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[医院风险管理:以航空业的标准操作程序为构建医疗沟通模式]

[Risk management in hospitals: standard operating procedures in aviation as a model for structuring medical communication].

作者信息

Schmidt C, Ramsauer B, Witzel K

机构信息

CRM Medical, Kitzbühel, Osterreich.

出版信息

Z Orthop Unfall. 2008 Mar-Apr;146(2):175-8. doi: 10.1055/s-2008-1038409.

Abstract

AIM

The working conditions for medical staff in German hospitals with emergency units are characterised by stress peaks. In such moments mistakes are more likely to be made. Communication problems and misunderstandings caused by these settings are the most frequent causes for blunders, errors and mistakes. The aim is to show an easy way to reduce the incidence of these problems.

METHOD

Within this prospectively randomised trial we compare the ability of 50 physicians to remember standardised information on patient's data passed on to them in a briefing. Half of the subjects used the so called 5-finger method as an easy means of memorising standardised information. The other 25 physicians memorised the patient's data in the usual way. In order to assess the information recalled by the subjects, all of them were asked to answer 15 questions on the data they had been given an hour earlier.

RESULTS

The subjects who used the 5-finger method were able to give on average 9.88 (of 15) correct answers and thus remembered significantly (p = 0.031) more information than the members of the control group.

CONCLUSION

Communication errors caused by homophony, ambiguity, anticipation and mental models are can be avoided in well-structured communication situations. The rules for such a type of communication can easily be learned and applied. Standardised communication has already proved to reduce the error rates in aviation. We conclude that it can be helpful to introduce standardised communication rules such as the 5-finger method in medical communication.

摘要

目的

德国设有急诊科室的医院中,医务人员的工作环境存在压力峰值。在这种情况下更容易出错。这些情况导致的沟通问题和误解是失误、差错和错误的最常见原因。目的是展示一种减少这些问题发生率的简便方法。

方法

在这项前瞻性随机试验中,我们比较了50名医生记住在简报中传达给他们的患者标准化信息的能力。一半受试者使用所谓的五指法作为记忆标准化信息的简便方法。另外25名医生以常规方式记忆患者数据。为了评估受试者回忆的信息,要求他们所有人回答关于一小时前提供给他们的数据的15个问题。

结果

使用五指法的受试者平均能够给出(15个问题中的)9.88个正确答案,因此比对照组成员记住的信息显著更多(p = 0.031)。

结论

在结构良好的沟通情境中,可以避免由同音异义、歧义、预期和心理模型导致的沟通错误。这种沟通类型的规则很容易学习和应用。标准化沟通已被证明能降低航空领域的错误率。我们得出结论,在医疗沟通中引入标准化沟通规则,如五指法,可能会有所帮助。

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