利用精益方法来改善对工作时间限制的遵守
J Jeffery Reeves1, Nicole Goldhaber1, Hannah Hollandsworth1
1Department of Surgery, University of California, San Diego Health, La Jolla.
JAMA surgery
|December 18, 2024
概括
精益方法学显著减少了一般外科住院的工作时间违规行为. 这项质量改进项目让实习生加强对工作时间法规的遵守,改善工作环境.
科学领域:
- 医学教育 医学教育
- 提高质量 提高质量
- 外科住院培训外科住院培训
背景情况:
- 持续遵守工作时间法规对一般外科住院计划提出了持续的挑战.
- 基于行业的流程改进技术为提高合规性提供了潜在的解决方案.
研究的目的:
- 评估精益方法论在增加在整体外科住院计划内遵守工作时间限制方面的有效性.
主要方法:
- 采用精益学方法的质量改进项目在一所大学的整体外科住院项目中实施.
- 干预措施针对不合规的根本原因,包括日程安排,工作流程和居民/教师期望.
- 在干预实施之前和之后,分析了居民时间日志和调查.
主要成果:
- 平均每周工作时间超过80小时的居民人数下降了10.2% (从12.4%降至2.2%).
- 在研究期间,对80小时工作限制的遵守感知从72%增加到88%.
- 教师报告的居民准备程度略有增加,尽管其他指标保持不变.
结论:
- 精益方法学可以有效地改善工作环境,并加强在外科住院计划中遵守住院工作时间.
- 让前线实习生参与流程改进计划对于成功实施至关重要.
更多相关视频
12:22Mindfulness in Motion MIM: An Onsite Mindfulness Based Intervention MBI for Chronically High Stress Work Environments to Increase Resiliency and Work Engagement
Published on: July 1, 2015
23.4K
08:30Operant Procedures for Assessing Behavioral Flexibility in Rats
Published on: February 15, 2015
20.8K
相关概念视频
Obedience
32.7K
According to obedience research, we may harm others under the forceful pressures of an authority figure (Milgram, 1974). How about if the inappropriate orders were delivered with less force? The increasing interdependence between nurses and physicians compelled Hofling and his colleagues to explore nurses’ reactions to a potentially harmful medical request made by the perceived authority figure, the doctor (Hofling, Brotzman, Dalrymple, Graves, & Pierce, 1966). In this situation,...
32.7K
Methods of Documentation II: POMR
912
The Problem-Oriented Medical Record (POMR) revolutionized medical record-keeping by introducing a systematic approach focusing on the patient's problems rather than merely listing symptoms. Dr. Lawrence Weed's introduction of this method in the 1960s marked a significant advancement in medical documentation. The POMR framework consists of four key components: the database, problem list, plan of care, and progress notes.
912
Social Traps
22.3K
Social traps are negative situations where people get caught in a direction or relationship that later proves to be unpleasant, with no easy way to back out of or avoid. The concept was orignally introduced by John Platt who applied psychology to Garrett Hardin's "Tragedy of the Commons", where in New England herd owners could let their cattle graze in the common ground. This situation seems like a good idea, but an individual could have an advantage. If they owned...
22.3K
Methods of Documentation V: CBE
878
Charting by Exception, or CBE, is a method of documentation used in healthcare, particularly in nursing, that focuses on documenting only significant or abnormal findings rather than recording every detail. This approach aims to streamline the documentation process, improve efficiency, and ensure that healthcare providers can quickly identify deviations from normalcy in patient assessments.
In CBE, healthcare professionals establish predefined standards of practice that define what constitutes...
In CBE, healthcare professionals establish predefined standards of practice that define what constitutes...
878
Methods of Documentation VI: Case Management Model
559
The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic...
For example, a patient with a chronic...
559
Legal Guidelines for Documentation
1.3K
The legal guidelines for nursing documentation are essential for ensuring accurate, professional, and ethical recording of patient care. The guidelines are discussed here:
1.3K
