbrella review.","authors":"Marya Yenita Sitohang, Jennifer Ervin, Humaira Maheen, Kim Dalziel, Tania King","doi":"10.1136/bmjoq-2026-004211","DOIUrl":"10.1136/bmjoq-2026-004211","url":null,"abstract":"<p><strong>Background: </strong>Clinical practice guidelines (CPGs) are key to standardised, evidence-based and equitable healthcare, and the inclusion of sex and gender considerations in CPGs is increasingly recognised as essential for quality care and health equity. This umbrella review synthesised evidence from reviews examining the extent and quality of sex and gender considerations in CPGs and identified barriers and best practice strategies to support their inclusion.</p><p><strong>Methods: </strong>Literature searches were conducted across eight databases, identifying systematic reviews and other reviews published between 2000 and 2025 that focused on sex and gender considerations in CPGs. Data extraction and quality appraisal followed Joanna Briggs Institute guidelines. After descriptively summarising the reviews, narrative synthesis was used to summarise how sex and gender considerations were integrated across the included reviews, identifying common issues and recommendations for improving their incorporation into CPGs.</p><p><strong>Results: </strong>Analysis of the seven included reviews (appraising a total of 784 CPGs) found that despite mention of sex or gender in 69% of CPGs, only 15% incorporated these factors into diagnostic or management recommendations, reflecting inconsistent, conceptually unclear and often superficial application. Major barriers included under-representation of women, limited sex and gender expertise on guideline committees, incomplete translation of sex-specific and gender-specific evidence into recommendations, inconsistent terminology and methodological limitations in guideline development. To address these gaps, the included reviews identified several strategies that could be implemented before, during and after the guideline development process.</p><p><strong>Conclusion: </strong>Sex and gender inclusion in CPGs remains inconsistent and superficial, with significant implications for health equity. Addressing this requires strengthening sex-informed and gender-informed evidence, ensuring diverse and expert representation in guideline development and adopting systematic approaches that translate evidence into equitable, population-responsive recommendations.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":"15 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13435981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148648197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing resource utilisation in outpatient clinics: impact of telephone and text reminders on did not attend and short notice cancellation .","authors":"Hp Priyantha Siriwardana, Frances Kiernan, Abhishek Kapila, Kimberly Ann Cardoso, David Agunede, Mahima Pillai, Russel Emamdee, Sritharan Kadirkamanathan","doi":"10.1136/bmjoq-2025-003774","DOIUrl":"10.1136/bmjoq-2025-003774","url":null,"abstract":"<p><p>Did not attend (DNA) and short notice cancellation (SNC) in outpatient (OP) clinics waste scarce capacity and delay care. We undertook a quality improvement project in general surgery OP clinics with the aim to reduce DNA below the baseline 12.2% and SNC below the baseline 5% using telephone and text reminders to increase OP appointment (OPA) slot utilisation from around 83% towards 85%-90%.We studied DNA and SNC in four consecutive phases in a general surgery clinic. Phase 1: a retrospective baseline OPA attendance; Phase 2: a prospective diagnostic where non-attenders were telephoned within 3 days to complete a questionnaire on reasons for DNA/SNC; Phase 3: Preappointment telephone reminders 72 hours before OPAs; Phase 4: one-way text reminder.Across four phases, 1500 OPA slots were analysed. Baseline utilisation was 82.8% in phase 1 (360 slots; DNA 12.2%, SNC 5.0%) and 83.3% in phase 2 (420 slots; DNA 11.7%, SNC 5.0%). Questionnaire responses: most non-attendees were forgetting their appointment or unable to get through to the hospital to cancel. Phase 3 (360 slots): 286 patients (79.4%) were successfully contacted, 251 confirmed attendance and 35 wanted to cancel, creating potentially reusable slots; DNA fell to 9.4% and SNC to 0.6%, but only 20 of the 35 freed slots were re-booked due to limited booking staff (utilisation; 85.8%). Phase 4: 360 slots, utilisation was 84.7% (DNA 8.1%, SNC 7.2%). Statistical process control charts suggested a favourable trend in DNA and SNC over time but did not demonstrate consistent special cause variation.Telephone reminders led to fewer SNCs and created opportunities to reallocate appointments, but impact was constrained by limited staff. One-way text reminders appeared to reduce DNA but higher SNC, suggesting that reminder systems alone are insufficient. Sustainable improvement in OPA utilisation requires reliable contact information, simple two-way routes for patients to cancel or rearrange, and adequate administrative capacity.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":"15 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13422818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening patient safety in a Cambodian hospital through structured weekly reporting: a low-cost quality improvement initiative.","authors":"Suren Kanayan","doi":"10.1136/bmjoq-2025-003930","DOIUrl":"10.1136/bmjoq-2025-003930","url":null,"abstract":"<p><strong>Background: </strong>Persistent patient safety issues in low-resource hospitals are often underreported, delaying corrective actions and increasing preventable harm.</p><p><strong>Objective: </strong>This project aimed to implement a low-cost, structured weekly reporting system to improve patient safety processes and outcomes across departments at a tertiary hospital in Phnom Penh, Cambodia.</p><p><strong>Methods: </strong>A one-page Departmental Wise Checklist was introduced in the emergency room/intensive care unit (ER), obstetrics and gynaecology, outpatient department and paediatrics. Weekly reviews, feedback loops and departmental champions supported consistent reporting and follow-through. Implementation emphasised planning, stakeholder engagement, iterative refinement through Plan-Do-Study-Act (PDSA) cycles and integration into routine workflows. Challenges including resistance to extra work, inconsistent submissions and escalation fatigue were addressed through simplified checklists, coaching and departmental champions, while oversight from the hospital quality improvement committee ensured accountability.</p><p><strong>Results: </strong>After 3 months, process measures showed substantial change: formally adopted Standard Operating Procedures (SOP) increased from 0 to 10, Basic Life Support-trained ER staff rose from 38% to 98%, incidents of expired blood products fell from 2 per month to none and reporting compliance averaged 92%. Concurrently, patient-level outcomes demonstrated change: monthly cases of neonatal hypothermia decreased from 6 to 2 and ER adverse events dropped from 4 to 1.</p><p><strong>Conclusions: </strong>These findings suggest that structured weekly reporting, combined with iterative feedback and active departmental engagement, may be associated with strengthening patient safety and accountability in low-resource settings. Long-term sustainability of these improvements is likely to depend on embedding the process into routine quality assurance activities, ongoing staff training and continued leadership oversight. However, sustainability beyond the 12-week intervention period has not yet been empirically assessed. The approach may provide a practical model for consideration and adaptation in similar low- and middle-income country hospitals, subject to local context and resources.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":"15 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13405020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148599021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimising the breast radiotherapy planning pathway: a quality improvement project at a regional cancer centre.","authors":"Douglas Etheridge, Ryan David Lewis, Adam Henry Aitkenhead, Christopher Scott Rose, Nathan Proudlove","doi":"10.1136/bmjoq-2025-004056","DOIUrl":"10.1136/bmjoq-2025-004056","url":null,"abstract":"<p><p>At the South West Wales Cancer Centre, breast radiotherapy accounts for 24% of the radiotherapy workload. In 2021, only 16% of patients started treatment within 14 days compared with the Welsh time-to-radiotherapy quality metric target of 80%. Delays risk poorer outcomes for patients and create inefficiencies as tasks are often batched and staff alternate between idle and peak workload periods.Earlier analysis showed that only 1%-2% of the overall breast radiotherapy pathway time was value-adding activity. Key delays occurred at several stages of the pathway, where the total duration of each stage, including time spent waiting in the queue and time actively worked on, averaged around 50% longer than scheduled. For example, CT simulation was typically scheduled for 2 days but took more than 4 days while organ at risk (OAR) delineation was scheduled for 2 days but took approximately 2.5 days. Our improvement strategy targeted these delays through: (1) expansion of the technologist plan approval (TPA) pathway, (2) introduction of daily workflow meetings and clearer, standardised planning protocols and (3) implementation of artificial intelligence (AI) auto-contouring for OAR delineation. These changes were tested using the Model for Improvement, with statistical process control monitoring of metrics plus staff feedback.The mean total radiotherapy breast pathway time from consent-to-treatment decreased from 19.5 days to 14.8 days, with patients commencing treatment within 14 days increasing from 16% to 55%. Use of the TPA pathway increased from 61% to 95% and plan queries reduced from 11% to 3%, reducing oncologist workload. Daily workflow meetings and improved protocols reduced average planning times from 4 days to 1.5 days and were valued by staff for improving workload equity and team cohesion. AI auto-contouring reduced OAR delineation from 2.3 to 0.6 days, though ongoing validation of contour quality is required.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":"15 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13404411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148599070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From patient to planet: integrating climate impact into a hospital medicine initiative reducing blood urea nitrogen testing.","authors":"Pamela Mathura, Xinyu Amy Shi, Sandra Marini, Narmin Kassam","doi":"10.1136/bmjoq-2025-004123","DOIUrl":"10.1136/bmjoq-2025-004123","url":null,"abstract":"<p><strong>Background: </strong>Pursuing climate-conscious care has become a key focus of quality improvement (QI) efforts. Hospitals across Alberta, Canada, implemented a multicomponent intervention to reduce unnecessary blood urea nitrogen (BUN) testing. This study evaluated the broader environmental impact of the intervention across multiple hospital medicine settings.</p><p><strong>Methods: </strong>Using a pre-post study design, monthly BUN test counts were compared before and after implementing the initiative across six hospital medicine wards to calculate percentage reductions. A secondary analysis assessed the initiative's environmental impact using the Lab Wisely Carbon Calculator, which converted reduced BUN testing into equivalent travel distances. Avoided carbon dioxide (CO₂) emissions were estimated at 32.1 g/test and tree equivalents were calculated using an annual absorption rate of 21.77 kg CO₂/tree.</p><p><strong>Results: </strong>Hospitals showed monthly reductions in unnecessary BUN testing between 51% and 95%, saving an estimated 5101.92 km of travel and avoiding 169.39 kg of CO₂ emissions monthly, equivalent to planting about 93 trees annually. The climate impact varied by hospital, reflecting differences in the intervention strategies used.</p><p><strong>Conclusions: </strong>Integrating environmental metrics into QI initiatives offers a strategic path to climate-conscious care, promoting sustainability alongside fiscal responsibility and resource efficiency.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":"15 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13404617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective cohort study identifies barriers and facilitators to point-of-care ultrasound use in an academic emergency department.","authors":"Alyssa Platt, Timothy Peterson, Erica Peethumnongsin, Maragatha Kuchibhatla, Rebecca G Theophanous","doi":"10.1136/bmjoq-2026-004210","DOIUrl":"10.1136/bmjoq-2026-004210","url":null,"abstract":"<p><strong>Background: </strong>Point-of-care ultrasound (POCUS) improves patient care by expedited diagnosis and safer procedures. Despite POCUS benefits, some clinicians, including emergency physicians, do not readily use POCUS.</p><p><strong>Objectives: </strong>The study objective identified barriers and facilitators to clinical POCUS use and performed an intervention to address these barriers.</p><p><strong>Methods: </strong>A prospective cohort study at a single academic hospital included emergency department attendings, residents and advanced practice providers (APPs). Participants were surveyed on perceived POCUS use barriers and facilitators (primary outcome). A multifaceted intervention from December 2023 to January 2024 addressed identified barriers and involved: in-person POCUS education during shift by ultrasound faculty, clinical POCUS workflow demonstration during resident conference/faculty meetings and QR code reference files on machines.</p><p><strong>Results: </strong>42/99 participants (42.4%) responded to surveys preintervention and 28 postintervention (28.3%). 56 physicians and APPs participated in the in-person POCUS intervention (17 attendings, 34 residents, 5 APPs). Perceived POCUS barriers were time constraints on shift; internet/connectivity problems and losing saved images; forgetting to finish exam worksheets online; images not uploading into Butterfly cloud by the end of shift and residents performing 'phantom scans'. Perceived POCUS facilitators included clear documentation protocols, hands-on teaching sessions and incentives for completing scans. Comfort in teaching diagnostic and procedural POCUS improved pre to postintervention but did not change for performing POCUS.</p><p><strong>Conclusion: </strong>Identified barriers and facilitators were incorporated into a multifaceted intervention to improve clinical POCUS workflow processes. Future individualised interventions for low POCUS users and institutional initiatives with POCUS champions can be studied for improved patient care.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":"15 3","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13404422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}