改善在第三级瘤医院实施I-PASS的交付情况
Maria C Franco Vega1, Mohamed Ait Aiss2, Maura Smith3
1Department of Hospital Medicine, Internal Medicine Division, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
BMJ open quality
|October 6, 2023
概括
通过I-PASS工具标准化患者交接,在医院医疗服务中显著改善了沟通和安全. 提供者采用率从23%增加到90%,增强了团队协作,减少了潜在的伤害.
科学领域:
- 改善医疗保健质量 改善医疗保健质量
- 患者安全研究 患者安全研究
- 医学沟通策略 医疗沟通策略
背景情况:
- 不一致的患者交接是可预防的患者伤害的主要原因.
- 医院医疗 (HM) 服务中增加的患者普查加剧了与非标准化交付相关的风险.
- 为了解决这些安全问题,在HM团队中启动了一项质量改进计划.
研究的目的:
- 为了在医院医疗团队中标准化一个现有的,经过验证的交付工具.
- 提高医疗保健提供者之间的交换沟通质量.
- 通过实施结构化移交流程来提高整体患者安全.
主要方法:
- 一个质量改进团队在第三级瘤医院的HM服务中研究了交接通信.
- 采用多个计划-做-研究-行动周期,利用过程流程图和根本原因分析.
- 作为标准化交付方法,实施了I-PASS (疾病严重程度,患者总结,行动清单,情况意识和应急计划以及接收者综合) 工具.
主要成果:
- 在初始干预后,交付工具的使用量从23%增加到72%,在项目完成时达到90%.
- 没有观察到移交时间的显著变化 (平均每患者<5分钟).
- 提供者报告了对交付质量,效率,通信错误和工具有效性的满意的看法.
结论:
- 质量改进方法有效鼓励采用经过验证的交付工具.
- 标准化的移交工具坚持显著改善了临床工作流程.
- 实施促进了白天和夜班团队之间的更好的沟通,提高了患者护理的连续性.
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