TY - JOUR
T1 - Evidence-based organization and patient safety strategies in European hospitals
AU - Sunol, Rosa
AU - Wagner, Cordula
AU - Arah, Onyebuchi A.
AU - Shaw, Charles D.
AU - Kristensen, Solvejg
AU - Thompson, Caroline A.
AU - Dersarkissian, Maral
AU - Bartels, Paul D.
AU - Pfaff, Holger
AU - Secanell, Mariona
AU - Mora, Nuria
AU - Vlcek, Frantisek
AU - Kutaj-Wasikowska, Halina
AU - Kutryba, Basia
AU - Michel, Philippe
AU - Groene, Oliver
AU - AUTHOR GROUP
AU - Klazinga, N.
AU - Kringos, D. S.
AU - Lombarts, M. J. M. H.
AU - Plochg, T.
AU - Lopez, M. A.
AU - S, M.
AU - S, R.
AU - Vallejo, P.
AU - B, P. D.
AU - K, S.
AU - M, P.
AU - Saillour-Glenisson, F.
AU - V, F.
AU - Car, M.
AU - Jones, S.
AU - Klaus, E.
AU - Bottaro, S.
AU - Garel, P.
AU - Saluvan, M.
AU - Bruneau, C.
AU - Depaigne-Loth, A.
AU - S, C. D.
AU - Hammer, A.
AU - Ommen, O.
AU - Pfaff, H.
AU - G, O.
AU - Botje, D.
AU - W, C.
AU - K-W, H.
AU - K, B.
AU - Escoval, A.
AU - Lívio, A.
AU - Eiras, M.
AU - Franca, M.
PY - 2014
Y1 - 2014
N2 - To explore how European hospitals have implemented patient safety strategies (PSS) and evidence-based organization of care pathway (EBOP) recommendations and examine the extent to which implementation varies between countries and hospitals. Mixed-method multilevel cross-sectional design in seven countries as part of the European Union-funded project 'Deepening our Understanding of Quality improvement in Europe' (DUQuE). Seventy-four acute care hospitals with 292 departments managing acute myocardial infarction (AMI), hip fracture, stroke, and obstetric deliveries. Main outcome measure Five multi-item composite measures-one generic measure for PSS and four pathway-specific measures for EBOP. Potassium chloride had only been removed from general medication stocks in 9.4-30.5% of different pathways wards and patients were adequately identified with wristband in 43.0-59.7%. Although 86.3% of areas treating AMI patients had immediate access to a specialist physician, only 56.0% had arrangements for patients to receive thrombolysis within 30 min of arrival at the hospital. A substantial amount of the total variance observed was due to between-hospital differences in the same country for PSS (65.9%). In EBOP, between-country differences play also an important role (10.1% in AMI to 57.1% in hip fracture). There were substantial gaps between evidence and practice of PSS and EBOP in a sample of European hospitals and variations due to country differences are more important in EBOP than in PSS, but less important than within-country variations. Agencies supporting the implementation of PSS and EBOP should closely re-examine the effectiveness of their current strategies
AB - To explore how European hospitals have implemented patient safety strategies (PSS) and evidence-based organization of care pathway (EBOP) recommendations and examine the extent to which implementation varies between countries and hospitals. Mixed-method multilevel cross-sectional design in seven countries as part of the European Union-funded project 'Deepening our Understanding of Quality improvement in Europe' (DUQuE). Seventy-four acute care hospitals with 292 departments managing acute myocardial infarction (AMI), hip fracture, stroke, and obstetric deliveries. Main outcome measure Five multi-item composite measures-one generic measure for PSS and four pathway-specific measures for EBOP. Potassium chloride had only been removed from general medication stocks in 9.4-30.5% of different pathways wards and patients were adequately identified with wristband in 43.0-59.7%. Although 86.3% of areas treating AMI patients had immediate access to a specialist physician, only 56.0% had arrangements for patients to receive thrombolysis within 30 min of arrival at the hospital. A substantial amount of the total variance observed was due to between-hospital differences in the same country for PSS (65.9%). In EBOP, between-country differences play also an important role (10.1% in AMI to 57.1% in hip fracture). There were substantial gaps between evidence and practice of PSS and EBOP in a sample of European hospitals and variations due to country differences are more important in EBOP than in PSS, but less important than within-country variations. Agencies supporting the implementation of PSS and EBOP should closely re-examine the effectiveness of their current strategies
U2 - https://doi.org/10.1093/intqhc/mzu016
DO - https://doi.org/10.1093/intqhc/mzu016
M3 - Article
C2 - 24578501
SN - 1353-4505
VL - 26
SP - 47
EP - 55
JO - International Journal for Quality in Health Care
JF - International Journal for Quality in Health Care
IS - Suppl. 1
ER -