Simsekler Mecit Can Emre, Ward James R, Clarkson P John
Department of Industrial and Systems Engineering, Khalifa University of Science and Technology, Abu Dhabi Campus, Abu Dhabi 127788, United Arab Emirates.
School of Management, University College London, 1 Canada Square, London E14 5AA, UK.
Int J Qual Health Care. 2018 Apr 1;30(3):227-233. doi: 10.1093/intqhc/mzx176.
While many system mapping approaches (SMAs) have been broadly used in safety-critical industries, few have so far been employed in the healthcare field to assist in the identification of patient safety risks. In this study, we evaluated a set of system modelling approaches to assess their potential contribution to the identification of risks affecting patient safety. The aim was to gain a greater understanding of the practical application of system modelling approaches with the help of the risk categorization framework developed in this study.
We conducted this study in a newly established Adult Attention Deficit Hyperactivity Disorder (ADHD) service at Cambridge and Peterborough Foundation Trust.
Eight key stakeholders of the chosen service, including clinicians, managers and administrative staff, were individually asked to evaluate a set of pre-defined six SMAs according to their usefulness in identifying patient safety risks through interview-based questionnaires.
It was found that each SMA could be useful in the chosen healthcare service in different ways. Further, specific types of diagrams were selected by stakeholders as more useful than others in identifying different sources of risks within the given system.
The results of the evaluation showed that the system diagram is the most useful SMA in risk identification within the given system, while limited time, resources and experience of stakeholders with SMAs may present possible obstacles for their potential use in the healthcare field in future.
虽然许多系统映射方法(SMA)已在安全关键行业中广泛使用,但迄今为止,在医疗保健领域中使用这些方法来协助识别患者安全风险的情况却很少。在本研究中,我们评估了一组系统建模方法,以评估它们对识别影响患者安全的风险的潜在贡献。目的是借助本研究中开发的风险分类框架,更深入地了解系统建模方法的实际应用。
我们在剑桥和彼得伯勒基金会信托基金新设立的成人注意力缺陷多动障碍(ADHD)服务部门进行了这项研究。
所选服务的八位关键利益相关者,包括临床医生、管理人员和行政人员,被分别要求通过基于访谈的问卷,根据他们在识别患者安全风险方面的有用性,对一组预先定义的六种系统映射方法进行评估。
发现每种系统映射方法在所选的医疗服务中都能以不同方式发挥作用。此外,利益相关者选择了特定类型的图表,认为它们在识别给定系统内不同风险源方面比其他图表更有用。
评估结果表明,系统图是在给定系统中进行风险识别时最有用的系统映射方法,而利益相关者使用系统映射方法的时间、资源和经验有限,可能会成为其未来在医疗领域潜在应用的障碍。