by
Farley, Donna.
Call Number
618.2009593 22
Publication Date
2010
Summary
A RAND study of teamwork-improvement initiatives in hospital labor and delivery (L & D) units was designed to document and learn from the experiences and outcomes of five L & D units as they implemented improvements in their teamwork practices over a one-year period. The study had two objectives: (1) better understand the conditions and actions required for hospital L & D units to achieve effective and sustainable teamwork practices, and (2) assess the extent to which successful adoption of teamwork practices may influence the experiences of L & D staff and patient outcomes. Substantial progress is possible in one year of implementing teamwork practices, which can improve proximal outcomes, such as staff knowledge and perceptions. More than a year of implementation effort is required to achieve a high level of performance on teamwork practices. Two dynamics might be involved in later years of implementation: (1) momentum from the first year might continue into later years, such that subsequent implementation might reinforce continued improvement, and (2) it might not be possible to sustain high intensity in implementation beyond the first year. The study results reinforce the importance of developing and implementing a well-crafted strategy by training staff in the L & D units, working consistently with staff to introduce practices, and providing coaching on effective use of practices. The study identified some key factors required by any given strategy for teamwork improvement, but it did not point to a standard template for implementation. This result implies that there may not be one fixed "intervention" that could be tested in comparative-control studies to develop further evidence for teamwork practices.
Format:
Electronic Resources
Relevance:
113746.9922
by
Farley, Donna.
Call Number
362.110973 22
Publication Date
2009
Summary
Presents the results of a two-year study that analyzes how patient safety practices are being adopted by U.S. health care providers, examines hospital experiences with a patient safety culture survey, and assesses patient safety outcomes trends. In case studies of four U.S. communities, researchers collected information on the dynamics of local patient safety activities and on adoption of safe practices by hospitals.
Format:
Electronic Resources
Relevance:
111148.1563
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by
Farley, Donna.
Call Number
610 22
Publication Date
2007
Summary
RAND has contracted with the Agency for Healthcare Research and Quality (AHRQ) to perform a longitudinal evaluation of the full scope of AHRQ's patient safety activities and to provide regular feedback to support the continuing improvement of the initiative over a four-year evaluation period. This interim report presents an update on the work RAND has performed during FY 2007 for the practice diffusion assessment. The assessment encompasses five specific analytic components: (1) development of a survey questionnaire to use for assessing adoption of the safe practices endorsed by the National Quality Foundation, (2) community studies of patient safety practice adoption and related activities, (3) continued analysis of trends in patient outcomes related to safety, (4) lessons from hospitals' use of patient safety tools developed by AHRQ, and (5) a second fielding of the hospital adverse event reporting system survey.
Format:
Electronic Resources
Relevance:
99137.9844
by
Farley, Donna.
Call Number
616.23806 22
Publication Date
2005
Summary
In partnership with the Army Medical Department (AMEDD), RAND researchers worked to implement clinical practice guidelines in treatment of three common ailments (asthma, diabetes, and low back pain). This report is an evaluation of the asthma practice guideline demonstration. It documents the extent to which intended actions were implemented, assesses short-term effects on clinical practices, and measures the quality and limitations of available data for monitoring practice improvements and clinical outcomes. The authors found that, although the implementation scored some notable successes, resource limitations and organizational barriers curbed overall progress. They conclude that allowing for flexibility, monitoring the facilities consistently, and training providers thoroughly are the keys to implementing the practice guidelines throughout AMEDD. The also concluded that patient education was an area in need of improvement.
Format:
Electronic Resources
Relevance:
21585.8398
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