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Although institutions for caring for the sick are known to have been around much earlier in history, the first teaching hospital was reportedly the Academy of Gundishapur in the Persian Empire during the Sassanid Era. In addition to systemizing medical treatment and knowledge, the scholars of the Gundishapur Academy also transformed medical education; students were authorized to methodically practice...
During the past two decades, healthcare cultures have evolved to recognize the nurse’s critical thinking skills and to promote independent functioning of nurses. Nurses, like all other healthcare professionals, focus on patient safety and deliver the right care at the right time. One example of this new cultural focus of patient safety is introduction of Rapid Response Systems (RRSs) that include...
An increased focus on patient safety on the part of regulatory and accreditation agencies has led to a host of reforms aimed at improving patient welfare. Rapid response systems (RRSs) have emerged at the same time as resident work hour restrictions have come into effect, public awareness of medical error has increased, and new models of residency program accreditation have been instituted.1,2 While...
A recent report by the National Registry of Cardiopulmonary Resuscitation (NRCPR) of 207 hospitals within the U.S. revealed that the majority (86%) has an organized team to respond to in-hospital cardiac arrests.1 Despite the existence of these teams, there is mounting evidence that errors in the management of care for patients with in-hospital cardiac arrests and other medical crises may contribute...
Following the landmark reports from the Institute of Medicine (IOM)1, 2 and other studies, numerous intervention programs have been introduced to improve patients’ safety.2 – 6 The evaluation of the impact of such complex system interventions continues to be a challenge. There is little robust evidence about the effectiveness of intervention programs aimed at system improvement.7 Rigorous evaluation...
Medical, nursing and other staff working on general wards form the most important component of hospital-wide patient safety systems. In relation to patient deterioration, ward staff roles include the regular monitoring, charting and interpretation of patients’ vital signs and other clinical variables; the identification of “at-risk” and deteriorating patients; the timely administration of simple,...
The introduction and maintenance of a rapid response system (RRS) in a hospital, regardless of the hospital’s size, is an introduction of a complex change of system and as such poses many difficulties in the measurement of its possible success. Before embarking on a hospital-wide modification, opponent voices require hard evidence of the beneficial effects of such a system change. This raises the...
Rapid Response Teams (RRTs) evolved as a system-based approach for the recognition of, and response to, the acutely ill hospital in-patient. They evolved following revelations that hospital in-patients who suffer adverse events, such as cardiac arrest or unanticipated admission to an intensive care unit (ICU), had documented physiological abnormalities prior to these events,1– 10 or had an inadequate...
Limited data exist regarding the cost-efficacy of changes in hospital systems. Such calculations are complex and require accounting, not just for the costs of implementing the therapy and the patient outcome benefits, but also for the subsequent resource utilization associated with any patient outcome benefits. The collection of such data is extraordinarily burdensome, complicated and subject to bias...
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