A5039900404- Hospital Admissions and Outcomes
- Patient Safety and Medication Errors
- Emergency and Acute Care Studies
- Sleep and Work-Related Fatigue
- Healthcare Policy and Management
- Medical Malpractice and Liability Issues
- Healthcare Operations and Scheduling Optimization
- Family and Patient Care in Intensive Care Units
- Innovations in Medical Education
- Healthcare professionals’ stress and burnout
- Child and Adolescent Health
- Healthcare cost, quality, practices
- Clinical Reasoning and Diagnostic Skills
- Simulation-Based Education in Healthcare
- Patient-Provider Communication in Healthcare
- Sleep and related disorders
- Respiratory Support and Mechanisms
- Ultrasound in Clinical Applications
- Cardiac, Anesthesia and Surgical Outcomes
- Healthcare Technology and Patient Monitoring
- Workplace Health and Well-being
- Childhood Cancer Survivors' Quality of Life
- Electronic Health Records Systems
- Patient Satisfaction in Healthcare
- Respiratory viral infections research
Boston Children's Hospital
2016-2025
Harvard University
2016-2025
Brigham and Women's Hospital
2016-2025
Circadian (United States)
2016-2025
Lurie Children's Hospital
2024
SleepMed
2005-2024
Boston Children's Museum
2008-2024
Pediatrics and Genetics
2010-2024
Division of Chemistry
2023
Massachusetts General Hospital
2001-2020
Although sleep deprivation has been shown to impair neurobehavioral performance, few studies have measured its effects on medical errors.
In the 10 years since publication of Institute Medicine's report To Err Is Human, extensive efforts have been undertaken to improve patient safety. The success these remains unclear.We conducted a retrospective study stratified random sample hospitals in North Carolina. A total 100 admissions per quarter from January 2002 through December 2007 were reviewed order by teams nurse reviewers both within (internal reviewers) and outside (external with use for Healthcare Improvement's Global...
<b>Objective</b> To determine the prevalence of depression and burnout among residents in paediatrics to establish if a relation exists between these disorders medication errors. <b>Design</b> Prospective cohort study. <b>Setting</b> Three urban freestanding children’s hospitals United States. <b>Participants</b> 123 three paediatric residency programmes. <b>Main outcome measures</b> Prevalence using Harvard national screening day scale, Maslach inventory, rate errors per resident month....
Objective: Critically ill patients require high-intensity care and may be at especially high risk of iatrogenic injury because they are severely ill. We sought to study the incidence nature adverse events serious errors in critical setting. Design: conducted a prospective 1-year observational study. Incidents were collected with use multifaceted approach including direct continuous observation. Two physicians independently assessed incident type, severity, preventability as well...
Knowledge of the physiological effects extended (24 hours or more) work shifts in postgraduate medical training is limited. We aimed to quantify hours, sleep, and attentional failures among first-year residents (postgraduate year 1) during a traditional rotation schedule that included an intervention limited scheduled 16 fewer consecutive hours.
Miscommunications are a leading cause of serious medical errors. Data from multicenter studies assessing programs designed to improve handoff information about patient care lacking.We conducted prospective intervention study resident handoff-improvement program in nine hospitals, measuring rates errors, preventable adverse events, and miscommunications, as well workflow. The included mnemonic standardize oral written handoffs, communication training, faculty development observation program,...
Objectives. Medication errors in pediatric inpatients occur at similar rates as adults but have 3 times the potential to cause harm. Error prevention strategies this setting remain largely untested. The objective of study was classify major types medication and determine which might most effectively prevent them. Methods. A prospective cohort conducted 1020 patients who were admitted 2 academic medical centers during a 6-week period April May 1999. characterized by subtype. Physician raters...
<h3>Context</h3>Sleep disorders often remain undiagnosed. Untreated sleep among police officers may adversely affect their health and safety pose a risk to the public.<h3>Objective</h3>To quantify associations between disorder self-reported health, safety, performance outcomes in officers.<h3>Design, Setting, Participants</h3>Cross-sectional prospective cohort study of North American participating either an online or on-site screening (n=4957) monthly follow-up surveys (n=3545 representing...
Our ability to express and accurately assess emotional states is central human life. The present study examines how people detect emotions during text-based communication, an environment that eliminates the nonverbal cues typically associated with emotion. results from 40 dyadic interactions suggest users relied on four strategies happiness versus sadness, including disagreement, negative affect terms, punctuation, verbosity. Contrary conventional wisdom, communication partners readily...
Handoff miscommunications are a leading cause of medical errors. Studies comprehensively assessing handoff improvement programs lacking.To determine whether introduction multifaceted program was associated with reduced rates errors and preventable adverse events, fewer omissions key data in written handoffs, improved verbal changes resident-physician workflow.Prospective intervention study 1255 patient admissions (642 before 613 after the intervention) involving 84 resident physicians (42 42...
The first cohort of IIPE projects from 2009 are beginning to realize some early successes. We bring you this article in the spirit sharing what works and doesn't. lesson about importance context is critical adopting adapting innovations your own learning environment. —Carol Carraccio, MD, MA Section Editor New duty hours standards have increased frequency transitions care or handoffs for resident physicians. Because miscommunications a leading cause adverse events hospitals, optimizing...
Abstract Objective To determine whether medical errors, family experience, and communication processes improved after implementation of an intervention to standardize the structure healthcare provider-family on centered rounds. Design Prospective, multicenter before study. Setting Pediatric inpatient units in seven North American hospitals, 17 December 2014 3 January 2017. Participants All patients admitted study (3106 admissions, 13171 patient days); 2148 parents or caregivers, 435 nurses,...
OBJECTIVE. To mitigate the risks of fatigue-related medical errors, Accreditation Council for Graduate Medical Education introduced work hour limits resident physicians in 2003. Our goal was to determine whether hours, sleep, and safety changed after implementation standards. METHODS. We conducted a prospective cohort study which residents from 3 large pediatric training programs provided daily reports hours sleep. In addition, they completed near-miss actual motor vehicle crashes,...
OBJECTIVE. Although initial research suggests that computerized physician order entry reduces pediatric medication errors, no comprehensive error surveillance studies have evaluated the effect of on children. Our objective was to evaluate comprehensively rate inpatient errors. METHODS. Using interrupted time-series regression analysis, we reviewed all charts, orders, and incident reports for 40 admissions per month NICU, PICU, wards 7 months before 9 after implementation commercial in a...
Patient handoffs are a key source of communication failures and adverse events in hospitals. Despite Accreditation Council for Graduate Medical Education requirements residency training programs to provide formal handoff skills monitor handoffs, well-established curricula validated assessment tools lacking. Developing curriculum is challenging because the need standardized processes faculty development, cultural resistance change, diverse institution- unit-level factors. In this article,...
The goal was to examine pediatric hospitalist rounding practices and characteristics associated with programs conducting family-centered rounds (FCRs).The Pediatric Hospitalist Triennial Survey, sent a subset of hospitalists on the Research in Inpatient Settings listserv from United States Canada, consisted 63 questions sociodemographic characteristics, training, practice practices.Among 265 respondents (response rate: 70%), 78% practiced academic hospitals 22% nonacademic hospitals....
<h3>Importance</h3> Medical errors and adverse events (AEs) are common among hospitalized children. While clinician reports the foundation of operational hospital safety surveillance a key component multifaceted research surveillance, patient family not routinely gathered. We hypothesized that novel family-reporting mechanism would improve incident detection. <h3>Objective</h3> To compare error AE rates (1) gathered systematically with vs without reporting, (2) reported by families...
<h3>Hypothesis</h3>A novel approach to identify at-risk periods among orthopedic surgical residents may direct fatigue risk mitigation and facilitate targeted interventions.<h3>Design</h3>A prospective cohort study with a minimum 2-week continuous assessment period. Data on sleep awake were processed using the sleep, activity, fatigue, task effectiveness model.<h3>Setting</h3>Rotations at 2 academic tertiary care centers.<h3>Participants</h3>Twenty-seven of 33 volunteer (82%) completed...
Children of parents expressing limited comfort with English (LCE) or proficiency may be at increased risk adverse events (harms due to medical care). No prior studies have examined, in a multicenter fashion, the association between language and systematically, actively collected that include family safety reporting.To examine parent LCE cohort hospitalized children.This prospective study was conducted from December 2014 January 2017, concurrent data collection Patient Family Centered I-PASS...
<h3>Importance</h3> Limited data exist regarding the incidence and nature of patient- family-reported medical errors, particularly in pediatrics. <h3>Objective</h3> To determine frequency with which parents experience patient safety incidents proportion reported that meet standard definitions errors preventable adverse events (AEs). <h3>Design, Setting, Participants</h3> We conducted a prospective cohort study from May 2013 to October 2014 within 2 general pediatric units at children's...
OBJECTIVES: An efficient and reliable process for measuring harm due to medical care is needed advance pediatric patient safety. Several studies have assessed the use of trigger tools in varying inpatient environments. Using Institute Healthcare Improvement’s adult-focused Global Trigger Tool as a model, we developed pilot tested tool that would identify most common causes METHODS: After formal training, 6 academic children’s hospitals used this novel review 100 randomly selected records per...