Family Medicine

Recommendations

Info

World Book of Family Medicine – European Edition 2015 Take home messages Feedback and taking action on feedback have become an ethical imperative for a practice Practice visits with a validated tool can provide the necessary feedback on quality of care and patient safety and are complementary to self-assessments Consensus on framework and indicators for quality of care assist in benchmarking and comparison between practices, population/ regions and countries Practice visits / generating feedback should be lean and mean All GPs and staff always have to be engaged in the feedback and improvement Original abstract http://www.woncaeurope.org/content/175-practice-visits-controlling-doctors-or-improving-practice References 1. Wensing M. A standardised instrument for patient evaluations of general practice care in Europe. Eur J Gen Pract 2000;6:82-7. 2. Buetow S, Wensing M. What might European general practice learn from New Zealand experience of practice accreditation? Eur J Gen Pract. 2008;14(1):40-4 3. Jaafaripooyan E, Agrizzi D, Akbari-Haghighi F: Healthcare accreditation systems: further perspectives on performance measures. Int J Qual Health Care 2011, 23:645–656 4. Shaw C, Groene O, Mora N, Sunol R: Accreditation and ISO certification: do they explain differences in quality management in European hospitals? Int J Qual Health Care 2010, 22:445–451. 5. Ivers N, Jamtvedt G, Flottorp S, Young JM, Odgaard-Jensen J, French SD, O'Brien MA, Johansen M, Grimshaw J, Oxman AD: Audit and feedback: effects on professional practice and healthcare outcomes. Cochrane Database Syst Rev 2012, 6:CD000259 6. O'Beirne M, Zwicker K, Sterling PD, Lait J, Lee Robertson H, Oelke ND: The status of accreditation in primary care. Qual Prim Care 2013, 21:23-31. 7. Szecsenyi J, Campbell S, Broge B, Laux G, Willms S, Wensing M, Goetz K: Effectiveness of a quality-improvement program in improving management of primary care practices. CMAJ 2011, 183:E1326–E1333 8. van Doorn – Klomberg et al. BMC Family Practice 2014, 15:179 http://www.biomedcentral.com/1471-2296/15/179 212
World Book of Family Medicine – European Edition 2015 Paul Moeremans, MD pp_rd@skynet.be 69 – Contribution of Drugs and Somnolence to Car Accidents with Victims: A Family Practice Study Paul Moeremans, MD GP, Mechelen, Belgium Somnolence at the wheel is a major cause of severe car-accidents is in most cases preventable Family practitioners can detect and prevent most cases therapy is expensive but cost effective. In 2004 and 2010, the UN General Assembly and World Health Organisation (WHO) (1) reviewed the costs of traffic accidents, and unanimously approved a policy statement urging that in the years 2011 to 2020, increased attention be given to the issue of road safety. The road traffic injury fatality rates per 10.000 population were 16,6 in South-East Asia; 32,2 in Africa; 32,2 in Eastern Mediterranean; 15,8 in the Americas; 13,4 in Europe and 15,6 in Western Pacific. In Australia it has been shown that driver fatigue is responsible for 17% of all accidents, 30% of which resulted in deaths. In 2010, 41% of a sample of US drivers who responded to a telephone survey admitted to having “fallen asleep or nodded of” at the wheel. Road transport causes over 95% of travel accidents and 90% of travel fatalities in Europe (2). Obstructive sleep apnoea, excessive workload and lack of physical and mental rest are preventable causes of sleep restriction, driver fatigue, sleep attacks and falling asleep at the wheel. Run-off-the-road single car collisions and head-on collisions by failure to brake make up 16% to 20% of serious highway accidents (3). Drivers aged 18-22, nurses, medical residents, medical doctors and police officers are especially at risk. Of the medical residents who drove after a night shift, 29% reported falling asleep at least once while driving and 14% reported a motor vehicle accident (4). 61% of accidents and injuries and 36% of fatalities occur between 00 and 08 hours, most of these between 03 and 06 hours. Benzodiazepine hypnotics and zopiclone significantly impair next morning driving performance. Less than 6 hours nocturnal sleep is associated with increased risk of rear-end collisions and single-car accidents (5). Maggie’s Law in the state of New Jersey, US, is the toughest and most detailed law regarding driver fatigue. A driver who causes a fatal accident after being awake for more than 24 consecutive hours can be convicted of second-degree homicide, and sentenced up to 10 years in prison. People in the state of heavy tiredness drive emergency vehicles and take “controlled” risks (6). Doctors far too often turn a blind eye to impaired driving ability of young attention deficit hyperactivity disorder patients, and of patients with a severe depression or mania (no reference). Different studies performed in many countries show a remarkable similarity of 8% to 10% of psychotropic substances in the blood of injured drivers: benzodiazepines, Z-drugs, antidepressants, antipsychotics, Parkinson drugs, antiepileptics, sedative antihistamines, antidepressants and thymo-regulators in people who were not warned at all of the well known vigilance deficits they create, especially in combination with alcohol and illicit drugs such as 213
Page 1 and 2:
The World Book of Family Medicine -
Page 3 and 4:
World Book of Family Medicine - Eur
Page 5 and 6:
Page 7 and 8:
Page 9 and 10:
Page 11 and 12:
Page 13 and 14:
Page 15 and 16:
Page 17 and 18:
The WP workshops on Ethics describe
Page 19 and 20:
Page 21 and 22:
Page 23 and 24:
Page 25 and 26:
Page 27 and 28:
Page 29 and 30:
Page 31 and 32:
Page 33 and 34:
Page 35 and 36:
Page 37 and 38:
Page 39 and 40:
Page 41 and 42:
Page 43 and 44:
Page 45 and 46:
References: World Book of Family Me
Page 47 and 48:
Page 49 and 50:
Page 51 and 52:
Original Abstract World Book of Fam
Page 53 and 54:
Page 55 and 56:
Page 57 and 58:
Page 59 and 60:
Page 61 and 62:
Page 63 and 64:
Page 65 and 66:
Page 67 and 68:
Page 69 and 70:
Page 71 and 72:
Page 73 and 74:
Page 75 and 76:
Page 77 and 78:
Page 79 and 80:
Page 81 and 82:
Original abstract World Book of Fam
Page 83 and 84:
Page 85 and 86:
Page 87 and 88:
Page 89 and 90:
Page 91 and 92:
Page 93 and 94:
Page 95 and 96:
Page 97 and 98:
Page 99 and 100:
Page 101 and 102:
Page 103 and 104:
Page 105 and 106:
Page 107 and 108:
References World Book of Family Med
Page 109 and 110:
Page 111 and 112:
Page 113 and 114:
Page 115 and 116:
Page 117 and 118:
Page 119 and 120:
Page 121 and 122:
Page 123 and 124:
Page 125 and 126:
Page 127 and 128:
Page 129 and 130:
Page 131 and 132:
Page 133 and 134:
Page 135 and 136:
Page 137 and 138:
Page 139 and 140:
Page 141 and 142:
Page 143 and 144:
Page 145 and 146:
Page 147 and 148:
Page 149 and 150:
Page 151 and 152:
Page 153 and 154:
Page 155 and 156:
Page 157 and 158:
Page 159 and 160:
Page 161 and 162: World Book of Family Medicine - Eur
Page 193 and 194: Original abstract World Book of Fam
Page 203 and 204: Take home messages World Book of
Page 211: World Book of Family Medicine - Eur
Page 215 and 216: References World Book of Family Med
Page 263 and 264:
Page 265 and 266:
Page 267 and 268:
Page 269 and 270:
Page 271 and 272:
Page 273 and 274:
Page 275 and 276:
Page 277 and 278:
Page 279 and 280:
Page 281 and 282:
Page 283 and 284:
Page 285 and 286:
Page 287 and 288:
Quaternary Prevention rubric (www.p
Page 289 and 290:
Page 291 and 292:
Page 293 and 294:
Page 295 and 296:
Page 297 and 298:
Page 299 and 300:
Page 301 and 302:
Page 303 and 304:
Page 305 and 306:
Page 307 and 308:
Page 309 and 310:
Page 311 and 312:
Page 313 and 314:
show all

Family Medicine

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?