Maximizing Surgical Success by Aligning Interventions to Outcomes: A Systematic Review.

Objective: This study aimed to identify common intraoperative interventions in surgery and evaluate their effectiveness in improving surgical outcomes.

Background: Despite decades of efforts, surgical adverse events remain stubbornly high. There are concerns that too much responsibility is placed on individuals to create change (ie, person-based interventions) rather than adapting systems to support human performance (ie, system-based interventions).

Equity in action: a scoping review and meta-framework for embedding equity in quality improvement.

Background: There are increasing efforts to include equity in all quality improvement (QI) initiatives. A comprehensive framework to embed equity in QI has been lacking, which acts as a barrier to the QI community from taking action to reduce healthcare inequities.

Objectives: The objectives of this scoping review were to: (1) map and summarise available equity frameworks for QI and (2) create a 'meta-framework' for QI leaders and practitioners, with engagement of people with lived experience of health inequities.

Implementation of O-RADS Ultrasound Reporting System: A Quality Improvement Initiative.

To determine the feasibility of implementing Ovarian-Adnexal Reporting & Data System (O-RADS) ultrasound (US) for reporting of adnexal masses at our institution, with a specific goal of increasing the use of O-RADS from a baseline of <5% to at least 75% over a 16-month period. A prospective interrupted time series quality improvement study was undertaken over a 16-month period. Plan, do, study, act cycles included: (1) Engagement of interested parties, (2) Targeted educational sessions, (3) Development of reporting templates, (4) Weekly audit-feedback.

Characteristics and Practices of High-Performing Centers in Organ Donor Identification and Referral: A Qualitative Study.

Background: The identification and referral (ID&R) of potential organ donors to provincial organ donation organizations (ODOs) is a critical first step in the organ donation process. However, even in provinces with mandatory referral legislation, there remains variability in ID&R rates across critical care units, with some units demonstrating high performance despite experiencing similar constraints associated with existing structures, policies, and practices.

Objective: We sought to identify the enablers and specific strategies that high-performing critical care units leveraged to achieve their exceptional performance.

Quality Indicators for Transition from Pediatric to Adult Care for Youth With Chronic Conditions: Proposal for an Online Modified Delphi Study.

Background: The transition from pediatric to adult care poses a significant health system-level challenge impeding the delivery of quality health services for youth with chronic health conditions. In Canada and globally, the transition to adult care is regarded as a top priority in adolescent health in need of readily applicable, adaptable, and relevant national metrics to evaluate and benchmark transition success across disease populations and clinical care settings. Unfortunately, existing literature fails to account for the lack of engagement from youth and caregivers in developing indicators, and its applicability across chronic conditions, primary care involvement, and health equity considerations.

Patient, caregiver and other knowledge user engagement in consensus-building healthcare initiatives: a scoping review protocol.

Introduction: Patient engagement and integrated knowledge translation (iKT) processes improve health outcomes and care experiences through meaningful partnerships in consensus-building initiatives and research. Consensus-building is essential for engaging a diverse group of experienced knowledge users in co-developing and supporting a solution where none readily exists or is less optimal. Patients and caregivers provide invaluable insights for building consensus in decision-making around healthcare, policy and research.

Social and Structural Drivers of Health and Transition to Adult Care.

Context: Youth with chronic health conditions experience challenges during their transition to adult care. Those with marginalized identities likely experience further disparities in care as they navigate structural barriers throughout transition.

Objectives: This scoping review aims to identify the social and structural drivers of health (SSDOH) associated with outcomes for youth transitioning to adult care, particularly those who experience structural marginalization, including Black, Indigenous, and 2-spirit, lesbian, gay, bisexual, transgender, queer or questioning, and others youth.

Applying an equity lens to hospital safety monitoring: a critical interpretive synthesis protocol.

Introduction: Hospital safety monitoring systems are foundational to how adverse events are identified and addressed. They are well positioned to bring equity-related safety issues to the forefront for action. However, there is uncertainty about how they have been, and can be, used to achieve this goal.

Quality Indicators for Youth Transitioning to Adult Care: A Systematic Review.

Background And Objective: Transition from pediatric to adult care is associated with adverse health outcomes for many adolescents with chronic illness. We identified quality indicators for transition to adult care that are broadly applicable across chronic illnesses and health systems.

Methods: Medline, Embase, and the Cumulative Index to Nursing and Allied Health Literature were searched, covering earliest available date to July 2021.

Can SBAR be implemented with high fidelity and does it improve communication between healthcare workers? A systematic review.

Objective: To characterise the extent to which health professionals perform SBAR (situation, background, assessment, recommendation) as intended (ie, with high fidelity) and the extent to which its use improves communication clarity or other quality measures.

Data Sources: Medline, Healthstar, PsycINFO, Embase and CINAHL to October 2020 and handsearching selected journals.

Study Selection And Outcome Measures: Eligible studies consisted of controlled trials and time series, including simple before-after design, assessing SBAR implementation fidelity or the effects of SBAR on communication clarity or other quality measures (eg, safety climate, patient outcomes).

Quality indicators for transition from paediatric to adult care for adolescents with chronic physical and mental illness: protocol for a systematic review.

Introduction: Transition from paediatric to adult care is a complex process, which poses significant challenges for adolescents with chronic physical and mental illnesses. For many, transfer to adult care is associated with poor health and psychosocial outcomes. Quality indicators to evaluate transition to adult care are needed to benchmark and compare performance across conditions and health systems.

Theory in quality improvement and patient safety education: A scoping review.

Introduction: Theory plays an important role in education programming and research. However, its use in quality improvement and patient safety education has yet to be fully characterized. The authors undertook a scoping review to examine the use of theory in quality improvement and patient safety education.

Computerised clinical decision support systems and absolute improvements in care: meta-analysis of controlled clinical trials.

Objective: To report the improvements achieved with clinical decision support systems and examine the heterogeneity from pooling effects across diverse clinical settings and intervention targets.

Design: Systematic review and meta-analysis.

Data Sources: Medline up to August 2019.

A Matter of Urgency: Reducing Clinical Text Message Interruptions During Educational Sessions.

Background: Text messaging is increasingly replacing paging as a tool to reach physicians on medical wards. However, this phenomenon has resulted in high volumes of nonurgent messages that can disrupt the learning climate.

Objective: Our objective was to reduce nonurgent educational interruptions to residents on general internal medicine.

Parent Preferences for Medical Error Disclosure: A Qualitative Study.

Objective: According to disclosure guidelines, patients experiencing adverse events due to medical errors should be offered full disclosure, whereas disclosure of near misses is not traditionally expected. This may conflict with parental expectations; surveys reveal most parents expect full disclosure whether errors resulted in harm or not. Protocols regarding whether to include children in these discussions have not been established.

Medication reconciliation during transitions of care as a patient safety strategy: a systematic review.

Medication reconciliation identifies and resolves unintentional discrepancies between patients' medication lists across transitions in care. The purpose of this review is to summarize evidence about the effectiveness of hospital-based medication reconciliation interventions. Searches encompassed MEDLINE through November 2012 and EMBASE and the Cochrane Central Register of Controlled Trials through July 2012.

Corticosteroid exposure not associated with long-term bone mineral density in pediatric liver transplantation.

Objectives: The aim of the study was to examine the association of corticosteroid exposure and other skeletal risk factors with bone mineral density (BMD) and fractures following pediatric liver transplantation (LT) at a large single center.

Patients And Methods: Lumbar spine BMD, measured using dual-energy x-ray absorptiometry (DXA), was corrected for bone age in 52 ambulatory children ages 4 to 18 years, at least 1 year post-LT. Potential risk factors for skeletal health such as corticosteroid exposure, dietary and lifestyle factors, and growth and fracture occurrence, were related to BMD using univariate and multivariate regression analyses.