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衡量手术中的简报和清单依从性:一种质量改进工具。

Measuring briefing and checklist compliance in surgery: a tool for quality improvement.

作者信息

Johnston Fabian M, Tergas Ana I, Bennett Jennifer L, Valero Vicente, Morrissey Candice K, Fader Amanda N, Hobson Deborah B, Weaver Sallie J, Rosen Michael A, Wick Elizabeth C

机构信息

The Johns Hopkins University, Baltimore, MD.

The Johns Hopkins University, Baltimore, MD

出版信息

Am J Med Qual. 2014 Nov-Dec;29(6):491-8. doi: 10.1177/1062860613509402. Epub 2013 Nov 22.

Abstract

Operating room briefings improve patient outcomes; however, implementation and methods to measure are lacking. A briefing audit tool was developed with 4 domains: briefing logistics, briefing basics, specific briefing content, and briefing participation. The tool evaluated preoperative briefings across surgical services at an academic medical center. Sixty-three preoperative briefings were observed. Introduction by name and role occurred in 15% of cases. There was a wide variation in discussion of the critical goals of the surgical procedure among services D (100%), A (26%), B (19%), and C (0%). Participation in the briefing was variable among stakeholders and between services. Verbal contributions were variable across all roles ranging from 65% (surgeons) to 11% (trainees and surgical technologist). Preoperative briefing compliance is variable. Deficiencies varied between service lines, possibly highlighting the need for service-specific customization of the briefing tool in surgery. This tool is a practical method for the study of briefing implementation.

摘要

手术室术前简报可改善患者预后;然而,目前缺乏相关实施方法及衡量手段。为此开发了一种包含四个领域的简报审计工具:简报后勤、简报基础、特定简报内容和简报参与情况。该工具对一家学术医疗中心各外科手术科室的术前简报进行了评估。共观察了63次术前简报。仅有15%的简报介绍了参与者的姓名和角色。各科室在讨论手术关键目标方面差异很大,其中科室D为100%,科室A为26%,科室B为19%,科室C为0%。利益相关者之间以及各科室之间参与简报的情况各不相同。所有角色的口头参与度也有所不同,范围从65%(外科医生)到11%(实习生和手术技师)。术前简报的合规情况参差不齐。各业务线之间的不足之处存在差异,这可能凸显了针对手术科室特定需求定制简报工具的必要性。该工具是研究简报实施情况的一种实用方法。

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