10,110 results match your criteria BMJ Quality & Safety [Journal]


Women's and healthcare professionals' views on immediate postnatal contraception provision: a literature review.

BMJ Sex Reprod Health 2019 Apr;45(2):88-94

Public Health England, London, UK.

Objectives: Provision of immediate postnatal contraception, including long-acting reversible contraceptive (LARC) methods, is increasingly identified and endorsed as a key strategy for reducing unplanned and rapid repeat pregnancies. This literature review aims to evaluatethe views of women and healthcare professionals regarding the receipt, initiation or delivery of these services.

Methods: Databases (Embase, Medline, CINAHL, HMIC) were searched for relevant English language studies, from January2003 to December 2017. Read More

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http://dx.doi.org/10.1136/bmjsrh-2018-200231DOI Listing

Reducing red blood cell folate testing: a case study in utilisation management.

BMJ Open Qual 2019 7;8(1):e000531. Epub 2019 Mar 7.

Pathology and Laboratory Medicine, Western University, London, Ontario, Canada.

Mandatory enrichment of wheat flour in Canada with folic acid since 1998 has caused folate deficiency to be rare. There were 3019 red blood cell (RBC) folate tests performed during an 18-month period at London Health Sciences Centre (LHSC)/St. Joseph's Healthcare London (SJHC) without any folate deficiency detected. Read More

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http://qir.bmj.com/lookup/doi/10.1136/bmjoq-2018-000531
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http://dx.doi.org/10.1136/bmjoq-2018-000531DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440601PMC
March 2019
1 Read

Use of WHO standards to improve quality of maternal and newborn hospital care: a study collecting both mothers' and staff perspective in a tertiary care hospital in Italy.

BMJ Open Qual 2019 13;8(1):e000525. Epub 2019 Feb 13.

WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.

Background: WHO developed a list of standards for improving maternal and newborn hospital care. However, there is little experience on their use, and no precise guidance on their implementation. This study aimed at documenting the use of the WHO standards for improving the quality of maternal and neonatal care (QMNC) in a tertiary hospital, Northeast Italy. Read More

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http://dx.doi.org/10.1136/bmjoq-2018-000525DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440608PMC
February 2019

'Golden Patient': A quality improvement project aiming to improve trauma theatre efficiency in the Royal Gwent Hospital.

BMJ Open Qual 2019 18;8(1):e000515. Epub 2019 Feb 18.

Orthopaedics, Royal Gwent Hospital, Newport, UK.

The efficiency of trauma lists when compared with elective orthopaedic lists is a frustration of many orthopaedic departments. At the Royal Gwent Hospital, late start times affecting total operating capacity of the trauma list were recognised as a problem within the department. The design team aimed to improve the start time of the list with the introduction of the 'golden patient' initiative. Read More

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http://dx.doi.org/10.1136/bmjoq-2018-000515DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440604PMC
February 2019

Reducing hospital-acquired pressure injuries.

BMJ Open Qual 2019 13;8(1):e000464. Epub 2019 Feb 13.

General Department of Medical Services, Quality & Patient Safety, Riyadh, Saudi Arabia.

Hospital-acquired pressure injury is a common preventable condition. Our hospital is a 144-bed governmental hospital in the Kingdom of Saudi Arabia that was found to have a 7.5% prevalence of hospital-acquired pressure injury in 2016. Read More

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http://qir.bmj.com/lookup/doi/10.1136/bmjoq-2018-000464
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http://dx.doi.org/10.1136/bmjoq-2018-000464DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440606PMC
February 2019
1 Read

Aggregated student confidence estimates support continuous quality improvements in a competencies-oriented curriculum.

BMJ Open Qual 2019 8;8(1):e000398. Epub 2019 Mar 8.

Medical Education, University of North Texas Health Science Center, Fort Worth, Texas, USA.

Introduction: Competencies oriented medical curricula are intended to support the development of those specific tasks likely to improve patient care outcomes. In 2005, our institution developed curricular objectives and instructional activities intended to enable our students to competently perform four specific clinical tasks (diagnose, treat, manage and explain phenomena) for each of approximately 100 common and/or important patient presentations (eg, dyspnoea). However, competencies oriented curricula must also develop outcome metrics aligned with their objectives and instructional activities in order to launch a continuous quality improvement (CQI) programme. Read More

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http://dx.doi.org/10.1136/bmjoq-2018-000398DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440597PMC

Demonstrating value: association of cost and quality outcomes with implementation of a value-driven oncology-hospitalist inpatient collaboration for patients with lung cancer.

BMJ Open Qual 2019 17;8(1):e000381. Epub 2019 Mar 17.

General Internal Medicine, UT MD Anderson Cancer Center, Houston, Texas, USA.

The hospitalist model of care has gained favour in many hospital systems for the value, cost-effectiveness and quality of care that hospitalists provide. Hospitalists are experts in high-acuity medical problems of patients and they are intimately knowledgeable about hospital operations that enable efficiency of patient care. This results in tremendous cost-savings for institutions especially since hospitalists are also obligated to be involved in quality and practice improvement initiatives. Read More

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http://dx.doi.org/10.1136/bmjoq-2018-000381DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440595PMC

Contribution of adverse events to death of hospitalised patients.

BMJ Open Qual 2019 13;8(1):e000377. Epub 2019 Feb 13.

Department of Community Medicine, University of Tromsø, Tromsø, Norway.

Background: There is no standardised method to investigate death as a patient safety indicator and we need valid and reliable measurements to use adverse events contributing to death as a quality measure.

Objective: To investigate the contribution of severe adverse events to death in hospitalised patients and clarify methodological differences using the Global Trigger Tool method on all inpatient deaths compared with a sample of general hospitalised patients.

Method: Retrospective records reviewing using the Global Trigger Tool method. Read More

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http://qir.bmj.com/lookup/doi/10.1136/bmjoq-2018-000377
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http://dx.doi.org/10.1136/bmjoq-2018-000377DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440591PMC
February 2019
1 Read

Using lean thinking to improve hypertension in a community health centre: a quality improvement report.

BMJ Open Qual 2019 8;8(1):e000373. Epub 2019 Feb 8.

Lynn Community Health Center, Lynn, Massachusetts, USA.

Background: Achieving better care at lower cost in the US healthcare safety net will require federally qualified health centres (FQHC) to implement new models of team-based population healthcare. Lean thinking may offer a way to reduce the financial risk of practice transformation while increasing the likelihood of sustained improvement.

Objective: To demonstrate system-level improvement in hypertension control in a large FQHC through the situational use of lean thinking and statistical process control. Read More

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http://dx.doi.org/10.1136/bmjoq-2018-000373DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440610PMC
February 2019

Optimising laboratory monitoring of chronic conditions in primary care: a quality improvement framework.

BMJ Open Qual 2019 29;8(1):e000349. Epub 2019 Mar 29.

Northern Devon Healthcare NHS Trust, Barnstaple, UK.

Monitoring of chronic conditions accounts for a significant proportion of blood testing in UK primary care; not all of this is based on evidence or guidelines. National benchmarking shows significant variation in testing rates for common blood tests. This project set out to standardise the blood tests used for monitoring of chronic conditions in primary care across North Devon, and to measure and reduce the harms of unwarranted testing. Read More

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http://dx.doi.org/10.1136/bmjoq-2018-000349DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440689PMC

Introducing an AKI predictive tool for patients undergoing orthopaedic surgery.

BMJ Open Qual 2019 29;8(1):e000306. Epub 2019 Mar 29.

Renal Medicine, Ninewells Hospital, Dundee, UK.

Patients undergoing surgery are at increased risk of acute kidney injury (AKI). AKI is associated with adverse outcomes such as increased mortality and future risk of developing chronic kidney disease. We have developed a validated preoperative scoring tool to predict postoperative AKI in patients undergoing orthopaedic surgery using seven readily available parameters. Read More

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http://qir.bmj.com/lookup/doi/10.1136/bmjoq-2017-000306
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http://dx.doi.org/10.1136/bmjoq-2017-000306DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440603PMC
March 2019
1 Read

Improving TB infection control in a regional hospital in the Eastern Cape, South Africa.

BMJ Open Qual 2019 1;8(1). Epub 2019 Mar 1.

Improving Global Health through Leadership Development, NHS Thames Valley and Wessex Leadership Academy, Otterbourne, UK.

This quality improvement (QI) work was carried out in Cecilia Makiwane Hospital (CMH), a regional public hospital in the Eastern Cape, South Africa (SA). SA has among the highest incidence of tuberculosis (TB) in the world and this is a leading cause of death in SA. Nosocomial infection is an important source of TB transmission. Read More

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http://qir.bmj.com/lookup/doi/10.1136/bmjoq-2018-000347
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http://dx.doi.org/10.1136/bmjoq-2018-000347DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440607PMC
March 2019
1 Read

Surgical management of intermittent exotropia: do we have an answer for all?

BMJ Open Ophthalmol 2019 8;4(1):e000243. Epub 2019 Mar 8.

Child Sight Institute, Jasti V Ramanamma Children's Eye Care Centre, L V Prasad Eye Institute, Hyderabad, India.

Intermittent exotropia (X(T)) is one of the most common form of strabismus with surgery being the mainstay of treatment. The main goal of surgery is to preserve binocular vision and stereopsis and to prevent its further loss. The decision to operate is mainly based on four aspects: increasing angle of exodeviation, deteriorating control of X(T), decrease in stereopsis for near or distance and quality of life. Read More

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http://dx.doi.org/10.1136/bmjophth-2018-000243DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440598PMC

How and why front-line health workers (did not) use a multifaceted mHealth intervention to support maternal and neonatal healthcare decision-making in Ghana.

BMJ Glob Health 2019 8;4(2):e001153. Epub 2019 Mar 8.

Ghana Health Service, Research and Development Division, Dodowa Research Centre, Accra, Ghana.

Introduction: Despite increasing use of mHealth interventions, there remains limited documentation of 'how and why' they are used and therefore the explanatory mechanisms behind observed effects on beneficiary health outcomes. We explored 'how and why' an mHealth intervention to support clinical decision-making by front-line providers of maternal and neonatal healthcare services in a low-resource setting was used. The intervention consisted of phone calls (voice calls), text messaging (short messaging service (SMS)), internet access (data) and access to emergency obstetric and neonatal protocols via an Unstructured Supplementary Service Data (USSD). Read More

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http://dx.doi.org/10.1136/bmjgh-2018-001153DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6441261PMC

Quality gap in maternal and newborn healthcare: a cross-sectional study in Myanmar.

BMJ Glob Health 2019 19;4(2):e001078. Epub 2019 Mar 19.

Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

Introduction: Access to maternal and newborn healthcare has improved in Myanmar. However, regular contact with skilled care providers does not necessarily result in quality care. We assessed adequate contact made by women and newborns with skilled care providers, reception of high-quality care and quality-adjusted contacts during antenatal care (ANC), peripartum care (PPC) and postnatal care (PNC) in Myanmar. Read More

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http://dx.doi.org/10.1136/bmjgh-2018-001078DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6441248PMC

Latent class analysis of the social determinants of health-seeking behaviour for delivery among pregnant women in Malawi.

BMJ Glob Health 2019 30;4(2):e000930. Epub 2019 Mar 30.

Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA.

Introduction: In the era of Sustainable Development Goals, reducing maternal and neonatal mortality is a priority. With one of the highest maternal mortality ratios in the world, Malawi has a significant opportunity for improvement. One effort to improve maternal outcomes involves increasing access to high-quality health facilities for delivery. Read More

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http://dx.doi.org/10.1136/bmjgh-2018-000930DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6441245PMC

Measuring primary healthcare expenditure in low-income and lower middle-income countries.

BMJ Glob Health 2019 21;4(1):e001497. Epub 2019 Feb 21.

Global Development Division, The Bill and Melinda Gates Foundation, Seattle, Washington, USA.

Primary healthcare (PHC) is considered as the pathway to Universal Health Coverage (UHC) and to achieving sustainable development goals. Measuring PHC expenditure is a critical first step to understanding why some countries improve access to health services, provide financial risk protection and achieve UHC. In this paper, we tested and examined different measurement options using the System of Health Accounts (SHA) 2011 for systematic monitoring of PHC expenditure. Read More

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http://dx.doi.org/10.1136/bmjgh-2019-001497DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6441277PMC
February 2019

Validity evidence for Quality Improvement Knowledge Application Tool Revised (QIKAT-R) scores: consequences of rater number and type using neurology cases.

BMJ Qual Saf 2019 Apr 17. Epub 2019 Apr 17.

Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA

Objectives: To develop neurology scenarios for use with the Quality Improvement Knowledge Application Tool Revised (QIKAT-R), gather and evaluate validity evidence, and project the impact of scenario number, rater number and rater type on score reliability.

Methods: Six neurological case scenarios were developed. Residents were randomly assigned three scenarios before and after a quality improvement (QI) course in 2015 and 2016. Read More

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http://dx.doi.org/10.1136/bmjqs-2018-008689DOI Listing

Quality measurement and nursing homes: measuring what matters.

BMJ Qual Saf 2019 Apr 17. Epub 2019 Apr 17.

Center for Health Equity Research and Promotion, Corporal Crescenz VA Medical Center, Philadelphia, PA, USA.

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http://qualitysafety.bmj.com/lookup/doi/10.1136/bmjqs-2019-0
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http://dx.doi.org/10.1136/bmjqs-2019-009447DOI Listing
April 2019
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Estimating the potential impact of the UK government's sugar reduction programme on child and adult health: modelling study.

BMJ 2019 04 17;365:l1417. Epub 2019 Apr 17.

Centre for Population Approaches to Non-Communicable Disease Prevention, Big Data Institute, University of Oxford, Headington, Oxford OX3 7FZ, UK.

Objective: To estimate the impact of the UK government's sugar reduction programme on child and adult obesity, adult disease burden, and healthcare costs.

Design: Modelling study.

Setting: Simulated scenario based on National Diet and Nutrition Survey waves 5 and 6, England. Read More

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http://dx.doi.org/10.1136/bmj.l1417DOI Listing
April 2019
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Diabetes in pregnancy in associations with perinatal and postneonatal mortality in First Nations and non-Indigenous populations in Quebec, Canada: population-based linked birth cohort study.

BMJ Open 2019 Apr 15;9(4):e025084. Epub 2019 Apr 15.

Obstetrics and Gynecology, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.

Objective: Both pregestational and gestational diabetes mellitus (PGDM, GDM) occur more frequently in First Nations (North American Indians) pregnant women than their non-Indigenous counterparts in Canada. We assessed whether the impacts of PGDM and GDM on perinatal and postneonatal mortality may differ in First Nations versus non-Indigenous populations.

Design: A population-based linked birth cohort study. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-025084DOI Listing

Persistence with opioids post discharge from hospitalisation for surgery in Australian adults: a retrospective cohort study.

BMJ Open 2019 Apr 16;9(4):e023990. Epub 2019 Apr 16.

Quality Use of Medicines and Pharmacy Research Centre, University of South Australia Division of Health Sciences, Adelaide, South Australia, Australia.

Objective: To determine time to opioid cessation post discharge from hospital in persons who had been admitted to hospital for a surgical procedure and were previously naïve to opioids.

Design, Setting And Participants: Retrospective cohort study using administrative health claims database from the Australian Government Department of Veterans' Affairs (DVA). DVA gold card holders aged between 18 and 100 years who were admitted to hospital for a surgical admission between 1 January 2014 and 30 December 2015 and naïve to opioid therapy prior to admission were included in the study. Read More

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http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2018-02399
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http://dx.doi.org/10.1136/bmjopen-2018-023990DOI Listing
April 2019
1 Read

Real-world persistence and adherence with oral bisphosphonates for osteoporosis: a systematic review.

BMJ Open 2019 Apr 14;9(4):e027049. Epub 2019 Apr 14.

Department of Health Professions, Manchester Metropolitan University, Manchester, UK.

Objectives: This study examined patient adherence and persistence to oral bisphosphonates for the treatment of osteoporosis in real-world settings.

Methods: A systematic review was completed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Allied and Complementary Medicine Database (AMED), Database of Abstracts of Reviews of Effects (DARE), Health Technology Assessment (HTA) and National Health Service Economic Evaluation Database NHS EED) databases were searched for studies published in English language up to April 2018. Read More

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http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2018-02704
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http://dx.doi.org/10.1136/bmjopen-2018-027049DOI Listing
April 2019
1 Read

Cost-effectiveness of faecal calprotectin used in primary care in the diagnosis of inflammatory bowel disease.

BMJ Open 2019 Apr 14;9(4):e027043. Epub 2019 Apr 14.

Department of Medicine, Division of Gastroenterology, University of British Columbia, Vancouver, Canada.

Objective: Inflammatory bowel disease (IBD) is a chronic, autoimmune, gastrointestinal disorder. Canada has one of the highest prevalence and incidence rates of IBD in the world. Diagnosis is challenging due to the similarity of symptoms to functional gastrointestinal disorders. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-027043DOI Listing

Involving the general practitioner during curative cancer treatment: a systematic review of health care interventions.

BMJ Open 2019 Apr 14;9(4):e026383. Epub 2019 Apr 14.

Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.

Objective: The role of primary care providers (PCP) in the cancer care continuum is expanding. In the post-treatment phase, this role is increasingly recognised by policy makers and healthcare professionals. During treatment, however, the role of PCP remains largely undefined. Read More

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http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2018-02638
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http://dx.doi.org/10.1136/bmjopen-2018-026383DOI Listing
April 2019
2 Reads

Walk, Talk and Listen: a pilot randomised controlled trial targeting functional fitness and loneliness in older adults with hearing loss.

BMJ Open 2019 Apr 14;9(4):e026169. Epub 2019 Apr 14.

Medicine, University of British Columbia, Kelowna, British Columbia, Canada.

Background: Age-related hearing loss (HL) is a prevalent disability associated with loneliness, isolation, declines in cognitive and physical function and premature mortality. Group audiological rehabilitation (GAR) and hearing technologies address communication and cognitive decline. However, the relationship between loneliness, physical function and GAR among older adults with HL has not been studied. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-026169DOI Listing

Does exercise impact gut microbiota composition in men receiving androgen deprivation therapy for prostate cancer? A single-blinded, two-armed, randomised controlled trial.

BMJ Open 2019 Apr 14;9(4):e024872. Epub 2019 Apr 14.

Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia, Australia.

Introduction: A potential link exists between prostate cancer (PCa) disease and treatment and increased inflammatory levels from gut dysbiosis. This study aims to examine if exercise favourably alters gut microbiota in men receiving androgen deprivation therapy (ADT) for PCa. Specifically, this study will explore whether: (1) exercise improves the composition of gut microbiota and increases the abundance of bacteria associated with health promotion and (2) whether gut health correlates with favourable inflammatory status, bowel function, continence and nausea among patients participating in the exercise intervention. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-024872DOI Listing

Psycho-oncology care in breast cancer centres: a nationwide survey.

BMJ Support Palliat Care 2019 Apr 13. Epub 2019 Apr 13.

Center for Integrated Oncology (CIO), Bonn, Germany.

Objective: To describe psycho-oncological care structures and processes in German breast cancer centres from the perspective of the centre administration.

Methods: The findings are based on a postal survey of a representative random sample of surgical sites of certified breast cancer centres in Germany. Data were collected in 2013 and 2014. Read More

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http://dx.doi.org/10.1136/bmjspcare-2018-001704DOI Listing

Healthcare portraiture and unconscious bias.

BMJ 2019 Apr 12;365:l1668. Epub 2019 Apr 12.

Department of Obstetrics and Gynaecology, Brigham and Women's Hospital, Harvard Medical School, USA.

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http://www.bmj.com/lookup/doi/10.1136/bmj.l1668
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http://dx.doi.org/10.1136/bmj.l1668DOI Listing
April 2019
1 Read

Patient activation intervention to facilitate participation in recovery after total knee replacement (MIME): a cluster randomised cross-over trial.

BMJ Qual Saf 2019 Apr 11. Epub 2019 Apr 11.

Faculty of Health, School of Nursing and Midwifery, Centre for Quality and Safety Research, Epworth Partnership, Deakin University, Geelong, Victoria, Australia.

Background: Patient participation in care is a fundamental element of safe and high-quality healthcare with the potential to enhance health outcomes and improve patient satisfaction.

Objectives: To test the efficacy of a clinician-facilitated, bedside multimedia () intervention designed to support patient participation in their recovery after total knee replacement surgery. The primary outcome was patients' reported worst pain intensity on postoperative day 3. Read More

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http://dx.doi.org/10.1136/bmjqs-2018-008975DOI Listing

iValidate: a communication-based clinical intervention in life-limiting illness.

BMJ Support Palliat Care 2019 Apr 11. Epub 2019 Apr 11.

ICU, Barwon Health, Geelong, Victoria, Australia.

Objectives: Report the implementation, user evaluation and key outcome measures of an educational intervention-the iValidate educational programme-designed to improve engagement in shared decision-making by health professionals caring for patients with life-limiting illness (LLI).

Design: Prospective, descriptive, cohort study.

Participants: Health professionals working in acute care settings caring for patients with an LLI. Read More

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http://spcare.bmj.com/lookup/doi/10.1136/bmjspcare-2018-0016
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http://dx.doi.org/10.1136/bmjspcare-2018-001669DOI Listing
April 2019
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Cost and cost-effectiveness of mHealth interventions for the prevention and control of type 2 diabetes mellitus: a protocol for a systematic review.

BMJ Open 2019 Apr 11;9(4):e027490. Epub 2019 Apr 11.

Institute for Global Health, University College London, London, UK.

Introduction: Type 2 diabetes mellitus (T2DM) remains one of the most common chronic diseases of adulthood which creates high degrees of morbidity and mortality worldwide. The incidence of T2DM continues to rise and recently, mHealth interventions have been increasingly used in the prevention, monitoring and management of T2DM. The aim of this study is to systematically review the published evidence on cost and cost-effectiveness of mHealth interventions for T2DM, as well as assess the quality of reporting of the evidence. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-027490DOI Listing

Patient-centred rehabilitation for non-communicable disease in a low-resource setting: study protocol for a feasibility and proof-of-concept randomised clinical trial.

BMJ Open 2019 Apr 11;9(4):e025732. Epub 2019 Apr 11.

Department of Physiotherapy, Stellenbosch University, Cape Town, South Africa.

Introduction: Non-communicable diseases (NCDs) are the leading cause of death globally. Even though NCD disproportionally affects low-to-middle income countries, these countries including South Africa, often have limited capacity for the prevention and control of NCDs. The standard evidence-based care for the long-term management of NCDs includes rehabilitation. Read More

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http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2018-02573
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http://dx.doi.org/10.1136/bmjopen-2018-025732DOI Listing
April 2019
6 Reads

Patients' and health professionals' attitudes and perceptions towards the initiation of preventive drugs for primary prevention of cardiovascular disease: protocol for a systematic review of qualitative studies.

BMJ Open 2019 Apr 11;9(4):e025587. Epub 2019 Apr 11.

Institute of Applied Health Research, University of Birmingham, Birmingham, West Midlands, UK.

Introduction: Lipid-lowering drugs and antihypertensive agents can be prescribed for the primary prevention of cardiovascular disease. In some cases, patients eligible for primary prevention of cardiovascular disease according to the European guidelines are not always started on preventive drugs. Existing research explores the attitudes of health professionals and patients towards cardiovascular preventive drugs but does not always differentiate between the attitudes towards drug initiation for primary or secondary prevention. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-025587DOI Listing

Gut-directed hypnotherapy versus standard medical treatment for nausea in children with functional nausea or functional dyspepsia: protocol of a multicentre randomised trial.

BMJ Open 2019 Apr 11;9(4):e024903. Epub 2019 Apr 11.

Department of Pediatrics, St. Antonius Hospital, Nieuwegein, The Netherlands.

Introduction: The treatment of chronic functional nausea or nausea due to functional dyspepsia in children is generally symptomatic. Moreover, these disorders pose a risk for worse psychosocial and health outcomes in children. Hypnotherapy (HT), by its ability to positively influence gastrointestinal and psychosocial functioning, may be an effective treatment for chronic nausea. Read More

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http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2018-02490
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http://dx.doi.org/10.1136/bmjopen-2018-024903DOI Listing
April 2019
1 Read

What factors are associated with resilient outcomes in children exposed to social adversity? A systematic review.

BMJ Open 2019 Apr 11;9(4):e024870. Epub 2019 Apr 11.

Intergenerational Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.

Objectives: Children exposed to social adversity-hardship as a result of social circumstances such as poverty or intergenerational trauma-are at increased risk of poor outcomes across the life course. Understanding what promotes resilient outcomes is essential for the development of evidence informed intervention strategies. We conducted a systematic review to identify how child resilience is measured and what factors are associated with resilient outcomes. Read More

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http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2018-02487
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http://dx.doi.org/10.1136/bmjopen-2018-024870DOI Listing
April 2019
2 Reads

Improving rates of ferrous sulfate prescription for suspected iron deficiency anaemia in infants.

BMJ Qual Saf 2019 Apr 10. Epub 2019 Apr 10.

Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA.

Background: Iron deficiency anaemia (IDA) in infancy is prevalent and associated with impaired neurodevelopment; however, studies suggest that treatment and follow-up rates are poor.

Objectives: To improve the rate of ferrous sulfate prescription for suspected IDA among infants aged 8-13 months to 75% or greater within 24 months.

Methods: We implemented a multidisciplinary process improvement effort aimed at standardising treatment for suspected IDA at two academic paediatric primary care clinics. Read More

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http://dx.doi.org/10.1136/bmjqs-2018-009098DOI Listing
April 2019
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The BMJ Awards 2019: Innovation in Quality Improvement Team of the Year.

Authors:
Jacqui Wise

BMJ 2019 Apr 10;365:l1653. Epub 2019 Apr 10.

London, UK.

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http://www.bmj.com/lookup/doi/10.1136/bmj.l1653
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http://dx.doi.org/10.1136/bmj.l1653DOI Listing
April 2019
2 Reads

A cohort study of functional electrical stimulation in people with multiple sclerosis demonstrating improvements in quality of life and cost-effectiveness.

Clin Rehabil 2019 Apr 10:269215519837326. Epub 2019 Apr 10.

1 The National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK.

Objective: The objective of this study was to determine the impact on health-related quality of life of functional electrical stimulation used to improve walking in people with multiple sclerosis and to explore cost-effectiveness.

Design: A retrospective analysis of patient records was conducted.

Setting: This study used outpatient therapy service as the study setting. Read More

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http://dx.doi.org/10.1177/0269215519837326DOI Listing
April 2019
3 Reads

Efficacy of pressure ulcer prevention interventions in adult intensive care units: a protocol for a systematic review and network meta-analysis.

BMJ Open 2019 Apr 9;9(4):e026727. Epub 2019 Apr 9.

Heart Center, Beijing Chaoyang Hospital affiliated with Capital Medical University, Beijing, China.

Introduction: Pressure ulcers (PUs) are associated with substantial health burden. Patients in intensive care units (ICUs) are at high risk for developing PU. In the absence of large randomised controlled trials (RCTs) that compare commonly known interventions for preventing PU in ICUs, uncertainty remains around the best practice strategy for PU management in adult ICUs. Read More

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http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2018-02672
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http://dx.doi.org/10.1136/bmjopen-2018-026727DOI Listing
April 2019
5 Reads

What is the impact on the readmission ratio of taking into account readmissions to other hospitals? A cross-sectional study.

BMJ Open 2019 Apr 9;9(4):e025740. Epub 2019 Apr 9.

IQ healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.

Objectives: Readmissions are used widespread as an indicator of the quality of care within hospitals. Including readmissions to other hospitals might have consequences for hospitals. The aim of our study is to determine the impact of taking into account readmissions to other hospitals on the readmission ratio. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-025740DOI Listing

A guided and unguided internet- and mobile-based intervention for chronic pain: health economic evaluation alongside a randomised controlled trial.

BMJ Open 2019 Apr 9;9(4):e023390. Epub 2019 Apr 9.

Department of Clinical Psychology and Psychotherapy, University of Ulm, Ulm, Germany.

Objective: This study aims at evaluating the cost-effectiveness and cost-utility of a guided and unguided internet-based intervention for chronic pain patients (ACTonPain and ACTonPain) compared with a waitlist control group (CG) as well as the comparative cost-effectiveness of the guided and the unguided version.

Design: This is a health economic evaluation alongside a three-arm randomised controlled trial from a societal perspective. Assessments were conducted at baseline, 9 weeks and 6 months after randomisation. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-023390DOI Listing

Efficacy and safety of dual SGLT 1/2 inhibitor sotagliflozin in type 1 diabetes: meta-analysis of randomised controlled trials.

BMJ 2019 Apr 9;365:l1328. Epub 2019 Apr 9.

Humanitas University Gradenigo Hospital, 8 Corso Regina Margherita, 10132 Turin, Italy.

Objective: To assess the efficacy and safety of dual sodium glucose cotransporter (SGLT) 1/2 inhibitor sotagliflozin in type 1 diabetes mellitus.

Design: Meta-analysis of randomised controlled trials.

Data Sources: Medline; Cochrane Library; Embase; international meeting abstracts; international and national clinical trial registries; and websites of US, European, and Japanese regulatory authorities, up to 10 January 2019. Read More

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http://www.bmj.com/lookup/doi/10.1136/bmj.l1328
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http://dx.doi.org/10.1136/bmj.l1328DOI Listing
April 2019
3 Reads

SANRA-a scale for the quality assessment of narrative review articles.

Res Integr Peer Rev 2019 26;4. Epub 2019 Mar 26.

Deutsches Ärzteblatt and Deutsches Ärzteblatt International, Dieselstraße 2, D-50859 Cologne, Germany.

Background: Narrative reviews are the commonest type of articles in the medical literature. However, unlike systematic reviews and randomized controlled trials (RCT) articles, for which formal instruments exist to evaluate quality, there is currently no instrument available to assess the quality of narrative reviews. In response to this gap, we developed SANRA, the Scale for the Assessment of Narrative Review Articles. Read More

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http://dx.doi.org/10.1186/s41073-019-0064-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6434870PMC

Role of comprehensive geriatric assessment in healthcare of older people in UK care homes: realist review.

BMJ Open 2019 Apr 8;9(4):e026921. Epub 2019 Apr 8.

National Institute of Health Research Collaboration for Leadership in Applied Health Research and Care East Midlands, Nottingham, UK.

Objectives: Comprehensive geriatric assessment (CGA) may be a way to deliver optimal care for care home residents. We used realist review to develop a theory-driven account of how CGA works in care homes.

Design: Realist review. Read More

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http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2018-02692
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http://dx.doi.org/10.1136/bmjopen-2018-026921DOI Listing
April 2019
2 Reads
2.063 Impact Factor

How human factors affect escalation of care: a protocol for a qualitative evidence synthesis of studies.

BMJ Open 2019 Apr 8;9(4):e025969. Epub 2019 Apr 8.

Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.

Introduction: Failure to rescue is defined as mortality after complications during hospital care. Incidence ranges 10.9%-13. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-025969DOI Listing

Healthcare Options for People Experiencing Depression (HOPE*D): the development and pilot testing of an encounter-based decision aid for use in primary care.

BMJ Open 2019 Apr 8;9(4):e025375. Epub 2019 Apr 8.

The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA.

Objective: To develop and pilot an encounter-based decision aid (eDA) for people with depression for use in primary care.

Design: We developed an eDA for depression through cognitive interviews and pilot tested it using a one-group pretest, post-test design in primary care. Feasibility, fidelity of eDA use and acceptability were assessed using recruitment rates and semistructured interviews with patients, medical assistants and clinicians. Read More

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http://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2018-02537
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http://dx.doi.org/10.1136/bmjopen-2018-025375DOI Listing
April 2019
5 Reads

Goal-directed versus outcome-based financial incentives for weight loss among low-income patients with obesity: rationale and design of the Financial Incentives foR Weight Reduction (FIReWoRk) randomised controlled trial.

BMJ Open 2019 Apr 8;9(4):e025278. Epub 2019 Apr 8.

Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.

Introduction: Obesity is a major public health challenge and exacerbates economic disparities through employment discrimination and increased personal health expenditures. Financial incentives for weight management may intensify individuals' utilisation of evidence-based behavioural strategies while addressing obesity-related economic disparities in low-income populations. Trials have focused on testing incentives contingent on achieving weight loss outcomes. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-025278DOI Listing
April 2019
1 Read

Indigenous and non-Indigenous people experiencing homelessness and mental illness in two Canadian cities: A retrospective analysis and implications for culturally informed action.

BMJ Open 2019 Apr 8;9(4):e024748. Epub 2019 Apr 8.

Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.

Objectives: Indigenous people in Canada are not only over-represented among the homeless population but their pathways to homelessness may differ from those of non-Indigenous people. This study investigated the history and current status of Indigenous and non-Indigenous people experiencing homelessness and mental illness. We hypothesised that compared with non-Indigenous people, those who are Indigenous would demonstrate histories of displacement earlier in life, higher rates of trauma and self-medication with alcohol and other substances. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-024748DOI Listing