Dr Paul Barach, BSc, MD, MPH - Wayne State University School of Medicine - Clinical Professor

Dr Paul Barach

BSc, MD, MPH

Wayne State University School of Medicine

Clinical Professor

Chicago, IL | United States

Main Specialties: Anesthesiology

Additional Specialties: Anesthesia, critical care

Dr Paul Barach, BSc, MD, MPH - Wayne State University School of Medicine - Clinical Professor

Dr Paul Barach

BSc, MD, MPH
Introduction

Dr Barach is an academic scientist and educator, board-certified in Anesthesia and Critical Care, who leads initiatives across clinical departments and support services, spearheading multiple projects and achieving physician alignment with strategic initiatives. Dr Barach advises and consults to academic medical centers and hospitals on the science of clinical practice improvement; acoustics and alarm fatigue; evaluation of practice transformation in diverse settings, and enjoys promoting the implementation of evidence for practice improvement. He has conducted a great deal of work over two decades on clinical and organizational performance, health systems improvement and patient safety.

Dr Barach is Clinical Professor at Wayne State University School of Medicine, Senior Medical Director at the Advisory Board Company, and Principal and founder of J Bara Innovation. Paul is double board-certified in Anesthesiology and Critical care, from the Massachusetts General Hospital affiliated with Harvard Medical School. He is a formally trained health services researcher, with advanced post graduate training in quality improvement and lean techniques at Intermountain Healthcare, and in advanced medical education and assessment methods from the Harvard Medical School Josiah Macy Program.

CAREER OBJECTIVES

• Driver of change and manager of complex processes, content knowledge and experience in large-scale quality improvement/transformation with talent management and organizational development/change strategies to accelerate and sustain achievement of population health/ accountable care, patient safety, and patient wellness outcome goals.
• Improve access, quality and affordability of hospital health and community-based care including working with top-levels of state, local and international governments.
• Advance integration of quality improvement and organizational development/change science through research, teaching, publications, and national partnerships.

SUMMARY OF QUALIFICATIONS

• Extensive clincial experience in academic acute, ambulatory and community settings, double Board certified in Anesthesia and Critical Care.
• Over 15 yrs. leading large-scale quality improvement/transformation initiatives at delivery system, regional, national and international levels.
• Applied human factors expertise, acoustics, alarm fatigue, user centered research, design thinking and systems analysis.
• Dedicated to coaching and mentoring leaders of large-scale quality improvement and health information technology initiatives.
• Committed to professional development and quality implementation science knowledge teaching to clinicians, faculty, management, fellows, residents, and graduate students.
• Advancing quality improvement science through teaching, research, publications, journal peer review, and contributions at national level.
• Extensive GME curriculum design, deployment and evaluation focused around CQI, Patient Safety, Human factors, implementation science
• Lead development of integrated delivery systems linked to community based services, which offer high quality care for families, older adults, and people with disabilities, recognizing the value and need for population health, and other drivers to achieve the aim of improved health, higher quality and more cost-effective care.

He has published over 400 publications/8500 citations and has presented at international and national conferences on more than 500 occasions, including over 60 keynote addresses. His research appears in journals such as British Medical Journal, Analgesia and Anesthesia, Annals of Internal Medicine, Annals of Thoracic Surgery, Medical Care Journal of the American Medical Association, BMJ Quality and Safety, and many other prestigious journals. He co-authored the WHO report Exploring patient participation in reducing health-care-related safety risks, and co-edited a 2-volume book with Professors Lipshultz, Jacobs and Laussen (Safety and Quality in Pediatric and Congenital Cardiac Care, Springer 2014, and another book with Professor Johnson and Haskell on Patient Stories  (Case Studies in Patient Safety Foundations for Core Competencies, Bartlett, 2015. His book on Surgical Patient Care: Improving Safety, Quality and Value: Theory and Practice, with Professors Sanchez, Johnson, and Jacobs, was published in 2017, and a book on hospital design and acoustics is scheduled for 2018 publication.

Further details can be found at: https://www.linkedin.com/in/paulbarach and https://uio.academia.edu/paulBarach and at https://www.researchgate.net/profile/Paul_Barach/publications/?pubType=article&ev=prf_pubs_art.

Primary Affiliation: Wayne State University School of Medicine - Chicago, IL , United States

Specialties:

Additional Specialties:

Research Interests:


View Dr Paul Barach’s Resume / CV
Metrics

84

Publications

615

Profile Views

576

Reads

396

PubMed Central Citations

Education
Apr 2018
Massachusetts General Hospital, Harvard Medical School
Anesthesia, Critical Care
Top co-authors
Julie K Johnson
Julie K Johnson

Centre for Clinical Governance Research

13
Gijs Hesselink
Gijs Hesselink

Scientific Institute for Quality of Healthcare

7
Maria Flink
Maria Flink

Karolinska Institutet

6
Cor Kalkman
Cor Kalkman

University Medical Center Utrecht

6
Hub Wollersheim
Hub Wollersheim

Scientific Institute for Quality of Healthcare (IQ healthcare)

6
Giulio Toccafondi
Giulio Toccafondi

3 Center for Clinical Risk Management

5
Mariann Olsson
Mariann Olsson

Karolinska Institutet

5
Carola Orrego
Carola Orrego

Instituto Universitario Avedis Donabedian

5
Lisette Schoonhoven
Lisette Schoonhoven

University of Southampton

5

Publications

84Publications

576Reads

396PubMed Central Citations

Measuring and improving comprehensive pediatric cardiac care: Learning from continuous quality improvement methods and tools

Progress in Pediatric Cardiology 48 (2018) 82–92

Progress in Pediatric Cardiology

Quality improvement (QI) is becoming a central part of the work of clinicians throughout healthcare. Continuous quality improvement (CQI), Lean Management Systems (LMS) and Lean Six Sigma (LSS) are management phi- losophies as well as management methods. They offer an approach, a set of tools, and a way of thinking about how to more effectively assess and study clinical flow, including addressing variation in clinical process and operations. We define CQI as the daily use of QI methods as a regular part of practice engaging all practice staff, constantly measuring structure, processes, outcomes against effective practices (benchmarking), moving from one QI project to the next, pursuing the goal of “The right care for every child every time”. It is based on clear scientific principles, a valid way of measuring change and has theories of reliability and human factors that underpin the interventions. Significant variations in quality of care provided to pediatric patients leading to substandard care have been well documented. For example, in antibiotic prescribing for community acquired pneumonia; pediatric sec- ondhand smoke reduction; screening for diabetes in cystic fibrosis program; and, in depression screening in Type 1 Diabetes. Despite this, not enough pediatric practices are performing continuous quality improvement (CQI) as part of their daily activities. All health care professionals caring for children should consider incorporating quality measurement into their practice. However, we need to focus on what is the right approach to take and the right questions to ask and address the challenges of aggregating scientifically imperfect tests of change. Increasingly, colleagues, patients, payers and certifying agencies expect such measurement to achieve the Triple Aim of better health, better care and lower cost. In addition, new payment models increasingly pay providers for demonstrated value rather than volume, and they expect participation in continuous improvement. Quality Improvement (QI) is a critical component of the American Board of Pediatrics (ABP) Maintenance of Certification (MOC) Part 4. This requires pediatricians to participate in a meaningful manner in two data-driven QI projects every five years. Pediatricians can select quality measures to evaluate whether patient outcomes and experience improve, and if not, identify and overcome barriers. In this paper we discuss performance improvement using CQI and related methods, suggest approaches to help pediatric cardiologists to ask the right questions when seeking to drive improvement, and consider the implications of measurement theory and complexity science for QI and CQI.

View Article
August 2018
5 Reads

Six Sigma in healthcare: a systematic review of the literature

International Journal of Quality & Reliability Management, Vol. 35 Issue: 5, pp.1075-1092, https://doi.org/10.1108/IJQRM-02-2017-0027

International Journal of Quality & Reliability Management

Purpose – The purpose of this paper is to illustrate the systematic role played by Six Sigma methodology in improving the quality of healthcare. The literature review identifies the relevant opportunities for successful introduction and development of Six Sigma approach in healthcare sector. Design/methodology/approach – A systematic methodology to identifying literature on Six Sigma in healthcare is presented. Web of Science, Medline, Emerald Insight, ASQ and ProQuest databases (1998-2016) were searched, and 68 papers of fair methodological quality were identified. Findings – The findings of the systematic review reveal a growing interest in research on Six Sigma adoption in healthcare. The findings indicate that Six Sigma applications in healthcare have been focused on the entire hospital with no real focus on a particular department or function. The key findings on benefits, success factors, challenges and common tools of Six Sigma from the existing literature are also presented in the paper. Research limitations/implications – The papers included in the systematic review were peer-reviewed papers available in English. Due to these limitations, relevant papers may have been excluded. Moreover, the authors have excluded all conference and white papers for their inclusion in this study. Originality/value – This paper can serve as a guide on how Six Sigma approach can be applied to improve the quality of healthcare. The authors also believe that this is possibly the most comprehensive systematic literature review on the topic and will set the foundation for various research avenues based on the key findings of this study.

View Article
July 2018
5 Reads

“Workin’ on Our Night Moves”: How Residents Prepare for Shift Handoffs

The Joint Commission Journal on Quality and Patient Safety 2018; 44:485–493

The Joint Commission Journal on Quality and Patient Safety

Background: Poor-quality handoffs have been associated with serious patient consequences. Researchers and educators have answered the call with efforts to increase system safety and resilience by supporting handoffs using increased communication standardization. The focus on strategies for formalizing the content and delivery of patient handoffs has considerable intuitive appeal; however, broader conceptual framing is required to both improve the process and develop and implement effective measures of handoff quality. Methods: Cognitive task interviews were conducted with internal medicine and surgery residents at three geographically diverse US Department of Veterans Affairs medical centers. Thirty-five residents participated in semi-structured interviews using a recent handoff as a prompt for in-depth discussion of goals, strategies, and information needs. Transcribed inter- view data were analyzed using thematic analysis. Results: Six cognitive tasks emerged during handoff preparation: (1) communicating status and care plan for each patient; (2) specifying tasks for the incoming night shift; (3) anticipating questions and problems likely to arise during the night shift; (4) streamlining patient care task load for the incoming resident; (5) prioritizing problems by acuity across the patient census, and (6) ensuring accurate and current documentation. Conclusions: Our study advances the understanding of the influence of the cognitive tasks residents engage in as they prepare to hand off patients from day shift to night shift. Cognitive preparation for the handoff includes activities critical to effective coordination yet easily overlooked because they are not readily observable. The cognitive activities identified point to strategies for cognitive support via improved technology, organizational interventions, and enhanced training.

View Article
July 2018
5 Reads

The danger of relying on the interpretation of p-values in single studies: Irreproducibility of results from clinical studies

Progress in Pediatric Cardiology 44 (2017) 57–61

Progress in Pediatric Cardiology

P-values are a common component and outcome measure in most every published observational or randomized clinical trial. However, junior faculty, fellows, and residents have little or no training in statistics and are forced to rely on the interpretation of results based solely on the authors or secondary sources. This education gap applies to an even larger audience including many physicians, researchers, journalists, and policy makers. That is a dangerous approach. Statistical analysis of data often involves the calculation and reporting of the p-value as statistically significant or not, without much further thought. But p-values are highly unreplicable and their definition is not directly associated with reproducibility. Findings from clinical studies are not valid if they cannot be reproduced. Although other methodological issues relate to reproducibility, such as statistical power to reproduce an effect, the p-value is arguably at the root of the problem given its wide variability from study to study. Many common misinterpretations and misuses of the p-value are practiced. It is essential to bring more awareness to this critical issue by providing a deeper educational understanding of the p-value to the proper interpretation of study re- sults. Recognizing this need the American Statistical Association (ASA) recently published its first ever policy statement concerning their proper use and interpretation of p-values for scientists and researchers. This policy statement addresses the misguided practice of interpreting study results based solely on the p-value, given that it is often irreproducible in subsequent, similar studies. To further educate and illustrate this issue we investigated the irreproducibility of the p-value by using simulation software and results reported from a published randomized control trial. We show that the probability of attaining another statistically significant p-value varied quite widely on replication. We also show that power alone determines the distribution of p, and will vary with sample size and effect size. The percentage of replication means which fell within the original confidence interval (CI) from each replicated experiment revealed that the 95% CI included only 85.4% of future replication means. In conclusion, p-values interpreted solely by themselves, can be misleading if interpreted devoid of context poten- tially leading to biased inferences from clinical studies.

View Article
June 2018
5 Reads

Improving Learner Handovers in Medical Education.

Acad Med 2017 07;92(7):927-931

E.J. Warm is the Sue P. and Richard W. Vilter Professor of Medicine and categorical medicine residency program director, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio. R. Englander is associate dean for undergraduate medical education, University of Minnesota Medical School, Minneapolis, Minnesota. A. Pereira is associate professor and assistant dean for clinical education, University of Minnesota Medical School, Minneapolis, Minnesota. P. Barach is clinical professor, Department of Pediatrics, Wayne State University School of Medicine, Detroit, Michigan.

View Article
July 2017
13 Reads
1 PubMed Central Citation(source)
2.93 Impact Factor

Readmitting Children with Heart Failure: the Importance of Communication, Coordination, and Continuity of Care.

J Pediatr 2016 10 15;177:13-16. Epub 2016 Aug 15.

Carman and Ann Adams Department of Pediatrics Wayne State University School of Medicine Children's Research Center of Michigan Children's Hospital of Michigan Detroit, Michigan. Electronic address:

View Article
October 2016
23 Reads
3.79 Impact Factor

A qualitative study of patient experiences of decentralized acute healthcare services.

Scand J Prim Health Care 2016 Sep 25;34(3):317-24. Epub 2016 Aug 25.

a Department of Research , Østfold Hospital Trust , Sarpsborg, Østfold , Norway ;

View Article
September 2016
9 Reads
2 PubMed Central Citations(source)
1.61 Impact Factor

Relationships between exterior views and nurse stress: an exploratory examination.

HERD 2008 ;1(2):27-38

Debajyoti Pati, HKS, Inc., 1919 McKinney Avenue, Dallas, TX 75201

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April 2016
5 Reads

A systematic review of hospital accreditation: the challenges of measuring complex intervention effects.

BMC Health Serv Res 2015 Jul 23;15:280. Epub 2015 Jul 23.

Department of Medicine and Health, South-Eastern Norway Regional Health Authority, Hamar, Norway.

View Article
July 2015
6 Reads
5 PubMed Central Citations(source)
1.66 Impact Factor

Patient-centered handovers between hospital and primary health care: an assessment of medical records.

Int J Med Inform 2015 May 22;84(5):355-62. Epub 2015 Jan 22.

Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Social Work, Stockholm, Sweden; Karolinska University Hospital, Department of Social Work, Stockholm, Sweden.

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May 2015
9 Reads
2 PubMed Central Citations(source)
2.00 Impact Factor

Interventions to improve patient safety in transitional care--a review of the evidence.

Work 2012 ;41 Suppl 1:2915-24

Forde Hospital, Norway.

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December 2014
7 Reads
1 PubMed Central Citation(source)

Improving clinical performance using rehearsal or warm-up: an advanced literature review of randomized and observational studies.

Acad Med 2014 Oct;89(10):1416-22

Dr. O'Leary is assistant professor, Department of Anesthesia, University of Toronto, and staff anesthesiologist, Hospital for Sick Children, Toronto, Ontario, Canada. Dr. O'Sullivan is research fellow, Department of Anesthesia, University College Cork, Cork, Ireland. Dr. Barach is anesthesiologist and visiting professor, University College Cork, Cork, Ireland. Professor Shorten is professor of anesthesia and dean, School of Medicine, University College Cork, Cork, Ireland.

View Article
October 2014
5 Reads
2.93 Impact Factor

Improving patient discharge and reducing hospital readmissions by using Intervention Mapping.

BMC Health Serv Res 2014 Sep 13;14:389. Epub 2014 Sep 13.

Radboud University Medical Center, Scientific Institute for Quality of Healthcare (IQ healthcare), 114 IQ healthcare, P,O, Box 9101, 6500 HB, Nijmegen, The Netherlands.

View Article
September 2014
7 Reads
9 PubMed Central Citations(source)
1.66 Impact Factor

Hospital alarms and patient safety.

JAMA 2014 Aug;312(6):651

Department of Medicine, University of Chicago, Chicago, Illinois.

View Article
August 2014
8 Reads
35.29 Impact Factor

Why has the safety and quality movement been slow to improve care?

International Journal of Clinical Practice

View Article
August 2014
12 Reads

How do supervising physicians decide to entrust residents with unsupervised tasks? A qualitative analysis.

J Hosp Med 2014 Mar 20;9(3):169-75. Epub 2014 Jan 20.

Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California.

View Article
March 2014
14 Reads
8 PubMed Central Citations(source)
2.08 Impact Factor

Expertise in medicine: using the expert performance approach to improve simulation training.

Med Educ 2014 Feb;48(2):115-23

Brain and Behaviour Laboratory, Liverpool John Moores University, Liverpool, UK.

View Article
February 2014
6 Reads
2 PubMed Central Citations(source)
3.20 Impact Factor

Clinical sensemaking: a systematic approach to reduce the impact of normalised deviance in the medical profession.

J R Soc Med 2013 Oct;106(10):387-90

School of Medicine, University College Cork, Ireland, District 1.

View Article
October 2013
7 Reads
1 PubMed Central Citation(source)
2.02 Impact Factor

What can artefact analysis tell us about patient transitions between the hospital and primary care? Lessons from the HANDOVER project.

Eur J Gen Pract 2013 Sep;19(3):185-93

Centre for Clinical Governance Research, University of New South Wales , Sydney , Australia.

View Article
September 2013
8 Reads
1 PubMed Central Citation(source)
0.81 Impact Factor

Organizational culture: an important context for addressing and improving hospital to community patient discharge.

Med Care 2013 Jan;51(1):90-8

Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.

View Article
January 2013
6 Reads
13 PubMed Central Citations(source)
3.23 Impact Factor

Conducting a multicentre and multinational qualitative study on patient transitions.

BMJ Qual Saf 2012 Dec 25;21 Suppl 1:i22-8. Epub 2012 Oct 25.

Centre for Clinical Governance Research, University of New South Wales, Sydney, NSW 2052, Australia.

View Article
December 2012
3 Reads
1 PubMed Central Citation(source)
3.99 Impact Factor

Mapping and assessing clinical handover training interventions.

BMJ Qual Saf 2012 Dec 16;21 Suppl 1:i50-7. Epub 2012 Oct 16.

Centre for Learning Sciences and Technologies, Open University of the Netherlands, PO Box 2960, Heerlen 6401 AT, The Netherlands;

View Article
December 2012
9 Reads
5 PubMed Central Citations(source)
3.99 Impact Factor

Searching for the missing pieces between the hospital and primary care: mapping the patient process during care transitions.

BMJ Qual Saf 2012 Dec 1;21 Suppl 1:i97-105. Epub 2012 Nov 1.

Faculty of Medicine, Centre for Clinical Governance Research, University of New South Wales, Sydney, NSW 2052, Australia.

View Article
December 2012
6 Reads
15 PubMed Central Citations(source)
3.99 Impact Factor

Evaluation of a predevelopment service delivery intervention: an application to improve clinical handovers.

BMJ Qual Saf 2012 Dec 13;21 Suppl 1:i29-38. Epub 2012 Sep 13.

Department of Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK.

View Article
December 2012
7 Reads
6 PubMed Central Citations(source)
3.99 Impact Factor

"It's like two worlds apart": an analysis of vulnerable patient handover practices at discharge from hospital.

BMJ Qual Saf 2012 Dec 30;21 Suppl 1:i67-75. Epub 2012 Oct 30.

Faculty of Health and Social Care, London South Bank University, Keyworth Street, K2 Building, London SE1 6NG, UK.

View Article
December 2012
9 Reads
9 PubMed Central Citations(source)
3.99 Impact Factor

Beliefs and experiences can influence patient participation in handover between primary and secondary care--a qualitative study of patient perspectives.

BMJ Qual Saf 2012 Dec 30;21 Suppl 1:i76-83. Epub 2012 Oct 30.

Department of Neurobiology, Care Sciences and Society, Division of Social Work, Karolinska Institutet, Stockholm, Sweden.

View Article
December 2012
8 Reads
8 PubMed Central Citations(source)
3.99 Impact Factor

The key actor: a qualitative study of patient participation in the handover process in Europe.

BMJ Qual Saf 2012 Dec 30;21 Suppl 1:i89-96. Epub 2012 Oct 30.

Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, B44, Karolinska Sjukhuset Huddinge, Stockholm 14186, Sweden.

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December 2012
8 Reads
8 PubMed Central Citations(source)
3.99 Impact Factor

Stakeholder perspectives on handovers between hospital staff and general practitioners: an evaluation through the microsystems lens.

BMJ Qual Saf 2012 Dec 1;21 Suppl 1:i106-13. Epub 2012 Nov 1.

Patient Safety Center, University Medical Centre Utrecht, Utrecht, The Netherlands.

View Article
December 2012
6 Reads
10 PubMed Central Citations(source)
3.99 Impact Factor

Hospitals and healthcare.

HERD 2008 ;1(3):128

View Article
October 2012
6 Reads

Improving patient handovers from hospital to primary care: a systematic review.

Ann Intern Med 2012 Sep;157(6):417-28

Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.

View Article
September 2012
6 Reads
4 PubMed Central Citations(source)
17.81 Impact Factor

Design of cardiovascular operating rooms for tomorrow's technology and clinical practice — Part 2!

Progress in Pediatric Cardiology 33 (2012) 57–65

Progress in Pediatric Cardiology

There is growing recognition that risks and hazards of health care associated injury and harm are a result of problems with the design of systems of care rather than poor performance by individual providers. The convergence of cardiovascular surgery and interventional imaging has resulted in new models of cardiovascular surgical suite design and new configurations of specialized surgical procedure rooms. Hybrid cardiovascular surgical procedure rooms are designed to accommodate both “open” surgery and “closed” vascular access procedures. These new rooms incorporate a variety of image-guidance modalities, are configured for surgical sterile precautions, and are designed for the use of general anesthesia. Proper design of advanced cardiovascular surgical procedure rooms requires an understanding of room configuration, surgical and anesthesia work "ow, lighting and air handling requirements, surgical team culture and behavior, and human factors. Integrated medical equipment assemblies that amalgamate features of open surgical equipment, closed interventional imaging equipment and advanced medical information technology will further infuence the form and function of tomorrow’s cardiovascular operating rooms.

View Article
March 2012
6 Reads

High reliability organizations and surgical microsystems: re-engineering surgical care.

Surg Clin North Am 2012 Feb 4;92(1):1-14. Epub 2012 Jan 4.

Department of Surgery, Saint Mary's Hospital, 56 Franklin Street, Waterbury, CT 06706, USA.

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February 2012
8 Reads
2 PubMed Central Citations(source)
1.88 Impact Factor

Making sense of root cause analysis investigations of surgery-related adverse events.

Surg Clin North Am 2012 Feb;92(1):101-15

University of Western Sydney, School of Nursing and Midwifery, Locked Bag 1797, Penrith South DC, New South Wales 1797, Australia.

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February 2012
5 Reads
2 PubMed Central Citations(source)
1.88 Impact Factor

Design of cardiovascular operating rooms for tomorrow's technology and clinical practice — Part one!

Prog Pediatr Cardiol (2011), doi:10.1016/j.ppedcard.2011.10.010

Progress In Pediatric Cardiology

View Article
December 2011
6 Reads

Balancing clinical team perceptions of the workplace: Applying ‘work domain analysis’ to pediatric cardiac care

Progress in Pediatric Cardiology 33 (2012) 25–32

Progress in Pediatric Cardiology

The safety, reliability, and stability of the pediatric cardiology workplace are continuously challenged. These factors include the complexity of patient care, keeping up to date with evidence based practice, harnessing the implications of innovations in technology, and adapting to changes in the structure of health services and facilities. The differences between individual clinical team perspectives and impressions formed by other teams across the organization produce divergent perspectives on clinical work. This paper makes a case for investing in a social science framework entitled ‘work domain analysis’ to better understand how health teams function reliably within the wider healthcare organization. Work domain analysis was developed to equip people in complex work environments with the skills and awareness to identify and adjust the margins for safety in normal work by making the boundaries between management imperatives, workload and safety (in this case, pediatric cardiac care) more apparent to a wider range of people. Healthcare can no longer afford to be precious about methods adopted from other industries due to the high complexity of the clinical workplace. The paper outlines an approach to work domain analysis that can greatly enhance the engagement and awareness of clinicians. The opportunities for practical applications of work domain analysis to pediatric care are discussed.

View Article
November 2011
6 Reads

Leadership, surgeon well-being and non-technical competencies of pediatric cardiac surgery

Prog Pediatr Cardiol (2011), doi:10.1016/j.ppedcard.2011.10.011

Progress in Pediatric Cardiology

Expectations of pediatric cardiac surgeons grow as the specialty evolves and yesterday's challenges become tomorrow's routine. The pioneering era of fast-paced major technical advances is behind us. Integration of surgery, cardiology and intensive care is nowthe basis of incremental improvements in perioperative and long termoutcomes. Surgeons can be natural leaders of this process because their skills, roles and experience are crucial in the preoperative, intra-operative and postoperative care of the patient and their family. However, the personality traits that draw physicians to the specialty and contribute to the drive to become a successful technical surgeon may be at odds with the collaborative aspects of this microsystem, both inside and outside the operating room. The potential for disruptive behavior on the part of the surgeon to impede the functioning of a large multidisciplinary teamproviding care of the upmost complexity raises fundamental questions about howto design reliable pediatric cardiac surgery teams. A new dynamic is needed to support team members, including the surgeon, in times of extreme stress and to help them avoid destructive,maladaptive responses. Focusing these efforts around the clinical microsystemrequires a detailed analysis of the teaminteractions, the underlying culture and support, and the clinical engagement of staff. Building and nurturing a resilient systemin a highly specialized environment where burnout, bullying and loss of staff exist remains a constant challenge.

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November 2011
8 Reads

Where to now for paediatric cardiac surgery?

ANZ J Surg 2011 Oct;81(10):659-60

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October 2011
6 Reads
1.12 Impact Factor

The July effect: fertile ground for systems improvement.

Ann Intern Med 2011 Sep 11;155(5):331-2. Epub 2011 Jul 11.

View Article
September 2011
6 Reads
3 PubMed Central Citations(source)
17.81 Impact Factor

A prospective study of paediatric cardiac surgical microsystems: assessing the relationships between non-routine events, teamwork and patient outcomes.

BMJ Qual Saf 2011 Jul 13;20(7):599-603. Epub 2011 Apr 13.

TNO Human Factors, 3769 ZG Soesterberg, The Netherlands.

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July 2011
6 Reads
8 PubMed Central Citations(source)
3.99 Impact Factor

Assessing and improving teamwork in cardiac surgery.

Qual Saf Health Care 2010 Dec;19(6):e29

TNO Human Factors, PO Box 23, 3769 ZG Soesterberg, The Netherlands.

View Article
December 2010
15 Reads
1 PubMed Central Citation(source)

When do supervising physicians decide to entrust residents with unsupervised tasks?

Acad Med 2010 Sep;85(9):1408-17

Center for Research and Development of Education, University Medical Center Utrecht, Utrecht, The Netherlands.

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September 2010
12 Reads
34 PubMed Central Citations(source)
2.93 Impact Factor

Evaluating policy and service interventions: framework to guide selection and interpretation of study end points.

BMJ 2010 Aug 27;341:c4413. Epub 2010 Aug 27.

Public Health, Epidemiology and Biostatistics, University of Birmingham, Edgbaston, West Midlands B15 2TT.

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August 2010
9 Reads
26 PubMed Central Citations(source)

Postoperative patient complaints: a prospective interview study of 12,276 patients.

J Clin Anesth 2010 Feb;22(1):13-21

Department of Anesthesia, University Hospital Basel, CH-4031 Basel, Switzerland.

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February 2010
5 Reads
12 PubMed Central Citations(source)
1.21 Impact Factor

Reducing variation in adverse events during the academic year.

BMJ 2009 Oct 13;339:b3949. Epub 2009 Oct 13.

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October 2009
6 Reads

Patient care handovers: what will it take to ensure quality and safety during times of transition?

Med J Aust 2009 Jun;190(11 Suppl):S110-2

Center for Clinical Governance Research in Health, University of New South Wales, sydney, NSW.

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June 2009
6 Reads
3 PubMed Central Citations(source)
4.09 Impact Factor

Designing a patient safety undergraduate medical curriculum: the Telluride Interdisciplinary Roundtable experience.

Teach Learn Med 2009 Jan-Mar;21(1):52-8

Institute for Patient Safety Excellence, University of Illinois at Chicago College of Medicine, Chicago, Illinois 60612, USA.

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March 2009
9 Reads
7 PubMed Central Citations(source)
1.12 Impact Factor

Anaesthetic complications associated with the treatment of patients with congenital cardiac disease: consensus definitions from the Multi-Societal Database Committee for Pediatric and Congenital Heart Disease.

Cardiol Young 2008 Dec;18 Suppl 2:271-81

Department of Pediatric Anesthesia, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas 77030, USA.

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December 2008
7 Reads
0.86 Impact Factor

Pulmonary complications associated with the treatment of patients with congenital cardiac disease: consensus definitions from the Multi-Societal Database Committee for Pediatric and Congenital Heart Disease.

Cardiol Young 2008 Dec;18 Suppl 2:215-21

The Congenital Heart Institute of Florida (CHIF), Clinical Assistant Professor of Pediatrics, University of South Florida, Florida Pediatric Associates, 880 Sixth Street South, Suite 370, St. Petersburg, FL 33701, USA.

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December 2008
9 Reads
3 PubMed Central Citations(source)
0.86 Impact Factor

A prospective observational study of human factors, adverse events, and patient outcomes in surgery for pediatric cardiac disease.

J Thorac Cardiovasc Surg 2008 Dec 6;136(6):1422-8. Epub 2008 Sep 6.

Department of Anesthesia, Utrecht Medical Center, Utrecht, The Netherlands.

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December 2008
6 Reads
9 PubMed Central Citations(source)
4.17 Impact Factor

We shape our buildings, then they kill us: why health-care buildings contribute to the error pandemic.

World Hosp Health Serv 2008 ;44(2):15-21

Utrecht University, Netherlands.

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December 2008
7 Reads

Examining links between sign-out reporting during shift changeovers and patient management risks.

Risk Anal 2008 Aug;28(4):969-81

Department of Industrial Engineering, University of Miami, Coral Gables, FL 33124-0623, USA.

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August 2008
9 Reads
3 PubMed Central Citations(source)
2.50 Impact Factor

Strategies to reduce patient harm: understanding the role of design and the built environment.

Authors:
Paul Barach

Stud Health Technol Inform 2008 ;132:14-22

University of Utrecht Medical Center, Utrecht, Netherlands.

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May 2008
6 Reads

Errors and the burden of errors: attitudes, perceptions, and the culture of safety in pediatric cardiac surgical teams.

Ann Thorac Surg 2008 Apr;85(4):1374-81

Department of Ophthalmology, School of Medicine, University of Szeged, Szeged, Hungary.

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April 2008
7 Reads
9 PubMed Central Citations(source)
3.85 Impact Factor

A new paradigm for the design of audible alarms that convey urgency information.

J Clin Monit Comput 2007 Dec 1;21(6):353-63. Epub 2007 Nov 1.

Division of Trauma Anesthesia & Critical Care, Department of Anesthesiology, School of Medicine, University of Miami, P.O. Box 016370 (M820), Miami, FL 33101, USA.

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December 2007
8 Reads
3 PubMed Central Citations(source)
1.45 Impact Factor

Latency: an important consideration in gulf war syndrome.

Neurotoxicology 2007 Sep 15;28(5):1043-4; author reply 1044-5. Epub 2007 Aug 15.

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September 2007
8 Reads
3.38 Impact Factor

Housestaff and medical student attitudes toward medical errors and adverse events.

Jt Comm J Qual Patient Saf 2007 Aug;33(8):493-501

Department of Medicine, Beth Israel Deaconess Medical Center, Boston, USA.

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August 2007
10 Reads
9 PubMed Central Citations(source)

Raised speed limits, case fatality and road deaths: a six year follow-up using ARIMA models.

Inj Prev 2007 Jun;13(3):156-61

University of Illinois at Chicago, School of Public Health, Division of Environmental and Occupational Health Sciences, Chicago, Illinois, USA.

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June 2007
7 Reads
3 PubMed Central Citations(source)
1.94 Impact Factor

Training teams for the perioperative environment: a research agenda.

Surg Innov 2006 Sep;13(3):170-8

Aptima, Inc, Woburn, Massachusetts 01801, USA.

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September 2006
7 Reads
1.34 Impact Factor

Wrong-side/wrong-site, wrong-procedure, and wrong-patient adverse events: Are they preventable?

Arch Surg 2006 Sep;141(9):931-9

Department of Pediatrics, The University of Chicago Comer Children's Hospital, Chicago, IL 60637, USA.

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September 2006
7 Reads
1 PubMed Central Citation(source)
4.93 Impact Factor

Emergency preparedness for biological and chemical incidents: a survey of anesthesiology residency programs in the United States.

Anesth Analg 2005 Oct;101(4):1135-40, table of contents

Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami School of Medicine/Jackson Memorial Hospital, R-C370, 1611 NW 12th Ave., Miami, Florida 33101, USA.

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October 2005
6 Reads
1 PubMed Central Citation(source)
3.47 Impact Factor

Five system barriers to achieving ultrasafe health care.

Ann Intern Med 2005 May;142(9):756-64

Cognitive Science Department, Brétigny-sur-Orge, France.

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May 2005
9 Reads
45 PubMed Central Citations(source)
17.81 Impact Factor

The role of teamwork in the professional education of physicians: current status and assessment recommendations.

Jt Comm J Qual Patient Saf 2005 Apr;31(4):185-202

American Institutes for Research, Washington, DC, USA.

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April 2005
5 Reads
19 PubMed Central Citations(source)

Disclosing adverse events to patients.

Jt Comm J Qual Patient Saf 2005 Jan;31(1):5-12

VA New England Geriatric Research, Education, and Clinical Center, Boston, USA.

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January 2005
9 Reads
2 PubMed Central Citations(source)

Cranial electrotherapy stimulation: a safe neuromedical treatment for anxiety, depression, or insomnia.

South Med J 2004 Dec;97(12):1269-70

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December 2004
7 Reads
3 PubMed Central Citations(source)
1.12 Impact Factor

Clarifying adverse drug events: a clinician's guide to terminology, documentation, and reporting.

Ann Intern Med 2004 May;140(10):795-801

Veterans Affairs Salt Lake City Health Care System and University of Utah School of Medicine, Salt Lake City, Utah, USA.

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May 2004
12 Reads
15 PubMed Central Citations(source)
17.81 Impact Factor

Raised speed limits, speed spillover, case-fatality rates, and road deaths in Israel: a 5-year follow-up.

Am J Public Health 2004 Apr;94(4):568-74

Hebrew University-Hadassah School of Community Medicine and Public Health, Unit of Occupational and Environmental Medicine and Injury Prevention Center, Jerusalem, Israel.

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April 2004
9 Reads
2 PubMed Central Citations(source)
4.55 Impact Factor

Microsystems in health care: Part 6. Designing patient safety into the microsystem.

Jt Comm J Qual Saf 2003 Aug;29(8):401-8

Department of Anesthesia and Critical Care, University of Chicago, Chicago, USA.

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August 2003
8 Reads
10 PubMed Central Citations(source)

Patient safety and the reliability of health care systems.

Ann Intern Med 2003 Jun;138(12):997-8

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June 2003
5 Reads
3 PubMed Central Citations(source)
17.81 Impact Factor

Creatine phosphate kinase elevations signaling muscle damage following exposures to anticholinesterases: 2 sentinel patients.

Arch Environ Health 2003 Mar;58(3):167-71

The Social Policy Research Institute, Skokie, Illinois 60076, USA.

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March 2003
9 Reads
2 PubMed Central Citations(source)

The end of the beginning: lessons learned from the patient safety movement.

Authors:
Paul Barach

J Leg Med 2003 Mar;24(1):7-27

Department of Anesthesia and Critical Care, University of Chicago, Chicago, IL, USA.

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March 2003
6 Reads
1 PubMed Central Citation(source)

Patient safety and health policy: a history and review.

Hematol Oncol Clin North Am 2002 Dec;16(6):1463-82

Department of Anesthesia and Critical Care, University of Chicago, 5841 South Maryland Avenue, MC 4028, Chicago, IL 60637, USA.

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December 2002
6 Reads
3 PubMed Central Citations(source)
2.29 Impact Factor

Creating effective leadership for improving patient safety.

Qual Manag Health Care 2002 ;11(1):69-78

University of Chicago Children's Hospital, Chicago, USA.

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December 2002
5 Reads
4 PubMed Central Citations(source)

Residents' hours of work.

BMJ 2002 Nov;325(7374):1184-5

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November 2002
7 Reads
1 PubMed Central Citation(source)

Multifactorial etiology of postoperative vision loss.

Anesthesiology 2002 Jun;96(6):1531-2; author reply 1532-3

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June 2002
5 Reads
2 PubMed Central Citations(source)
5.88 Impact Factor
Top co-authors
Julie K Johnson
Julie K Johnson

Centre for Clinical Governance Research

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Gijs Hesselink
Gijs Hesselink

Scientific Institute for Quality of Healthcare

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Maria Flink
Maria Flink

Karolinska Institutet

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Cor Kalkman
Cor Kalkman

University Medical Center Utrecht

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Hub Wollersheim
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Scientific Institute for Quality of Healthcare (IQ healthcare)

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Giulio Toccafondi
Giulio Toccafondi

3 Center for Clinical Risk Management

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Mariann Olsson
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Karolinska Institutet

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Instituto Universitario Avedis Donabedian

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Lisette Schoonhoven
Lisette Schoonhoven

University of Southampton

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