Do good without fear and tell the truth. For Henry Beecher, this was both wisdom and paradox. Reality and perception are not always the same. Beecher was born in Peck, Kansas in 1904 with the birth ...

Patients. Reasons for consulting in primary care vary across the year,7 therefore a random sampling frame was developed to ensure sampled consultations were spread evenly across the calendar year, ...

LEARNING FROM CLINICAL MICROSYSTEMS. We have worked with several microsystems seeking to improve their care for patients. Some of them seemed to have a clear sense of their identity as a system and, ...

Objective To provide a description of the Imperial College Mortality Surveillance System and subsequent investigations by the Care Quality Commission (CQC) in National Health Service (NHS) hospitals ...

Introduction The term ‘second victim’ refers to the healthcare professional who experiences emotional distress following an adverse event. This distress has been shown to be similar to that of the ...

Background Surgical errors in ophthalmology can have devastating consequences. We developed an artificial intelligence (AI)-based surgical safety system to prevent errors in patient identification, ...

Most quality improvement or change management interventions are currently designed intuitively and their results are often disappointing. While improving the effectiveness of interventions requires ...

The time is ripe for a formal structured review of guidance on quality improvement reports Samuel Beckett wrote “ Ever tried. Ever failed. No matter. Try again. Fail again. Fail better .” Fiona Moss ...

Quality indicators are ubiquitous in healthcare and serve a variety of purposes for many different stakeholders. Few would question the value of monitoring the quality of care, but the increasing ...

Objectives To provide national estimates of the number and clinical and economic burden of medication errors in the National Health Service (NHS) in England. Methods We used UK-based prevalence of ...

In the past 15 years, SEIPS (Systems Engineering Initiative for Patient Safety)1–3 and related conceptual models4 5 were developed to study and improve healthcare. These theoretical models depict how ...

Background Little is known about factors affecting implementation of patient safety programmes in low and middle-income countries. The goal of our study was to evaluate the implementation of a patient ...