Culwick Caroline, Devine Chris, Coombs Catherine
GWH.
BMJ Qual Improv Rep. 2014 Sep 12;3(1). doi: 10.1136/bmjquality.u203298.w1533. eCollection 2014.
Effective handovers are vital to patient safety and continuity of care, and this is recognised by several national bodies including the GMC. The existing model at Great Western Hospital (GWH) involved three general surgical teams and a urology team placing their printed patient lists, complete with weekend jobs, in a folder for the on-call team to collect at the weekend. We recognised a need to reduce time searching for patients, jobs and reviews, and to streamline weekend ward rounds. A unified weekend list ordering all surgical patients by ward and bed number was introduced. Discrepancies in the layout of each team's weekday list necessitated the design of a new weekday list to match the weekend list to facilitate the easy transfer of information between the two lists. A colour coding system was also used to highlight specific jobs. Prior to this improvement project only 7.1% of those polled were satisfied with the existing system, after a series of interventions satisfaction increased to 85.7%. The significant increase in overall satisfaction with surgical handover following the introduction of the unified weekend list is promising. Locating patients and identifying jobs is easier and weekend ward rounds can conducted in a more logical and timely fashion. It has also helped facilitate the transition to consultant ward rounds of all surgical inpatients at the weekends with promising feedback from a recent consultants meeting.
有效的交接班对患者安全和护理的连续性至关重要,这一点得到了包括英国医学总会在内的多个国家机构的认可。大西部医院(GWH)现有的模式是,三个普通外科团队和一个泌尿外科团队将打印好的患者名单(包括周末的工作安排)放在一个文件夹中,供值班团队在周末领取。我们认识到有必要减少查找患者、工作安排和检查结果的时间,并简化周末的病房巡查流程。于是引入了一个统一的周末名单,按病房和床号对所有外科患者进行排序。由于每个团队工作日名单的格式存在差异,因此需要设计一个新的工作日名单,使其与周末名单相匹配,以便于在两个名单之间轻松传递信息。还使用了颜色编码系统来突出显示特定的工作安排。在这个改进项目实施之前,只有7.1%的受访者对现有系统感到满意,经过一系列干预措施后,满意度提高到了85.7%。引入统一的周末名单后,外科交接班的总体满意度大幅提高,这很有前景。查找患者和确定工作安排变得更加容易,周末的病房巡查也可以更有条理、更及时地进行。它还有助于在周末推动所有外科住院患者向顾问查房的过渡,最近一次顾问会议的反馈很有希望。