BMJ Open Quality最新文献

{"title":"Supportive supervision visits in a large community hypertension programme in Nigeria: implementation methods and outcomes.","authors":"Gabriel Lamkur Shedul, Nanna Ripiye, Erica L Jamro, Ikechukwu A Orji, Grace Julcit Shedul, Eugenia N Ugwuneji, Emmanuel Okpetu, Boni M Ale, Samuel Osagie, Abigail S Baldridge, Namratha R Kandula, Mark D Huffman, Dike Ojji, Lisa Hirschhorn","doi":"10.1136/bmjoq-2024-003163","DOIUrl":"10.1136/bmjoq-2024-003163","url":null,"abstract":"<p><strong>Background: </strong>The Hypertension Treatment in Nigeria (HTN) Programme established a system for hypertension diagnosis and management in 60 public primary healthcare facilities in the Federal Capital Territory of Nigeria through the implementation of HEARTS, a multi-level strategy bundle including team-based care led by community health extension workers (CHEWs). To improve HEARTS implementation, supportive supervision was added as an implementation strategy in April 2020.</p><p><strong>Methods: </strong>A multidisciplinary supportive supervision team and data collection forms were developed and implemented at HTN-supported sites. Data from April 2020 to December 2023 from supportive supervision visits were used to measure supportive supervision implementation outcomes, including reach, fidelity, adoption and feasibility and effectiveness of quality of care, data reporting and facility readiness. Descriptive analyses were performed to summarise outcomes. Jonckheere-Terpstra or Cochran-Armitage trend test was used to measure change over time for medians or proportions, respectively.</p><p><strong>Results: </strong>The programme successfully designed and performed quarterly supportive supervision visits. There was high reach (100% sites with visits each year), fidelity (median 100% (IQR 89%-100%) of core components completed), adoption (100% teams provided quarterly visits) and increase in feasibility (planned visits completed) (90.8% to 97.8%, p=0.002). Effectiveness outcomes included an increase in patients with blood pressure (BP) checked in the last 3 days (78.4% to 84.4%, p=0.009), treatment cards without errors (71.5% to 85%. p<0.001), but a slight drop in CHEW fidelity to BP measurement technique (91.5% to 86.5%, p=0.02). Facility readiness increased in adequate staffing (56.7% to 98.3%, p<0.001), but decreased for equipment availability (98.3% to 90.0%, p=0.03). Overall, the proportion of facilities with all readiness components present increased from 0% to 63.3% (p<0.001).</p><p><strong>Conclusions: </strong>We designed and implemented a supportive supervision strategy with strong implementation outcomes and most effectiveness outcomes including facility readiness to provide quality hypertension care in Nigeria. This approach can be modelled for supporting HEARTS implementation in other settings.</p><p><strong>Trial registration number: </strong>The trial was prospectively registered at www.</p><p><strong>Clinicaltrials: </strong>gov under NCT04158154 on 8 November 2019; https://clinicaltrials.gov/ct2/show/NCT04158154.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":"14 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699508","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 pharmacy processes in medication delivery service through digitalisation and automation.","authors":"Kian Hong Hong Ng, Wen Jun Tiew, Yook Ting Amanda Woo, Wei Xiong Nathaniel Lim, Tou Teik George Lim, Arleen Susan Baskaran","doi":"10.1136/bmjoq-2024-003150","DOIUrl":"10.1136/bmjoq-2024-003150","url":null,"abstract":"<p><p>The rapid expansion of medication delivery service (MDS) during COVID-19 created many new roles in the pharmacy which are manpower intensive and not sustainable as pharmacy resumes counter collection services. To keep MDS operations sustainable, we identified the need to streamline and automate processes which are manual and repetitive. We seek to determine if the Plan, Do, Study, Act (PDSA) cycles would effectively reduce the man-hours required for the MDS over two phases in 1 year. Phase 1 involved digitalisation of order taking and automation of the data entry process. Phase 2 involved automating the order generation and accounting process to replicate the patient information matching task which was performed manually during bagging and dispatch of delivery orders. The baseline period for this study was from December 2020 to January 2021. The results following implementation of PDSA cycles in the respective phases were collected between January 2021 to June 2021 and July 2021 to December 2021. The average time taken for data entry per delivery order reduced from a range of 0.5 to 2.15 min to 0.08 to 0.1 min depending on the ordering method (p<0.05). The average time taken for bagging and dispatch per delivery order shortened from 2.7 min to 0.28 min (p<0.05). The improvements were sustained and cumulatively contributed to 11.8-man-hour savings. The impact of the interventions was discussed. As MDS gains prominence as an important alternative for medication collection due to its rapid expansion due to COVID-19, it is crucial for the pharmacy to expand its capacity and information technology capabilities to cope with higher workload from both MDS and walk-in patients.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":"14 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699491","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":"Feedback from bereaved relatives via Medical Examiners: what kinds of concerns are raised?","authors":"Saskie Dorman, Becky Protopsaltis, Ryan Barter, Andy Brogan","doi":"10.1136/bmjoq-2024-003152","DOIUrl":"10.1136/bmjoq-2024-003152","url":null,"abstract":"<p><p>Relatives can offer important insights into the quality of care. In England, the Medical Examiner (ME) system has been introduced to identify if there are any causes for concern relating to the cause of death or the person's care in their final illness. We reviewed feedback from bereaved relatives to identify opportunities for improvement. Routinely collected data (date and place of death, demographics, relationship to the person who had died, concerns raised via the ME system) were collated over 12 months (March 2023 to February 2024, East Dorset, UK). Each comment recorded in the ME records was read by one of the authors and issues identified were coded as themes. Concerns were recorded in 8% and appreciative comments in 12%. The most frequent concerns raised related to family/carer communication (56% of concerns raised). Feedback also reported issues relating to access, delays and care which did not attend to what mattered. Effective feedback loops and meaningful action are important elements of generative governance.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":"14 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699483","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":"Initiative to improve oxygen prescribing and oxygen delivery to patients in the emergency department of a national referral hospital.","authors":"Sherab Wangdi, Pema Dechen, Kinley Dorji, Jambay Choden, Loday Drakpa, Pema Tshering, Kinley Tshering, Tashi Tshering, Ugyen Dorji, Ugyen Tshering","doi":"10.1136/bmjoq-2024-003132","DOIUrl":"10.1136/bmjoq-2024-003132","url":null,"abstract":"<p><p>Oxygen is the most commonly used drug and is used in the treatment of hypoxaemia. Like any other drug, it should be prescribed appropriately with correct dose via correct device and based on individual needs. Unmonitored and unrestricted use of oxygen can be harmful to patients. The British Thoracic Society has set guidelines about the indication of oxygen use, target goals and how we can titrate oxygen according to the needs of the patients. A quality improvement project was undertaken with the aim of improving the oxygen prescription among the health personnel and improving the appropriate delivery of oxygen to the patients in an emergency department at a national referral hospital in Bhutan for a period of 12 weeks. Our team implemented five Plan-Do-Study-Act cycles based on the data analysis of each cycle, following discussions and after reviewing previous quality improvement projects. The intervention of team education and sensitisation and frequent reminders via posters, emails and group messages were effective in improving the compliance and prescription rates. The doctors' prescription improved from 20% to 82% and nurses' oxygen record from 22% to 83%, and patients receiving oxygen consistent with valid prescription improved from 34% to 86%.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":"14 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699486","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":"Patterns of errors and weaknesses in the diagnostic process: retrospective analysis of malpractice claims and adverse events from two national databases.","authors":"Siri Tribler, Charlotte Frendved, Eva Benfeldt, Rikke Mørch Jørgensen, Kim Lyngby Mikkelsen","doi":"10.1136/bmjoq-2024-003198","DOIUrl":"10.1136/bmjoq-2024-003198","url":null,"abstract":"<p><strong>Background: </strong>Diagnostic errors (DEs) are a significant global patient safety issue, often associated with increased morbidity and mortality due to overlooked, delayed, or incorrect diagnoses. Our aim was to study the occurrence of DEs and adverse events (AEs), patient-related harm to identify vulnerable steps in the diagnostic process.</p><p><strong>Methods: </strong>A retrospective analysis of data from two public, national databases-National Health Care Compensation Claims Database (2009-2018) and Danish Patient Safety Database with AEs (2015-2020). Vulnerable steps in the diagnostic process were identified using a scoring tool developed by The Controlled Risk Insurance Company.</p><p><strong>Results: </strong>In the analysis of patient compensation claims, 14.5% of all settled cases (n=90 000) were classified as due to a DE, with a 59% compensation rate for DEs, twice the rate compared with other compensated cases (25%). DEs constituted 29% of all compensated cases. Death due to DEs was 8.3% (n=680 cases), 1.8 times higher compared with other cases and DEs resulted in higher degrees of disability.In the overall reported AEs, 0.3% of AEs were fatal and 1.7% AEs caused severe patient harm, per year. In a representative sample of AEs with a severe or fatal consequence (n=269), 33% were due to DEs.The initial clinical assessment was a cause or contributor to the DE in 80% of the compensation cases and in 83% of the severe or fatal AEs. The follow-up and coordination phase were a cause in 33% of compensation cases and 46% of severe or fatal AEs.</p><p><strong>Conclusions: </strong>Errors and AEs in the diagnostic process are prevalent and a significant patient safety issue in Danish healthcare. This study identifies vulnerable steps in the diagnostic process, with patterns correlated to different degrees of severity, and highlights steps for future improvements efforts needed to mitigate the risk of DEs.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":"14 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690979","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":"Clinical impact of Choosing Wisely Canada hepatology recommendations: an interrupted time-series analysis using data from GEMINI.","authors":"Saeha Shin, Surain B Roberts, Yashasavi Sachar, Amol A Verma, Fahad Razak, Mayur Brahmania","doi":"10.1136/bmjoq-2024-003142","DOIUrl":"10.1136/bmjoq-2024-003142","url":null,"abstract":"<p><strong>Introduction: </strong>Choosing Wisely Canada (CWC) Hepatology published recommendations in 2017 aiming to reduce low-value care and testing, including serum ammonia tests for hepatic encephalopathy (HE) and transfusion of blood products for minor invasive procedures. We explored the impact of these recommendations in reducing rates of low-value testing and care.</p><p><strong>Methods: </strong>We included all medicine inpatients from 23 hospitals in Ontario, Canada from the GEMINI database between April 2015 and March 2022. Weekly rates of low-value care were measured before and after the CWC Hepatology recommendations (19 July 2017). Interrupted time-series regression models were used to assess time trends for rates of low-value care. Subgroup analysis was completed on hospitalisations under hepatology or gastroenterology services.</p><p><strong>Results: </strong>Of 59 155 patients identified with liver disease, 17 906 developed HE and 11 676 cirrhosis patients underwent minor invasive procedures. In the HE cohort, there was no immediate change in the rate of ammonia tests with recommendations, but the overall rate decreased by 0.002 tests per hospitalisation per week (95% CI -0.00413 to -0.000009). With recommendations, we observed an increase in the rate of 0.242 (95% CI 0.010 to 0.474 transfusions/hospitalisation), but no significant difference in the rate change nor in the rate of platelet and vitamin K transfusions. There was no significant change in the rate of platelet and vitamin K transfusions. Hospitalisations under hepatology or gastroenterology services also did not have a change in rates of low-value care overall, except for ammonia tests where the rate decreased by 0.012 tests (95% CI -0.0177 to -0.00626 tests/hospitalisation) per week after recommendations.</p><p><strong>Conclusions: </strong>The CWC recommendations were associated with a reduction in the rate of serum ammonia tests, but not with transfusion of blood products. Thus, there remains an opportunity to reduce low-value care and application of clinical guidelines.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":"14 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690841","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":"Improving capacity and flow in a children and young people's Community Eating Disorder Service (CEDS): how a quality improvement initiative led to a reduction in waiting times in the service.","authors":"Sophia Ulhaq, Kamel Cheradi, Abab Ahmed, Kitty Thanki, Mark Dalby","doi":"10.1136/bmjoq-2024-002959","DOIUrl":"10.1136/bmjoq-2024-002959","url":null,"abstract":"<p><p>Eating disorders are serious mental health conditions associated with significant morbidity and mortality. High levels of demand on services have led to increases in wait times to access support. Early intervention of eating disorders is critical to prevent entrenchment of illness and improve prognosis, with long wait times associated with higher rates of relapse.The East London Community Eating Disorder Service has seen an increase in wait time for routine referral from the 2-week local target to 17 weeks. Additionally, there have been long wait times to access treatment, including therapy and psychiatry support.A quality improvement (QI) framework was used in June 2022 to tackle the issues with capacity and flow with an aim to reduce wait times for routine referral from 17 weeks to 2 weeks in 12 months.A QI project team was formed which sought to understand the demands and capacity of the system using process mapping.From this, the team created a driver diagram and used Plan, Do, Study, Act cycles to test change iteratively. Measurements and data were displayed on control and run charts to help learn from the change ideas tested.Improvements were made and sustained, including reduction of routine referral wait time from 17 weeks to 2 weeks in 12 months. Additionally, internal wait lists reduced from 73 patients on the psychiatry list to 0 in 3 months and from 50 families waiting for therapy to 0 in 7 months.A number of inactive cases reduced from 65 to 0 during testing, thus contributing to improved flow through the service. A striking £130 233.21 annual savings in agency staff expenditure was achieved by January 2023.This has enabled a positive culture shift in the service.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":"14 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690844","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":"Improving the quality of care for preterm infants in the golden hour.","authors":"Nalina Amuji, Shashidhar Appaji Rao, Prashantha Yemmethimmanahalli Nagaraju, Kanekal Gautham Suresh, Sofia Steven, Chandrakala Bada Shekharappa","doi":"10.1136/bmjoq-2023-002277","DOIUrl":"10.1136/bmjoq-2023-002277","url":null,"abstract":"<p><strong>Background: </strong>The quality of care provided during the first golden hour after birth in preterm neonates significantly impacts both short- and long-term outcomes. However, implementation of these care processes varies across centres, is not standardised and affects the quality of care.</p><p><strong>Aim: </strong>To improve the quality of care provided during the first golden hour in neonates born at <34 weeks' gestation.</p><p><strong>Methods: </strong>This quality improvement initiative was conducted in a 30-bedded tertiary care teaching hospital in southern India over 28 months (April 2019-July 2021). Evidence-based interventions to improve admission temperature, respiratory care and administering parenteral nutrition and antibiotics during the golden hour were implemented through Plan-Do-Study-Act cycles in four phases for eligible neonates. The effect of these practice changes on clinical outcomes, including intraventricular haemorrhage, necrotising enterocolitis, retinopathy of prematurity, bronchopulmonary dysplasia and survival ratewere studied.</p><p><strong>Results: </strong>A total of 311 eligible neonates were included in the study. Admission hypothermia significantly reduced from 79% to 22% (p=0.003), and adherence to the respiratory bundle improved from 13% to 77% (p<0.001). The time taken for administration of parenteral nutrition improved from 102±23 min to 62.5±26.7 min (mean±SD) (p<0.001). The median time for administration of antibiotics improved from 162 (135, 173) min to 74 (69, 102) min (median±IQR) (p=0.001) and improvement in mean blood glucose from 35 (12) mg/dL to 54 (14) mg/dL (mean±SD) (p<0.001) at neonatal intensive care unit (NICU) admission, and admission time to NICU from 66.4±16 min to 41±13.8 min (p<0.001).</p><p><strong>Conclusion: </strong>Quality improvement project of improving care in the golden hour after birth in < 34 weeks neonates reduces admission hypothermia and hypoglycaemia and improves the time of admission to NICU, and time of administration of parenteral nutrition and antibiotics.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":"14 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690976","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":"Improving diagnosis-based quality measures: an application of machine learning to the prediction of substance use disorder among outpatients.","authors":"Katherine J Hoggatt, Alex H S Harris, Corey J Hayes, Donna Washington, Emily C Williams","doi":"10.1136/bmjoq-2024-003017","DOIUrl":"10.1136/bmjoq-2024-003017","url":null,"abstract":"<p><strong>Objective: </strong>Substance use disorder (SUD) is clinically under-detected and under-documented. We built and validated machine learning (ML) models to estimate SUD prevalence from electronic health record (EHR) data and to assess variation in facility-level SUD identification using clinically documented diagnoses vs model-based estimated prevalence.</p><p><strong>Methods: </strong>Predictors included demographics, SUD-related diagnoses and healthcare utilisation. The criterion outcome for model development was prevalent SUD assessed via a patient survey across 30 geographically representative Veterans Health Administration (VA) sites (n=5989 patients). We split the data into training and testing datasets and built a series of ML models using cross-validation to minimise over-fitting. We selected the final model based on its performance in predicting SUD in the testing dataset. Using the final model, we estimated SUD prevalence at all 30 sites. We then compared facilities based on SUD identification using two alternative SUD identification measures: the facility-level SUD diagnosis rate and model-based estimated SUD prevalence.</p><p><strong>Results: </strong>The best-performing LASSO model with n=61 predictors doubled the sensitivity for classifying SUD relative to a model with only documented SUD diagnoses (0.682 vs 0.331). Across the 30 sites, SUD diagnosis rates ranged from 6.4%-13.9% and predicted SUD prevalence ranged from 9.7-16.0%. The difference in facility-level SUD identification (observed diagnosis rate minus predicted prevalence) ranged from -7.2 to +1.3 percentage points. Comparing facilities' rank ordering on documented SUD diagnosis rates vs estimated SUD prevalence, 16 out of 30 sites had a ranking that changed by at least a quintile (ie, 6 places or more).</p><p><strong>Conclusions: </strong>This analysis shows that use of model-based performance measures may help address measurement blind spots that arise due to differences in diagnostic accuracy across sites. Although model-based estimates better estimate SUD prevalence relative to diagnoses alone for facility quality assessment, further improvements and individual SUD detection both require enhanced direct screening for non-alcohol drug use.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":"14 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691037","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":"Failure mode and effects analysis applied to central venous catheter placement.","authors":"James R Duncan, Daniel Harwood, Bruno Maranhao, Ellen Wertenberger, Jacob Grant, Mona Ostman","doi":"10.1136/bmjoq-2024-003173","DOIUrl":"10.1136/bmjoq-2024-003173","url":null,"abstract":"<p><p>Despite diligent efforts, complications continue to occur during the placement of central venous catheters (CVCs). Healthcare Failure Mode and Effect Analysis has been promoted as a process improvement tool and this review describes the strategic application of Failure Mode and Effects Analysis (FMEA) to CVC placement. The objective is to demonstrate the utility of FMEA first as a tool for identifying quality or safety issues and second for guiding mitigation efforts.</p>","PeriodicalId":9052,"journal":{"name":"BMJ Open Quality","volume":"14 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690843","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}