Search

Aim: To describe the contributing factors and types of reported medication incidents in home care related to the flow of information in different phases of the medication process, as reported by multi‐professional healthcare groups. Design: This descriptive, qualitative study used retrospective data. Methods: An incident‐reporting database was used to collect 14,289 incident reports from 2017 to 2019 in a city in Finland. We used this data to select medication incidents (n = 1027) related to the flow of information in home care and between home care and hospitals. Data were divided into five groups based on the medication phase: (1) prescribing, (2) dispensing, (3) administration, (4) documentation and (5) self‐administration. In addition, the types of medication‐related incidents were described. The data were examined using abductive content analysis. The EQUATOR SRQR checklist was used in this report. Results: Four main categories were identified from the data: (1) issues related to information management, (2) cooperation issues between different actors, (3) work environment and lack of resources and (4) factors related to healthcare workers. Cooperation issues contributed to medication‐related incidents during each phase. Incomplete communication was a contributing factor to medication incidents. This occurred between home care, remote care, hospital, the client and the client's relatives. Specifically, a lack of information‐sharing occurred in repatriation situations, where care transitioned between different healthcare professionals. Conclusion: Healthcare professionals, organisations, clients and their relatives should focus on the efficient and safe acquisition of medications. Specifically, the use of electronic communication systems, together with oral reports and checklists for discharge situations, and timely cooperation with pharmacists should be developed to manage information flows. Relevance to Clinical Practice: These findings demonstrate that healthcare professionals require uniform models and strategies to accurately and safely prescribe, dispense and administer medications in home care settings. No patient or public contributions. [ABSTRACT FROM AUTHOR]

Background: Adverse events occur frequently at emergency departments (ED) because of several risk factors related to varying conditions. It is still unclear, which factors lead to patient safety incident reports. The aim of this study was to explore the root causes behind ED-associated patient safety incidents reported by personnel, and based on the findings, to suggest learning objectives for improving patient safety., Methods: The study material included incident reports (n = 340) which concerned the ED of a teaching hospital over one year. We used a mixed method combining quantitative descriptive statistics and qualitative research by inductive content analysis and deductive Ishikawa root cause analysis., Results: Most (76.5%) incidents were reported after patient transfer from the ED. Nurses reported 70% of incidents and physicians 7.4%. Of the reports, 40% were related to information flow or management. Incidents were evaluated as no harm (29.4%), mild (46%), moderate (19.7%), and severe (1.2%) harm to the patient. The main consequences for the organization were reputation loss (44.1%) and extra work (38.9%). In the qualitative analysis, nine specific problem groups were found: insufficient introduction, adherence to guidelines and protocols, insufficient human resources, deficient professional skills, medication management deficiencies, incomplete information transfer from the ED, language proficiency, unprofessional behaviour, identification error, and patient-dependent problems. Six organizational themes were identified: medical staff orientation, onboarding and competence requirements; human resources; electronic medical records and information transfer; medication documentation system; interprofessional collaboration; resources for specific patient groups such as geriatric, mental health, and patients with substance abuse disorder. Entirely human factor-related themes could not be defined because their associations with system factors were complex and multifaceted. Individual and organizational learning objectives were addressed, such as adherence to the proper use of instructions and adequate onboarding., Conclusions: System factors caused most of the patient safety incidents reported concerning ED. The introduction and training of ED -processes is elementary, as is multiprofessional collaboration. More research is needed about teamwork skills, patients with special needs and non-critical patients, and the reporting of severe incidents., (© 2024. The Author(s).)

Purpose: Although prior studies have noted the importance of trust for project performance, research remains scant on describing the role of trust when using lean design management (LDM) in projects. The purpose of this paper is to explore the connection between LDM and interpersonal trust in solving construction projects' design management problems. Design/methodology/approach: A qualitative study was conducted that included 29 trust- and LDM-themed semi-structured interviews in the USA (California), Brazil and Finland; 11 focus group discussions were also organized to validate the interview findings. Findings: The study reveals how LDM contributes to solving design management problems through two distinct but interconnected mechanisms: improved information flow; and improved trust among project team members. A conceptual framework was crafted to illustrate the mechanisms in building trust by means of the social domain of LDM concepts. Research limitations/implications: The conceptual framework requires testing through an international survey or through multiple case studies. Practical implications: The results indicate that design management would benefit from trustful environments and that trust may be the catalyst for actors' engagement with LDM. Managers in charge of design within projects can use the conceptual framework when selecting the appropriate LDM tools, which should include both the social and technical domains. Originality/value: The study emphasizes the importance of the social domain of LDM concepts. Previous studies have focussed on information flow aspects of LDM but have overlooked the value of interpersonal trust in solving design management problems. [ABSTRACT FROM AUTHOR]

Introduction: We studied how well healthcare personnel in healthcare centers (HCs) in the South Ostrobothnia region of Finland are able to obtain patient information thorough electronic patient record (EPR) systems. This study followed the changes in availability of patient information during a 7-year period, from 2003 to the end of 2010. The patient group studied focused on those involved in anticoagulant (AC) treatment. Subjects and Methods: A structured questionnaire was sent in 2003 to the staff of 15 HCs. The questionnaire dealt with access and availability of patient information from the EPR. Respondents were asked to rate how often they obtain information concerning AC treatment from various sources. Results: In total, 1,114 questionnaires were sent, and 860 answers were received; the response rate was 77%. A repeat study was conducted in 2010, and 932 responses were obtained (response rate, 56%). Paper-based AC treatment cards carried by the patients were an important information source for 75.0% of the respondents in 2003 and 55.4% in 2010. For all new AC treatments, the EPR was a primary information source for 33.3% of respondents in 2003 and 60.2% in 2010. Conclusions: This study indicated that during the study period there was an improvement in access to EPR but that this did not always improve the overall availability of data. Results show that problems in information flow from secondary care to the HCs persist. Almost half of the patients dealt with in the HCs were affected by at least some problems. In the 7 years covered by this study, EPR systems have become more important as information sources for clinical data, but there is still room for improvement. [ABSTRACT FROM AUTHOR]

(2011) Journal of Nursing Management 209-217 To describe important information in the care processes of patients with cardiac symptoms. Process-based work-flow models are increasingly being used in healthcare. At the same time, developments in information systems offer the possibility of supporting improvements in process and information management in healthcare. To better utilize these possibilities we need to understand more about important information content and flow during treatment processes. A qualitative approach involving the critical incident technique was used. Critical incidents were collected using a semi-structured questionnaire (50 respondents) and interviews ( n = 10). Three incident categories of important information were identified: (1) process-related incidents, (2) managerial incidents and (3) clinical incidents. Process-related incidents focused on agreed-care practices and the importance of the care environment. Managerial incidents focused on human and material resources. Clinical incidents focused on medical and nursing care and the importance of patient education. Information content, information flow and the timing of such information should be modelled further in order to improve the management of care processes. Increasing knowledge about essential points of information as part of nursing management is important. [ABSTRACT FROM AUTHOR]