Systematic review of safety checklists for use by medical care teams in acute hospital settings--limited evidence of effectiveness.

Background: Patient safety is a fundamental component of good quality health care. Checklists have been proposed as a method of improving patient safety. This systematic review, asked "In acute hospital settings, would the use of safety checklists applied by medical care teams, compared to not using checklists, improve patient safety?"

Methods: We searched the Cochrane Library, MEDLINE, CINAHL, and EMBASE for randomised controlled trials published in English before September 2009.

Why don't hospital staff activate the rapid response system (RRS)? How frequently is it needed and can the process be improved?

Background: The rapid response system (RRS) is a process of accessing help for health professionals when a patient under their care becomes severely ill. Recent studies and meta-analyses show a reduction in cardiac arrests by a one-third in hospitals that have introduced a rapid response team, although the effect on overall hospital mortality is less clear. It has been suggested that the difficulty in establishing the benefit of the RRS has been due to implementation difficulties and a reluctance of clinical staff to call for additional help.

ISBAR for clear communication: one hospital's experience spreading the message.

All health services rely on efficient and accurate communication between health professionals to ensure safe and effective patient care. Our health service introduced a standardised technique, ISBAR (Identify, Situation, Background, Assessment, Request), for telephone communication. We describe and evaluate the implementation of this project; evaluation was undertaken using program logic mapping.