Melissa McGonnell, Matt Orr, Joan Backman, Shannon A Johnson, Fiona Davidson, Penny Corkum
Examining the role of the visuospatial sketchpad in children's math calculation skills using Baddeley and Hitch's model of working memory
Acta psychologica
determine whether medical errors family experience communication processes improved implementation intervention standardize structure healthcare providerfamily communication family centered rounds prospective multicenter intervention study pediatric inpatient units seven north american hospitals 17 december 2014 3 january 2017 patients admitted study units 3106 admissions 13171 patient days 2148 parents caregivers 435 nurses 203 medical students 586 residents families nurses physicians coproduced intervention standardize healthcare providerfamily communication ward rounds family centered rounds included structured high reliability communication bedside rounds emphasizing health literacy family engagement bidirectional communication structured written realtime summaries rounds formal training programme healthcare providers strategies support teamwork implementation process improvement medical errors primary outcome including harmful errors preventable adverse events nonharmful errors modeled using poisson regression generalized estimating equations clustered site family experience communication processes eg family engagement rounds errors measured via established systematic surveillance methodology including family safety reporting overall rate medical errors per 1000 patient days unchanged 412 95 confidence interval 312 545 preintervention v 358 269 477 postintervention p021 harmful errors preventable adverse events decreased 379 207 153 281 v 129 89 186 p001 postintervention nonpreventable adverse events also decreased 126 89 179 v 52 31 88 p0003 top box eg excellent ratings six 25 components family reported experience improved none worsened family centered rounds occurred frequently 722 535 854 v 828 649 926 p002 family engagement 556 329 762 v 667 430 841 p004 nurse engagement 204 70 466 v 355 170 596 p003 rounds improved families expressing concerns start rounds 182 56 453 v 377 176 633 p003 reading back plans 47 07 252 v 265 127 73 p002 increased trainee teaching duration rounds change significantly although overall errors unchanged harmful medical errors decreased family experience communication processes improved implementation structured communication intervention family centered rounds coproduced families nurses physicians family centered care processes may improve safety quality care without negatively impacting teaching duration rounds clinicaltrialsgov nct02320175