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同行倡导计划的早期经验:使用质量改进来优化在手术室的行为和沟通断开连接
Shaina R Eckhouse1,2, Margaret Huston3, Eileen R Smith4
1From the Departments of Perioperative Services (Eckhouse, Thomson, Theodorou, Martin), Barnes Jewish Hospital, Saint Louis, MO.
Journal of the American College of Surgeons
|September 5, 2024
概括
在手术室的一个新的同行倡导计划减少了与行为和沟通有关的安全事件报告. 这项干预措施通过解决工作场所断开的联系,改善了团队互动和患者护理.
科学领域:
- 改善医疗保健质量 改善医疗保健质量
- 外科手术的安全性
- 医学中的团队动力学
背景情况:
- 手术室 (OR) 是一个分层的环境,外科医生的行为会影响团队合作.
- 沟通和行为问题可能导致安全事件报告.
- 需要进行干预措施来改善OR团队的功能和患者的治疗结果.
研究的目的:
- 为了减少安全事件报告系统 (SERS) 报告与OR中的行为和通信断开联系的情况.
- 实施和评估一种新的干预措施,以解决OR环境中的人际关系问题.
- 从2019年11月到2023年3月,促进更好的团队协作和患者安全.
主要方法:
- 一个多学科团队开发了一个新的报告系统,将安全事件与行为问题分开.
- 实施同行倡导者 (PA) 角色来调解沟通和行为断开的连接.
- 利用计划-做-学习-行动周期来完善PA计划和人际交往技能培训.
主要成果:
- 同行倡导者计划在为期2年的试验中管理了39次断开连接.
- 护士最常发起报告的断开,而外科医生最常识别它们.
- 观察到有关行为和沟通的每月SERS报告减少.
结论:
- 一种多学科的方法成功地创建了一个流程来管理OR通信和行为问题.
- 同行倡导者计划促进了关系的恢复,并减少了SERS在人际关系问题上的使用.
- 这种干预改善了外科手术期间的环境和团队协作.
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