Rhee Amanda J, Valentin-Salgado Yessenia, Eshak David, Feldman David, Kischak Pat, Reich David L, LoPachin Vicki, Brodman Michael
1 The Mount Sinai Hospital, New York, NY.
2 FOJP Service Corporation, New York, NY.
Am J Med Qual. 2017 Jul/Aug;32(4):369-375. doi: 10.1177/1062860616662703. Epub 2016 Aug 10.
Preventable medical errors in the operating room are most often caused by ineffective communication and suboptimal team dynamics. TeamSTEPPS is a government-funded, evidence-based program that provides tools and education to improve teamwork in medicine. The study hospital implemented TeamSTEPPS in the operating room and merged the program with a surgical safety checklist. Audits were performed to collect both quantitative and qualitative information on time out (brief) and debrief conversations, using a standardized audit tool. A total of 1610 audits over 6 months were performed by live auditors. Performance was sustained at desired levels or improved for all qualitative metrics using χ and linear regression analyses. Additionally, the absolute number of wrong site/side/person surgery and unintentionally retained foreign body counts decreased after TeamSTEPPS implementation.
手术室中可预防的医疗差错通常是由沟通不畅和团队协作不佳导致的。TeamSTEPPS是一个由政府资助、基于证据的项目,它提供工具和培训以改善医疗领域的团队协作。研究医院在手术室实施了TeamSTEPPS,并将该项目与手术安全检查表相结合。使用标准化审计工具进行审计,以收集关于术前暂停(简报)和术后总结谈话的定量和定性信息。现场审计员在6个月内共进行了1610次审计。使用χ检验和线性回归分析,所有定性指标的表现均维持在期望水平或有所改善。此外,实施TeamSTEPPS后,手术部位/侧别/人员错误以及无意遗留异物的绝对数量有所减少。