Moffatt-Bruce Susan, McAlearney Ann Scheck, Aldrich Alison, Latimer Tina, Funai Edmund
Adv Health Care Manag. 2014;16:51-67. doi: 10.1108/s1474-823120140000016003.
Clinical front-line staff are best positioned within the organizations to identify patient safety problems and craft solutions. However, in traditional models, safety committees are led by senior executives who are not clinically responsible for patients. This top-down approach can result in missed opportunities to address patient-centered challenges and better manage the health of the defined populations served by these organizations.
DESIGN/METHODOLOGY/APPROACH: To foster teamwork, enhance empowerment, and improve the patient care environment, Operations Councils led by trained front-line staff were deployed in 15 clinical areas at the Ohio State University Wexner Medical Center (OSUWMC) as a performance improvement tool.
Standardized training of Council facilitators was designed and implemented to guide the performance improvement process. Balanced scorecards were developed in each Council based on the risks and concerns of that particular clinical area. After initial implementation of the Operations Councils, patient safety events declined and team engagement improved by over 34% across the medical center; the highest changes were seen in areas where Operations Councils had been deployed. Additionally, outcome metrics including area-specific and system-wide mortality and readmissions improved after implementation.
ORIGINALITY/VALUE: We suggest that this type of approach may be an appropriate strategy to consider in other health care organizations as such institutions are challenged to better manage the health of their defined patient populations.
临床一线工作人员在组织中最有条件识别患者安全问题并制定解决方案。然而,在传统模式中,安全委员会由对患者没有临床责任的高级管理人员领导。这种自上而下的方法可能会导致错过解决以患者为中心的挑战以及更好地管理这些组织所服务的特定人群健康的机会。
设计/方法/途径:为了促进团队合作、增强自主权并改善患者护理环境,俄亥俄州立大学韦克斯纳医学中心(OSUWMC)在15个临床领域部署了由训练有素的一线工作人员领导的运营委员会,作为一种绩效改进工具。
设计并实施了对委员会促进者的标准化培训,以指导绩效改进过程。每个委员会根据该特定临床领域的风险和关注点制定了平衡计分卡。运营委员会初步实施后,患者安全事件减少,整个医疗中心的团队参与度提高了34%以上;在部署运营委员会的领域变化最大。此外,实施后包括特定区域和全系统死亡率及再入院率在内的结果指标有所改善。
原创性/价值:我们建议,这种方法可能是其他医疗保健组织可考虑的一种合适策略,因为这些机构面临着更好地管理其特定患者群体健康的挑战。