Publications by authors named "Derek W Meeks"
Progress in reducing diagnostic errors remains slow partly due to poorly defined methods to identify errors, high-risk situations, and adverse events. Electronic trigger (e-trigger) tools, which mine vast amounts of patient data to identify signals indicative of a likely error or adverse event, offer a promising method to efficiently identify errors. The increasing amounts of longitudinal electronic data and maturing data warehousing techniques and infrastructure offer an unprecedented opportunity to implement new types of e-trigger tools that use algorithms to identify risks and events related to the diagnostic process.
View Article and Find Full Text PDFBackground: Many healthcare organisations (HCOs) use peer review to evaluate clinical performance, but it is unclear whether these data provide useful insights for assessing the sharp end of patient safety.
Objective: To describe outcomes of peer review within the Department of Veterans Affairs (VA) healthcare system and identify opportunities to leverage peer review data for measurement and improvement of safety.
Design: We partnered with the VA's Risk Management Program Office to perform descriptive analyses of aggregated peer review data collected from 135 VA facilities between October 2011 and September 2012.
An analysis of electronic health record-related patient safety concerns.
J Am Med Inform Assoc
May 2015
Objective: A recent Institute of Medicine report called for attention to safety issues related to electronic health records (EHRs). We analyzed EHR-related safety concerns reported within a large, integrated healthcare system.
Methods: The Informatics Patient Safety Office of the Veterans Health Administration (VA) maintains a non-punitive, voluntary reporting system to collect and investigate EHR-related safety concerns (ie, adverse events, potential events, and near misses).
Objective: The intersection of electronic health records (EHR) and patient safety is complex. To examine the applicability of two previously developed conceptual models comprehensively to understand safety implications of EHR implementation in the English National Health Service (NHS).
Methods: We conducted a secondary analysis of interview data from a 30-month longitudinal, prospective, case study-based evaluation of EHR implementation in 12 NHS hospitals.
Importance: Little is known about the relationship between physicians' diagnostic accuracy and their confidence in that accuracy.
Objective: To evaluate how physicians' diagnostic calibration, defined as the relationship between diagnostic accuracy and confidence in that accuracy, changes with evolution of the diagnostic process and with increasing diagnostic difficulty of clinical case vignettes.
Design, Setting, And Participants: We recruited general internists from an online physician community and asked them to diagnose 4 previously validated case vignettes of variable difficulty (2 easier; 2 more difficult).
Background: the purpose of this study was to assess predictive factors and compliance with surgical site infection (SSI) prevention guidelines at 2 county hospitals.
Design: chart review and analysis of laparotomy patients undergoing colorectal, hysterectomy, or abdominal vascular procedures over two 6-month periods 1 year apart and evaluation of safety climate using the Safety Attitudes Questionnaire (SAQ).
Results: overall compliance with all antibiotic prophylaxis guidelines was 62% (n = 442).
Background: Appendectomy for appendicitis is a common operation that is performed by most general surgeons. Despite the large number of appendectomies, numerous management controversies continue.
Methods: Review of the pertinent English language literature.