Heideveld-Chevalking A J, Calsbeek H, Emond Y J, Damen J, Meijerink W J H J, Hofland J, Wolff A P
Department of Operating Theatres Radboud University Medical Centre Nijmegen The Netherlands.
Scientific Institute for Quality of Healthcare, Radboud Institute for Health Sciences Radboud University Medical Centre Nijmegen The Netherlands.
BJS Open. 2018 Apr 3;2(3):119-127. doi: 10.1002/bjs5.44. eCollection 2018 Jun.
A Surgical Patient safety Observation Tool (SPOT) was developed and tested in a multicentre observational pilot study. The tool enables monitoring and benchmarking perioperative safety performance across departments and hospitals, covering international patient safety goals.
Nineteen perioperative patient safety observation topics were selected from Dutch perioperative patient safety guidelines, which also cover international patient safety goals. All items that measured these selected topics were then extracted from available local observation checklists of the participating hospitals. Experts individually prioritized the best measurement items per topic in an initial written Delphi round. The second (face to face) Delphi round resulted in consensus on the content of SPOT, after which the measurable elements (MEs) per topic were defined. Finally, the tool was piloted in eight hospitals for measurability, applicability, improvement potential, discriminatory capacity and feasibility.
The pilot test showed good measurability for all 19 patient safety topics (range of 8-291 MEs among topics), with good applicability (median 97 (range 11·8-100) per cent). The overall improvement potential appeared to be good (median 89 (range 72·5-100) per cent), and at topic level the tool showed good discriminatory capacity (variation 27·5 per cent, range in compliance 72·5-100 per cent). Overall scores showed relatively little variation between the participating hospitals (variation 13 per cent, range in compliance 83-96 per cent). All eight auditors considered SPOT a straightforward and easy-to-use tracer tool.
A comprehensive tool to measure safety of care was developed and validated using a systematic, stepwise method, enabling hospitals to monitor, benchmark and improve perioperative safety performance.
手术患者安全观察工具（SPOT）在一项多中心观察性试点研究中得以开发和测试。该工具能够跨部门和医院监测围手术期安全绩效，并涵盖国际患者安全目标。
从荷兰围手术期患者安全指南中选取了19个围手术期患者安全观察主题，这些主题同样涵盖国际患者安全目标。随后从参与研究医院现有的本地观察检查表中提取所有测量这些选定主题的项目。专家们在第一轮书面德尔菲法中分别对每个主题的最佳测量项目进行了优先排序。第二轮（面对面）德尔菲法就SPOT的内容达成了共识，之后确定了每个主题的可测量要素（ME）。最后，该工具在八家医院进行了试点，以检验其可测量性、适用性、改进潜力、区分能力和可行性。
试点测试表明，所有19个患者安全主题均具有良好的可测量性（各主题的可测量要素范围为8 - 291个），适用性良好（中位数为97%（范围为11.8 - 100%））。总体改进潜力似乎良好（中位数为89%（范围为72.5 - 100%）），在主题层面该工具显示出良好的区分能力（差异为27.5%，合规范围为72.5 - 100%）。参与研究的医院之间总体得分差异相对较小（差异为13%，合规范围为83 - 96%）。所有八位审核人员均认为SPOT是一种简单易用的追踪工具。
使用系统、逐步的方法开发并验证了一种用于衡量护理安全的综合工具，使医院能够监测、对标并改善围手术期安全绩效。
