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B D Harrison

Publications and source records attributed to B D Harrison.

114 records · Page 7Linked to original sources
PubMedDate not supplied

Setting up interdepartmental peer review. The British Thoracic Society's scheme.

In 1992 the British Thoracic Society arranged a series of voluntary interdepartmental peer reviews. Their prime objective was to help to improve services by enabling clinicians to share experiences and ideas on the organisational aspects of the service and training provided. This paper outlines the planning and implementation of the scheme and some of the key results, and discusses the benefits and difficulties of such 'peer reviews'. Much of the benefit comes from the free exchange of ideas at the time of the reviews and 82% of the participants felt that they had picked up new ideas during the review. In their reports, reviewers outlined the strengths and weaknesses of the units and put forward a list of their key recommendations for change. Importantly, in half of the reviews the reviewers identified factors requiring change that had not been anticipated by the reviewed units. In most cases, the reports were subsequently shown to the managers concerned. One year after the review, 53% of 144 major recommendations had been achieved or were imminent. This form of voluntary peer review benefits both the reviewers and the reviewed and could well be adopted by other specialties.

Humans↗
PubMedDate not supplied

Psychosocial risk factors in near-fatal asthma and in asthma deaths.

BACKGROUND: A description of near-fatal asthma (NFA) and comparison with patients who died of asthma in an English health district between 1988 and 1995. METHODS: The hospital case notes of patients aged under 65 years with NFA, identified from the intensive therapy unit register, were reviewed using forms based on those of the East Anglian confidential asthma death enquiry. Details were compared with patients dying from asthma in the same population during the same period. RESULTS: Between 1988 and 1995, 19 patients suffered 23 episodes of NFA and 44 died from asthma. Those with NFA were significantly younger. There were more women in both groups. Two patients with NFA subsequently died of asthma. Significantly more patients with NFA had had a previous NFA episode than those who died. Five had a cardio-respiratory arrest. Thirteen required intermittent positive pressure ventilation (IPPV). PaCO2 ranged from 6.1 to 17.8 kPa; nine had PaCO2 > or = 10 kPa and three recovered without IPPV. Adverse psychological and social factors were similar in both groups. Denial was the commonest psychological factor and domestic, financial or employment stress, smoking or passive smoking the commonest adverse social factors; only two with NFA and seven who died had no recorded adverse psychological or social factors. CONCLUSIONS: NFA and deaths from asthma occur in asthmatics who have many psychosocial risk factors in common. Special attention needs to be directed at patients with these adverse psychosocial factors, emphasising that they need continued follow-up with support to help them manage their asthma according to currently recommended practice.

Acute Disease↗