Responsible Practice or Restricted Practice? an Empirical Study of the Use of Clinical Guidelines in Medical Negligence Litigation.

In medical negligence litigation, the standard for breach of duty is measured against the Bolam test which reflects accepted practice. Despite protracted debate and common law development, the Bolam standard remains the touchstone for litigation in this area. Clinical guidelines (CGs) are statements based upon best available medical evidence and are designed to facilitate clinical decision-making to optimise outcomes thereby reflecting expected practice.

Intervening to enhance collaboration in translational research: A relational coordination approach.

Introduction: A core challenge of a multidisciplinary and multi-organizational translational research enterprise such as a Clinical and Translational Research Award (CTSA) is coordinating and integrating the work of individuals, workgroups, and organizations accustomed to working independently and autonomously. Tufts Clinical and Translational Science Institute (CTSI) undertook and studied a multifacted intervention to address this challenge and to create a culture of systems thinking, process awareness, responsive to others' needs, and shared decision-making.

Intervention: The intervention, based on relational coordination, included 1) relational interventions, in three staff retreats and a diagnostic survey to provide feedback on the current quality of relational coordination, and 2) structural interventions, in the launching of five new cross-functional teams with regular meeting structures.

DEVO-(WO) MAN? A MOVE IN RESPECT OF PERSONAL SOVEREIGNTY AND DECISION-MAKING IN HEALTH CARE? Anita Border v Lewisham and Greenwich NHS Trust [2015] EWCA Civ 8.

This case commentary discusses a recent case concerning the determination of acceptable clinical practice. It critically examines two particular elements of the judgment-the method for the determination of acceptable clinical practice including the impact (if any) of the Bolitho exception. It then moves on to considering the importance of consent as a pre-requisite for medical treatment and the interplay of negligence and battery in this area.

Teamwork methods for accountable care: relational coordination and TeamSTEPPS®.

Background: To deliver greater value in the accountable care context, the Institute of Medicine argues for a culture of teamwork at multiple levels--across professional and organizational siloes and with patients and their families and communities. The logic of performance improvement is that data are needed to target interventions and to assess their impact. We argue that efforts to build teamwork will benefit from teamwork measures that provide diagnostic information regarding the current state and teamwork interventions that can respond to the opportunities identified in the current state.

Pathways of health technology diffusion: the United States and low-income countries.

In the United States, the complex process of getting health care technologies into practice takes place in a competitive health system that is driven by technological innovation. Federal, state, and local governments' roles in the diffusion process are limited. In low-income countries, where competitive markets are not as prominent, diffusing medical innovations requires an alternative understanding of how new technologies are adopted.