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Patient safety initiatives in obstetrics: a rapid review
OBJECTIVES: This review was commissioned by WHO, South Africa-Country office because of an exponential increase in medical litigation claims related to patient safety in obstetrical care in the country. A rapid review was conducted to examine the effectiveness of quality improvement (QI) strategies...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6042535/ https://www.ncbi.nlm.nih.gov/pubmed/29982200 http://dx.doi.org/10.1136/bmjopen-2017-020170 |
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author | Antony, Jesmin Zarin, Wasifa Pham, Ba’ Nincic, Vera Cardoso, Roberta Ivory, John D Ghassemi, Marco Barber, Sarah Louise Straus, Sharon E Tricco, Andrea C |
author_facet | Antony, Jesmin Zarin, Wasifa Pham, Ba’ Nincic, Vera Cardoso, Roberta Ivory, John D Ghassemi, Marco Barber, Sarah Louise Straus, Sharon E Tricco, Andrea C |
author_sort | Antony, Jesmin |
collection | PubMed |
description | OBJECTIVES: This review was commissioned by WHO, South Africa-Country office because of an exponential increase in medical litigation claims related to patient safety in obstetrical care in the country. A rapid review was conducted to examine the effectiveness of quality improvement (QI) strategies on maternal and newborn patient safety outcomes, risk of litigation and burden of associated costs. DESIGN: A rapid review of the literature was conducted to provide decision-makers with timely evidence. Medical and legal databases (eg, MEDLINE, Embase, LexisNexis Academic, etc) and reference lists of relevant studies were searched. Two reviewers independently performed study selection, abstracted data and appraised risk of bias. Results were summarised narratively. INTERVENTIONS: We included randomised clinical trials (RCTs) of QI strategies targeting health systems (eg, team changes) and healthcare providers (eg, clinician education) to improve the safety of women and their newborns. Eligible studies were limited to trials published in English between 2004 and 2015. PRIMARY AND SECONDARY OUTCOME MEASURES: RCTs reporting on patient safety outcomes (eg, stillbirths, mortality and caesarean sections), litigation claims and associated costs were included. RESULTS: The search yielded 4793 citations, of which 10 RCTs met our eligibility criteria and provided information on over 500 000 participants. The results are presented by QI strategy, which varied from one study to another. Studies including provider education alone (one RCT), provider education in combination with audit and feedback (two RCTs) or clinician reminders (one RCT), as well as provider education with patient education and audit and feedback (one RCT), reported some improvements to patient safety outcomes. None of the studies reported on litigation claims or the associated costs. CONCLUSIONS: Our results suggest that provider education and other QI strategy combinations targeting healthcare providers may improve the safety of women and their newborns during childbirth. |
format | Online Article Text |
id | pubmed-6042535 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-60425352018-07-16 Patient safety initiatives in obstetrics: a rapid review Antony, Jesmin Zarin, Wasifa Pham, Ba’ Nincic, Vera Cardoso, Roberta Ivory, John D Ghassemi, Marco Barber, Sarah Louise Straus, Sharon E Tricco, Andrea C BMJ Open Obstetrics and Gynaecology OBJECTIVES: This review was commissioned by WHO, South Africa-Country office because of an exponential increase in medical litigation claims related to patient safety in obstetrical care in the country. A rapid review was conducted to examine the effectiveness of quality improvement (QI) strategies on maternal and newborn patient safety outcomes, risk of litigation and burden of associated costs. DESIGN: A rapid review of the literature was conducted to provide decision-makers with timely evidence. Medical and legal databases (eg, MEDLINE, Embase, LexisNexis Academic, etc) and reference lists of relevant studies were searched. Two reviewers independently performed study selection, abstracted data and appraised risk of bias. Results were summarised narratively. INTERVENTIONS: We included randomised clinical trials (RCTs) of QI strategies targeting health systems (eg, team changes) and healthcare providers (eg, clinician education) to improve the safety of women and their newborns. Eligible studies were limited to trials published in English between 2004 and 2015. PRIMARY AND SECONDARY OUTCOME MEASURES: RCTs reporting on patient safety outcomes (eg, stillbirths, mortality and caesarean sections), litigation claims and associated costs were included. RESULTS: The search yielded 4793 citations, of which 10 RCTs met our eligibility criteria and provided information on over 500 000 participants. The results are presented by QI strategy, which varied from one study to another. Studies including provider education alone (one RCT), provider education in combination with audit and feedback (two RCTs) or clinician reminders (one RCT), as well as provider education with patient education and audit and feedback (one RCT), reported some improvements to patient safety outcomes. None of the studies reported on litigation claims or the associated costs. CONCLUSIONS: Our results suggest that provider education and other QI strategy combinations targeting healthcare providers may improve the safety of women and their newborns during childbirth. BMJ Publishing Group 2018-07-06 /pmc/articles/PMC6042535/ /pubmed/29982200 http://dx.doi.org/10.1136/bmjopen-2017-020170 Text en © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
spellingShingle | Obstetrics and Gynaecology Antony, Jesmin Zarin, Wasifa Pham, Ba’ Nincic, Vera Cardoso, Roberta Ivory, John D Ghassemi, Marco Barber, Sarah Louise Straus, Sharon E Tricco, Andrea C Patient safety initiatives in obstetrics: a rapid review |
title | Patient safety initiatives in obstetrics: a rapid review |
title_full | Patient safety initiatives in obstetrics: a rapid review |
title_fullStr | Patient safety initiatives in obstetrics: a rapid review |
title_full_unstemmed | Patient safety initiatives in obstetrics: a rapid review |
title_short | Patient safety initiatives in obstetrics: a rapid review |
title_sort | patient safety initiatives in obstetrics: a rapid review |
topic | Obstetrics and Gynaecology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6042535/ https://www.ncbi.nlm.nih.gov/pubmed/29982200 http://dx.doi.org/10.1136/bmjopen-2017-020170 |
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