Parker Antay L, Forsythe Lydia L, Kohlmorgen Ingrid K
Texas Health Care LLC, Fort Worth, TX.
University of Texas Arlington, Arlington, TX.
J Healthc Risk Manag. 2019 Apr;38(4):19-31. doi: 10.1002/jhrm.21352. Epub 2018 Sep 13.
The objective of this integrative review of literature was to investigate and evaluate feasibility and potential for success of TeamSTEPPS implementation, the influence of TeamSTEPPS for Office-Based Care on the clinical error rate in a private outpatient clinic, and influence of TeamSTEPPS for Office-Based Care on patient satisfaction.
Patient safety remains a top priority for all health care providers in all clinical settings. Despite multiple varied efforts, clinical errors directly attributed to communication are consistently at the top of the list of root causes, although improvement strategies such as Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) have been implemented, there is insufficient data reported measuring the influence of this intervention on patient safety, clinical errors related to communication, and patient satisfaction.
A systematic search of the electronic databases MEDLINE Complete, CINAHL Complete, Embase, and Science Direct was conducted to seek literature that reported the effectiveness of the TeamSTEPPS tool to reduce clinical errors, improve communication, and increase patient satisfaction. Nineteen studies met inclusion criteria. Levels of evidence for each study was determined using the 2009 American Association of Critical Care Nursing (AACN) levels.
The present review is consistent with marked improvement in communication, decrease in clinical error rates, and improvement in patient satisfaction. There is a significant need for evaluation of the impact of this validated toolkit from the Agency for Healthcare Research and Quality to maintain a sustainable health care environment for all stakeholders. As a result of this integrative review, a quality improvement project related to both the primary and secondary end points is in progress.
本综合性文献综述的目的是调查和评估实施团队策略与工具以提升绩效和患者安全（TeamSTEPPS）的可行性及成功潜力，评估基于办公室的护理（OB-C）中TeamSTEPPS对一家私立门诊临床错误率的影响，以及OB-C中TeamSTEPPS对患者满意度的影响。
患者安全仍是所有临床环境中所有医疗服务提供者的首要任务。尽管进行了多种不同的努力，但直接归因于沟通的临床错误一直位居根本原因榜首。尽管已实施了诸如团队策略与工具以提升绩效和患者安全（TeamSTEPPS）等改进策略，但报告该干预措施对患者安全、与沟通相关的临床错误以及患者满意度影响的数据不足。
对电子数据库MEDLINE Complete、CINAHL Complete、Embase和ScienceDirect进行系统检索，以查找报告TeamSTEPPS工具在减少临床错误、改善沟通和提高患者满意度方面有效性的文献。19项研究符合纳入标准。使用2009年美国重症护理协会（AACN）的标准确定每项研究的证据水平。
本综述结果显示，沟通有显著改善，临床错误率降低，患者满意度提高。迫切需要评估美国医疗保健研究与质量局（Agency for Healthcare Research and Quality）这一经过验证的工具包的影响，以便为所有利益相关者维持可持续的医疗环境。作为本次综合性综述的结果，一个与主要和次要终点相关的质量改进项目正在进行中。
