Manser Tanja
Department of Psychology, University of Fribourg , Switzerland.
J Public Health Res. 2013 Dec 1;2(3):e33. doi: 10.4081/jphr.2013.e33.
The integration of human factors science in research and interventions aimed at increased patient safety has led to considerable improvements. However, some challenges to patient safety persist and may require human factors experts to critically reflect upon their predominant approaches to research and improvement. This paper is a call to start a discussion of these issues in the area of patient handover. Briefly reviewing recent handover research shows that while these studies have provided valuable insights into the communication practices for a range of handover situations, the predominant research strategy of studying isolated handover episodes replicates the very problem of fragmentation of care that the studies aim to overcome. Thus, there seems to be a need for a patient-centred approach to handover research that aims to investigate the interdependencies of handover episodes during a series of transitions occurring along the care path. Such an approach may contribute to novel insights and help to increase the effectiveness and sustainability of interventions to improve handover. Significance for public healthWhile much of public health research has a preventive focus, health services research is generally concerned with the ways in which care is provided to those requiring treatment. This paper calls for a patient-centred approach to research on patient handover; a significant contributor to adverse events in healthcare. It is argued that this approach has the potential to improve our understanding of handover processes along the continuum of care. Thus, it can provide a scientific foundation for effective improvements in handover that are likely to reduce patient harm and help to maintain patient safety.
将人因学融入旨在提高患者安全的研究和干预措施中已带来了显著改善。然而，患者安全仍面临一些挑战，可能需要人因学专家批判性地反思他们在研究和改进方面的主流方法。本文呼吁在患者交接领域展开对这些问题的讨论。简要回顾近期的交接研究表明，虽然这些研究为一系列交接情况的沟通实践提供了宝贵见解，但研究孤立交接事件的主流研究策略恰恰重现了研究旨在克服的护理碎片化问题。因此，似乎需要一种以患者为中心的交接研究方法，旨在调查沿护理路径发生的一系列过渡期间交接事件的相互依存关系。这种方法可能有助于获得新的见解，并有助于提高改善交接的干预措施的有效性和可持续性。对公共卫生的意义虽然许多公共卫生研究侧重于预防，但卫生服务研究通常关注为需要治疗的人提供护理的方式。本文呼吁采用以患者为中心的方法来研究患者交接，这是医疗保健中不良事件的一个重要促成因素。有人认为，这种方法有可能增进我们对整个护理过程中交接流程的理解。因此，它可以为有效改善交接提供科学依据，这可能会减少患者伤害并有助于维持患者安全。
