Understanding Patient Personality in Medical Care: Five-Factor Model.

Personality is the description of an individual's tendencies when acting or reacting to others. Clinicians spontaneously form impressions of a patient's apparent personality yet such unstructured impressions might lead to snap judgments or unhelpful labels. Here we review the evidence-based five-factor model from psychology science for understanding personalities (OCEAN taxonomy).

Multivariable risk scores for predicting short-term outcomes for emergency department patients with unexplained syncope: A systematic review.

Objectives: Emergency department (ED) patients with unexplained syncope are at risk of experiencing an adverse event within 30 days. Our objective was to systematically review the accuracy of multivariate risk stratification scores for identifying adult syncope patients at high and low risk of an adverse event over the next 30 days.

Methods: We conducted a systematic review of electronic databases (MEDLINE, Cochrane, Embase, and CINAHL) from database creation until May 2020.

Did This Patient Have Cardiac Syncope?: The Rational Clinical Examination Systematic Review.

Importance: Syncope can result from a reduction in cardiac output from serious cardiac conditions, such as arrhythmias or structural heart disease (cardiac syncope), or other causes, such as vasovagal syncope or orthostatic hypotension.

Objective: To perform a systematic review of studies of the accuracy of the clinical examination for identifying patients with cardiac syncope.

Study Selection: Studies of adults presenting to primary care, emergency departments, or referred to specialty clinics.

Frequency and clinical relevance of inconsistent code status documentation.

Background: Accurate and complete documentation of hospitalized patients' code status is important to ensure that healthcare providers take appropriate action in the event of a cardiac arrest.

Objective: Determine the frequency and clinical relevance of incomplete and inconsistent code status documentation.

Design: Point-prevalence study.

Application of a trigger tool in near real time to inform quality improvement activities: a prospective study in a general medicine ward.

Background: Retrospective record review using trigger tools remains the most widely used method for measuring adverse events (AEs) to identify targets for improvement and measure temporal trends. However, medical records often contain limited information about factors contributing to AEs. We implemented an augmented trigger tool that supplemented record review with debriefing front-line staff to obtain details not included in the medical record.

Patient safety, resident well-being and continuity of care with different resident duty schedules in the intensive care unit: a randomized trial.

Background: Shorter resident duty periods are increasingly mandated to improve patient safety and physician well-being. However, increases in continuity-related errors may counteract the purported benefits of reducing fatigue. We evaluated the effects of 3 resident schedules in the intensive care unit (ICU) on patient safety, resident well-being and continuity of care.

Sustaining quality improvement and patient safety training in graduate medical education: lessons from social theory.

Purpose: Despite an official mandate to incorporate formal quality improvement (QI) and patient safety (PS) training into graduate medical education, many QI/PS curricular efforts face implementation challenges and are not sustained. Educators are increasingly turning to sociocultural theories to address issues such as curricular uptake in medical education. The authors conducted a case study using Bourdieu's concepts of "field" and "habitus" to identify theoretically derived strategies that can promote sustained implementation of QI/PS curricula.

Getting the message: a quality improvement initiative to reduce pages sent to the wrong physician.

Background: One in seven pages are sent to the wrong physician and may result in unnecessary delays that potentially threaten patient safety. The authors aimed to implement a new team-based paging process to reduce pages sent to the wrong physician.

Methods: The authors redesigned the paging process on general internal medicine (GIM) wards at a Canadian academic medical centre by implementing a standardised team-based paging process (pages directed to one physician responsible for receiving pages on behalf of the entire physician team) using rapid-cycle change methods.

Usability evaluation of order sets in a computerised provider order entry system.

Background: Computerised provider order entry (CPOE) is an important patient safety intervention that has encountered significant barriers to implementation. The usability of a CPOE system plays a significant role in its acceptance. The authors conducted a heuristic evaluation of a CPOE order set system to uncover existing usability issues prior to implementation.

Does user-centred design affect the efficiency, usability and safety of CPOE order sets?

Background: Application of user-centred design principles to Computerized provider order entry (CPOE) systems may improve task efficiency, usability or safety, but there is limited evaluative research of its impact on CPOE systems.

Objective: We evaluated the task efficiency, usability, and safety of three order set formats: our hospital's planned CPOE order sets (CPOE Test), computer order sets based on user-centred design principles (User Centred Design), and existing pre-printed paper order sets (Paper).

Participants: 27 staff physicians, residents and medical students.

Teaching quality improvement and patient safety to trainees: a systematic review.

Purpose: To systematically review published quality improvement (QI) and patient safety (PS) curricula for medical students and/or residents to (1) determine educational content and teaching methods, (2) assess learning outcomes achieved, and (3) identify factors promoting or hindering curricular implementation.

Method: Data sources included Medline (to January 2009), EMBASE, HealthSTAR, and article bibliographies. Studies selected reported curricula outlining specific educational content and teaching format.

Prolonged time to alarm in infusion devices operated at low flow rates.

Objective: To evaluate the time to occlusion alarm for peristaltic infusion devices used in Toronto adult critical care units.

Design: Cross-sectional study.

Setting: Biomedical engineering departments of four Toronto teaching hospitals.

Frequency, type and clinical importance of medication history errors at admission to hospital: a systematic review.

Background: Over a quarter of hospital prescribing errors are attributable to incomplete medication histories being obtained at the time of admission. We undertook a systematic review of studies describing the frequency, type and clinical importance of medication history errors at hospital admission.

Methods: We searched MEDLINE, EMBASE and CINAHL for articles published from 1966 through April 2005 and bibliographies of papers subsequently retrieved from the search.

Unintended medication discrepancies at the time of hospital admission.

Background: Prior studies suggest that unintended medication discrepancies that represent errors are common at the time of hospital admission. These errors are particularly worthy of attention because they are not likely to be detected by computerized physician order entry systems.

Methods: We prospectively studied patients reporting the use of at least 4 regular prescription medications who were admitted to general internal medicine clinical teaching units.

Fat embolism syndrome and elective knee arthroplasty.

Purpose: To report a case of fat embolism syndrome (FES) following elective left knee arthroplasty and review the diagnosis, investigation, prevention and perioperative management of this condition.

Clinical Features: A 76-yr-old lady presented for left total knee arthroplasty under general anesthesia. After an uneventful anesthetic and initial recovery, she developed respiratory and neurological complications six hours postoperatively necessitating supportive care in the intensive care unit.