One size fits all? Challenges faced by physicians during shift handovers in a hospital with high sender/recipient ratio.

Introduction: The aim of the present study was to investigate the challenges faced by physicians during shift handovers in a university hospital that has a high handover sender/recipient ratio.

Methods: A multifaceted approach was adopted, comprising recording and analysis of handover information, rating of handover quality, and shadowing of handover recipients. Data was collected at the general medical ward of a university hospital in Singapore for a period of three months.

Radiology department, human factors and organizational perspectives: using action research to improve patient safety.

Background: Action research is a participatory research method based on active cooperation between researchers and subjects. In clinical practice, action research enables active involvement of workers in developing and implementing actions promoting patient safety. This article describes a participatory action research project that was conducted in the radiology department of a tertiary care university hospital.

Creating patient safety capacity in a nation's health system: A comparison between Israel and Canada.

Injuries to patients by the healthcare system (i.e., adverse events) are common and their impact on individuals and systems is considerable.

Nasogastric tube, temperature probe, and bougie stapling during bariatric surgery: a multicenter survey.

Background: An adverse event in laparoscopic bariatric surgery that has not received much scrutiny involves tube/probe stapling or suturing during gastrectomy or gastroenterostomy.

Methods: A retrospective analysis was performed using a questionnaire sent to all bariatric surgeons (n = 43) in Israel.

Results: Eight surgeons reported on 17 cases in which intraoperative nasogastric/orogastric tube (n = 8), temperature probe (n = 6), or bougie stapling (n = 3) was identified.

The value of 'gentle reminder' on safe medical behaviour.

Background: Based on knowledge and methods from cognitive psychology and behavioural economics we introduced 'Gentle reminder.' This procedure calls for public planning of safety norms, and an agreement of all team members to help each other to adhere to this plan.

Methods: Team members agree to gently remind their coworkers every time they deviate from the safety norm.

Preoperative briefing in the operating room: shared cognition, teamwork, and patient safety.

Contemporary preoperative team briefings conducted to improve patient safety focus mainly on supplying identification details regarding the patient and the surgical procedure. Drawing on cognitive theory principles, in this study a briefing protocol was developed that presents a broader perspective model of the patient and the planned procedure. In addition to customary identification details and drug sensitivities, the new briefing also includes review of significant background information, needed equipment, planned surgery stages, and so forth.

Healthcare climate: a framework for measuring and improving patient safety.

Objectives: Reviews of patient safety efforts suggest that technical/administrative change must be augmented by global factors such as organizational culture and climate. The objective was to outline a comprehensive model for healthcare climate and test one of its elements, the nursing subclimate, in terms of several patient safety outcomes.

Design: Measure organizational climate in nursing units, followed by random sampling of patient safety practices in each unit 6 months later.

Anesthesiologists on ambulances: where do we stand?

Purpose Of Review: This manuscript provides a critical review of the literature regarding the staffing of emergency medical services, with particular emphasis on anesthesiologists.

Recent Findings: Significant anesthesiology contributions to prehospital care include introduction of new airway management tools and improved physiological monitoring. Contributions to quality of care include patient benefit in terms of life years gained and a specific reduction in mortality from acute myocardial infarction.

Air transportation of patients with end-stage liver disease to distant liver transplantation centers.

The Israeli population does not meet its transplantation organ needs. Therefore, liver transplantation (LTX) candidates are sometimes transported to centers abroad. We aimed to assess the demographic and clinical issues concerning this policy.

The hostile environment of the intensive care unit.

Intensive care units (ICUs) were developed for patients with special needs and include an array of technology to support medical care. However, basic lessons in ergonomics, human factors, and human performance fail to propagate in this complex medical environment. Complicated, error-prone devices are commonly used.

Lateral decubitus position for percutaneous nephrolithotripsy in the morbidly obese or kyphotic patient.

Background And Purpose: Morbidly obese or debilitated patients do not tolerate the prone position used for percutaneous nephrolithotripsy (PCNL) well and may suffer from severe cardiorespiratory compromise in this position. The purpose of this study is to demonstrate a simple way to overcome this difficulty.

Patients And Methods: Two morbidly obese patients, ages 48 and 32 years, with Body Mass Indices of 47.

[Avoiding human errors in the hospital--mission possible?!].

The way to combat the high frequency of errors and mistakes that endanger both the physician and the patient is by root cause analysis of accidents as well as investigation of "near misses". There is a need for a new approach to error prevention by re-education of the medical teams. A few examples are presented on how to approach an untoward event so as to learn from it rather than punish.