BMJ Quality & Safety最新文献

{"title":"Early achieved ambulation is associated with reduced venous thromboembolism among hospitalised medicine patients.","authors":"Erik H Hoyer, Daniel J Brotman, Daniel Young, Brandyn D Lau, Elizabeth Colantuoni, Karli Funk, Elliott R Haut, Ximin Li, Michael B Streiff","doi":"10.1136/bmjqs-2026-020720","DOIUrl":"https://doi.org/10.1136/bmjqs-2026-020720","url":null,"abstract":"","PeriodicalId":9077,"journal":{"name":"BMJ Quality & Safety","volume":" ","pages":""},"PeriodicalIF":6.8,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of patient engagement in patient safety on reducing adverse events: a systematic review and meta-analysis.","authors":"Sixue Cai, Liqin Wei, Yunting Luo, Yan Cai, Yan Jiang","doi":"10.1136/bmjqs-2026-020874","DOIUrl":"https://doi.org/10.1136/bmjqs-2026-020874","url":null,"abstract":"","PeriodicalId":9077,"journal":{"name":"BMJ Quality & Safety","volume":" ","pages":""},"PeriodicalIF":6.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orthopaedic surgical implementation gap: an exploratory descriptive analysis tracking the use of common elective orthopaedic surgeries in England across two decades.","authors":"Laura Kudrna, Kelly Ann Schmidtke, Hannah Crothers, Katharine Reeves, Mary Kariuki, Chetan Khatri, Imran A Ahmed, Gevdeep Bhabra, Stephen Metcalfe, Samuel I Watson, Richard Lilford","doi":"10.1136/bmjqs-2026-020202","DOIUrl":"https://doi.org/10.1136/bmjqs-2026-020202","url":null,"abstract":"","PeriodicalId":9077,"journal":{"name":"BMJ Quality & Safety","volume":" ","pages":""},"PeriodicalIF":6.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of non-technical skills training on patient outcomes in surgery: a systematic review and meta-analysis.","authors":"Ibrahim M Muhammad, Maha F Valiyakathu, Gianluigi Zanovello, Stefan Haensel, Bhaskar Somani, Nicholas Raison","doi":"10.1136/bmjqs-2026-020646","DOIUrl":"https://doi.org/10.1136/bmjqs-2026-020646","url":null,"abstract":"<p><strong>Background: </strong>Non-technical skills (NTS) such as teamwork, communication and leadership are essential for surgical safety, but their impact on patient outcomes is uncertain. This systematic review evaluated whether NTS interventions improve operative and patient outcomes in surgical settings.</p><p><strong>Methods: </strong>Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, seven databases were searched for randomised and non-randomised studies of NTS interventions reporting patient or operative outcomes. Eligible interventions included team training, simulation, Crew Resource Management, Team Strategies and Tools to Enhance Performance and Patient Safety and in-theatre coaching. Risk of bias was assessed with the Cochrane risk-of-bias tool for randomized trials and Risk Of Bias In Non-randomised Studies - of Interventions tools, and findings were synthesised both quantitatively and narratively.</p><p><strong>Results: </strong>13 studies met inclusion criteria. NTS interventions consistently improved teamwork, communication and checklist adherence, with a statistically significant gain in validated performance scores (mean difference (MD) 6.91 points, 95% CI 2.95 to 10.9). Clinical outcomes were less consistent: individual large, system-level programmes reported reductions in complications and mortality (relative reductions ≈15-20%), but pooled controlled analyses did not demonstrate statistically significant improvements in complications (OR 0.91, 95% CI 0.45 to 1.86), readmission (OR 0.90, 95% CI 0.61 to 1.33) or length of stay (MD -0.84 days, 95% CI -3.40 to 1.73).</p><p><strong>Conclusions: </strong>NTS training reliably improves observed teamwork and communication behaviours in the operating theatre, but the current evidence for a resulting benefit to patients is weak and dominated by non-randomised, higher risk of bias studies; the sole randomised trial found no significant benefit. Sustained, system-wide implementation with ongoing reinforcement and cultural alignment was associated with more consistent behavioural gains, but adequately powered randomised trials are needed before firm practice recommendations can be made.</p><p><strong>Prospero registration number: </strong>CRD420250648285.</p>","PeriodicalId":9077,"journal":{"name":"BMJ Quality & Safety","volume":" ","pages":""},"PeriodicalIF":6.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uncovering the missing links: from peripheral intravenous catheter policy and care to measurable outcomes.","authors":"Josephine Lovegrove, Claire Rickard","doi":"10.1136/bmjqs-2025-020023","DOIUrl":"https://doi.org/10.1136/bmjqs-2025-020023","url":null,"abstract":"","PeriodicalId":9077,"journal":{"name":"BMJ Quality & Safety","volume":" ","pages":""},"PeriodicalIF":6.8,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interprofessional learning as a mechanism for quality improvement and patient safety.","authors":"Andreas Xyrichis, Merrick Zwarenstein","doi":"10.1136/bmjqs-2026-020465","DOIUrl":"10.1136/bmjqs-2026-020465","url":null,"abstract":"","PeriodicalId":9077,"journal":{"name":"BMJ Quality & Safety","volume":" ","pages":"658-660"},"PeriodicalIF":6.8,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Who chooses to engage? Understanding the characteristics of physicians who voluntarily engage with an audit and feedback intervention: a retrospective cohort study.","authors":"Cherry Chu, Noah Ivers, Braeden Terpou, Mina Tadrous, Canyucel Gungor, Geneviève Rouleau, Laura Desveaux","doi":"10.1136/bmjqs-2025-019490","DOIUrl":"10.1136/bmjqs-2025-019490","url":null,"abstract":"<p><strong>Background: </strong>Voluntary clinician engagement in audit and feedback (A&F) initiatives is often suboptimal. We compared a range of characteristics between physicians who voluntarily engaged and those who did not.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using administrative databases and a survey. The cohort included Ontario primary care physicians practising between April 2017 and March 2020. The A&F group voluntarily enrolled in an A&F intervention; control physicians did not enrol. We compared demographic, practice and patient characteristics between groups. Four validated questionnaires measured beliefs about feedback and improvement. Logistic regression modelled adjusted odds of A&F engagement.</p><p><strong>Results: </strong>Of 10 654 active primary care physicians in Ontario, 1400 voluntarily engaged in A&F compared with 9254 controls. Physicians had higher odds of engaging with A&F if they had a larger roster size (OR (95% CI) 2.75 (2.15 to 3.51), p<0.001) and worked in home care (1.75 (1.55 to 1.97), p<0.001), and lower odds of engaging if they had higher continuity of care (0.66 (0.49 to 0.90), p=0.008), practised for more years (0.53 (0.44 to 0.62), p<0.001) and enrolled in a fee-for-service model (0.74 (0.65 to 0.85), p<0.001). Physicians engaged with A&F had fewer racialised or immigrant patients (25% vs 30% in marginalisation quintile 5, standardised mean difference=0.10), while other demographic characteristics were similar. Among the survey respondents (36 A&F physicians and 90 controls), higher principal support (2.28 (1.29 to 4.48), p=0.008), lower perceived need for change (discrepancy) (0.39 (0.20 to 0.70), p=0.003) and lower engagement in QI (0.43 (0.18 to 0.88), p=0.032) predicted A&F engagement.</p><p><strong>Conclusion: </strong>To expand A&F's reach and impact, future efforts should (1) tailor outreach to physicians with larger, more diverse practice populations, (2) seek to understand why physicians with higher perceived need for change engage less, (3) understand which physicians are most likely to benefit and (4) co-design how to make A&F more relevant and actionable for those serving marginalised communities.</p>","PeriodicalId":9077,"journal":{"name":"BMJ Quality & Safety","volume":" ","pages":"661-672"},"PeriodicalIF":6.8,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145740996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How can we prevent clinical deskilling when using AI?","authors":"Ian Scott, Anton van der Vegt, Peter Douglas","doi":"10.1136/bmjqs-2026-020130","DOIUrl":"10.1136/bmjqs-2026-020130","url":null,"abstract":"","PeriodicalId":9077,"journal":{"name":"BMJ Quality & Safety","volume":" ","pages":"722-726"},"PeriodicalIF":6.8,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Audit and feedback in primary care: if you build it, will they come? Understanding which clinicians engage with an audit and feedback intervention.","authors":"Steve Van den Bulck, Bert Vaes","doi":"10.1136/bmjqs-2025-019939","DOIUrl":"10.1136/bmjqs-2025-019939","url":null,"abstract":"","PeriodicalId":9077,"journal":{"name":"BMJ Quality & Safety","volume":" ","pages":"655-657"},"PeriodicalIF":6.8,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148381529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International survey of people living with chronic conditions: development and evaluation of the PaRIS Patient Questionnaire (PaRIS-PQ) in 18 countries.","authors":"Jose M Valderas, Ian Porter, Jonathan P Evans, Monique Heijmans, Mieke Rijken, Oliver Groene, Janika Bloemeke-Cammin, Rosa Sunol, Rachel Williams, Marta Ballester, Katherine de Bienassis, Candan Kendir, Frederico Guanais, Dolf de Boer, Michael van den Berg","doi":"10.1136/bmjqs-2025-018548","DOIUrl":"10.1136/bmjqs-2025-018548","url":null,"abstract":"<p><strong>Background: </strong>The Patient Reported Indicator Surveys (PaRIS) initiative of the Organisation for Economic Co-operation and Development aimed to develop a valid and reliable instrument for self-reported assessment of health outcomes and experiences in primary and ambulatory care for people living with chronic conditions. This paper reports on the development and evaluation of the PaRIS Patient Questionnaire (PaRIS-PQ) in an 18-country field trial.</p><p><strong>Methods: </strong>Following systematic reviews of instruments measuring core domains in the PaRIS conceptual framework (outcomes, experiences, health and healthcare capabilities and health behaviours), four instruments for each domain were shortlisted, and their psychometric performance was assessed using the Evaluating the Measurement of Patient-Reported Outcomes tool. In a modified Delphi procedure, one instrument was selected for each domain, along with additional relevant items. The preliminary English questionnaire was translated and cognitively tested. Psychometric evaluation was conducted on field trial data at item (missingness, distribution, ceiling/floor effects) and scale level (reliability, structure, construct validity).</p><p><strong>Findings: </strong>217 instruments were identified measuring one or more of the domains of the conceptual framework. Following mapping and prioritisation, the first draft of the PaRIS-PQ included 118 items. In the field trial (18 countries, 10 894 patients) median completion time ranged 24-33 minutes. PaRIS-PQ performed well at item and scale level. Reliability was ≥0.70 for most relevant measures at patient level, but not at practice and country level. Validity was adequate overall. Removal of additional items (3) resulted in the final PaRIS-PQ (115 items).</p><p><strong>Interpretation: </strong>PaRIS-PQ demonstrates adequate psychometric performance for measuring experiences and outcomes of primary care for people living with chronic conditions. The instrument facilitates the collection of essential information for health policy and systems decision-making.</p>","PeriodicalId":9077,"journal":{"name":"BMJ Quality & Safety","volume":" ","pages":"687-697"},"PeriodicalIF":6.8,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}