Vergales Jeffrey, Addison Nancy, Vendittelli Analise, Nicholson Evelyn, Carver D Jeannean, Stemland Christopher, Hoke Tracey, Gangemi James
University of Virginia Health System, Charlottesville, VA
University of Virginia Health System, Charlottesville, VA.
Am J Med Qual. 2015 Mar-Apr;30(2):119-25. doi: 10.1177/1062860613518419. Epub 2014 Jan 17.
The goal was to develop and implement a comprehensive, primarily face-to-face handoff process that begins in the operating room and concludes at the bedside in the intensive care unit (ICU) for pediatric patients undergoing congenital heart surgery. Involving all stakeholders in the planning phase, the framework of the handoff system encompassed a combination of a formalized handoff tool, focused process steps that occurred prior to patient arrival in the ICU, and an emphasis on face-to-face communication at the conclusion of the handoff. The final process was evaluated by the use of observer checklists to examine quality metrics and timing for all patients admitted to the ICU following cardiac surgery. The process was found to improve how various providers view the efficiency of handoff, the ease of asking questions at each step, and the overall capability to improve patient care regardless of overall surgical complexity.
目标是为接受先天性心脏手术的儿科患者制定并实施一个全面的、主要是面对面的交接流程，该流程始于手术室，在重症监护病房（ICU）的床边结束。交接系统的框架在规划阶段让所有利益相关者参与其中，它包括一个正式的交接工具、患者到达ICU之前的重点流程步骤，以及在交接结束时强调面对面沟通。通过使用观察清单来评估最终流程，以检查心脏手术后入住ICU的所有患者的质量指标和时间安排。结果发现，该流程改善了不同医护人员对交接效率的看法、在每个步骤提问的便利性，以及无论手术整体复杂性如何都能改善患者护理的总体能力。
