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  • Book
    Rahul K. Shah, Sandip A. Godambe, editors.
    Summary: This text uses a case-based approach to share knowledge and techniques on how to operationalize much of the theoretical underpinnings of hospital quality and safety. Written and edited by leaders in healthcare, education, and engineering, these 22 chapters provide insights as to where the field of improvement and safety science is with regards to the views and aspirations of healthcare advocates and patients. Each chapter also includes vignettes to further solidify the theoretical underpinnings and drive home learning. End of chapter commentary by the editors highlight important concepts and connections between various chapters in the text. Patient Safety and Quality Improvement in Healthcare: A Case-Based Approach presents a novel approach towards hospital safety and quality with the goal to help healthcare providers reach zero harm within their organizations.

    Contents:
    Introduction: A Case-Based Approach to Quality Improvement
    Organizational Safety Culture: The Foundation for Safety and Quality Improvement
    Creation of Quality Management Systems: Frameworks for Performance Excellence
    Reliability, Resilience, and Developing a Problem-Solving Culture
    Building an Engaging Toyota Production System Culture to Drive Winning Performance for our Patients, Caregivers, Hospitals, and Communities
    What to Do When an Event Happens: Building Trust in Every Step
    Communication with Disclosure and Its Importance in Safety
    Using Data to Drive Change
    Quality Methodology
    Designing Improvement Teams for Success
    Handoffs: Reducing Harm Through High Reliability and Inter-Professional Communication
    Safety II: A Novel Approach to Reducing Harm
    Bundles and Checklists
    Pathways and Guidelines: An Approach to Operationalizing Patient Safety and Quality Improvement
    Accountable Justifications and Peer Comparisons as Behavioral Economic Nudges to Improve Clinical Practice
    Diagnostic Errors and Their Associated Cognitive Biases
    An Improvement Operating System: A Case for a Digital Infrastructure for Continuous Improvement
    Patient Flow in Healthcare: A Key to Quality
    It Takes Teamwork: Consideration of Difficult Hospital-Acquired Conditions
    Human Factors in Healthcare
    Workforce Safety
    Changing the Improvement Paradigm for Our Kids.
    Digital Access Springer 2021
  • Article
    Walker MD, Alexander E, Hunt WE, MacCarty CS, Mahaley MS, Mealey J, Norrell HA, Owens G, Ransohoff J, Wilson CB, Gehan EA, Strike TA.
    J Neurosurg. 1978 Sep;49(3):333-43.
    A controlled, prospective, randomized study evaluated the use of 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) and/or radiotherapy in the treatment of patients who were operated on and had histological confirmation of anaplastic glioma. A total of 303 patients were randomized into this study, of whom 222 (73%) were within the Valid Study Group (VSG), having met the protocol criteria of neuropathology, corticosteroid control, and therapeutic approach. Patients were divided into four random groups, and received BCNU (80 mg/sq m/day on 3 successive days every 6 to 8 weeks), and/or radiotherapy (5000 to 6000 rads to the whole brain through bilateral opposing ports), or best conventional care but no chemotherapy or radiotherapy. Analysis was performed on all patients who received any amount of therapy (VSG) and on the Adequately Treated Group (ATG), who had received 5000 or more rads radiotherapy, two or more courses of chemotherapy, and had a minimum survival of 8 or more weeks (the interval that would have been required to have received either the radiotherapy or chemotherapy). Median survival of patients in the VSG was, best conventional care: 14 weeks (ATG: 17.0 weeks); BCNU: 18.5 weeks (ATG: 25.0 weeks); radiotherapy: 35 weeks (ATG: 37.5 weeks); and BCNU plus radiotherapy: 34.5 weeks (ATG: 40.5 weeks). All therapeutic modalities showed some statistical superiority compared to best conventional care. There was no significant difference between the four groups in relation to age distribution, sex, location of tumor, diagnosis, tumor characteristics, signs or symptoms, or the amount of corticosteroid used. An analysis of prognostic factors indicates that the initial performance status (Karnofsky rating), age, the use of only a surgical biopsy, parietal location, the presence of seizures, or the involvement of cranial nerves II, III, IV, and VI are all of significance. Toxicity included acceptable, reversible thrombocytopenia and leukopenia.
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