Centre Director, Dr. Kaveh Shojania, selected as Editor-in-Chief for BMJ Quality & Safety (formerly Quality and Safety in Health Care)
In the last several years, Quality and Safety in Health Care has come to be regarded by many as the leading journal in the fields of quality improvement and patient safety. QSHC had an impact factor of 2.8 until Jan 2009 when the name changed to BMJ Quality & Safety, making it the highest impact journal in the field. (BMJ Quality & Safety’s new impact factor will come out in 2013 after it has two years worth of citations with the new name). The journal receives over 800 manuscripts a year, and has an acceptance rate of approximately 15%.
The name change to BMJ Quality & Safety reflects the co-ownership of the journal by the BMJGroup (British Medical Journal Group) and the BMJ's interest in profiling work in quality improvement and patient safety. The other co-owner of the journal is the UK Health Foundation, a non-profit organization with an approximately £750 million endowment to focus on improving the quality of care in the UK and adding to knowledge about quality improvement in general.
Notable articles published in 2012 include:
This paper reports the results of a 2-year, controlled trial looking at the impacts of the widely disseminated central line bundle to reduce central venous catheter-blood stream infections. The study showed substantial reductions in infections, comparable to those seen in the original Michigan study reported in the New England Journal of Medicine. However, the study showed that control ICUs achieved the same reductions. A companion editorial discusses the implications of this major study, including what it says about the effectiveness of central line bundles and our understanding of checklists in general.
Interest in patient safety accelerated after the US Institute of Medicine report, To Err is Human, estimated that medical error caused 44,000-98,000 patients each year in US hospitals alone. This showed that such figures substantially over-estimate deaths due to medical error, with only 5% of hospital deaths judged even “probably preventable.”
This study does not undermine the importance of improving patient safety, but it should redirect attention away from hospital mortality as a useful source of patient safety data. A companion editorial discusses these and other implications of this largest study to date of preventable hospitals deaths.
This paper reports a fascinating and efficient way of identifying hazards and strategies for mitigating them in cardiac surgery using direct observation of 20 operations at each of 5 hospitals by human factors experts. A companion editorial discusses the findings of this study and the history of advances in patient safety through human factors investigations of cardiac surgery.