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放射肿瘤学住院医师培训中的患者安全和质量改进:对住院医师培训项目主任的全国调查。

Radiation oncology resident training in patient safety and quality improvement: a national survey of residency program directors.

机构信息

Department of Radiation Oncology, Washington University in St. Louis, 4921 Parkview Place, CAM LL, CB 8224, St. Louis, MO, 63110, USA.

Department of Radiation Oncology, University of Washington, Seattle, WA, USA.

出版信息

Radiat Oncol. 2018 Sep 24;13(1):186. doi: 10.1186/s13014-018-1128-5.

Abstract

BACKGROUND

Physicians and physicists are expected to contribute to patient safety and quality improvement (QI) in Radiation Oncology (RO), but prior studies suggest that training for this may be inadequate. RO and medical physics (MP) program directors (PDs) were surveyed to better understand the current patient safety/QI training in their residency programs.

METHODS

PDs were surveyed via email in January 2017. Survey questions inquired about current training, curriculum elements, and barriers to development and/or improvement of safety and QI training.

RESULTS

Eighty-nine RO PDs and 84 MP PDs were surveyed, and 21 RO PDs (28%) and 31 MP PDs (37%) responded. Both RO and MP PDs had favorable opinions of current safety and QI training, and used a range of resources for program development, especially safety and QI publications. Various curriculum elements were reported. Curriculum elements used by RO and MP PDs were similar, except RO were more likely than MP PDs to implement morbidity and mortality (M&M) conference (72% vs. 45%, p < 0.05). RO and MP PDs similarly cited various barriers, but RO PDs were more likely to cite lack of experience than MP PDs (40% vs. 16%, p < 0.05). PDs responded similarly independent of whether they reported using a departmental incident learning system (ILS) or not.

CONCLUSIONS

PDs view patient safety/QI as an important part of resident education. Most PDs agreed that residents are adequately exposed to patient safety/QI and prepared to meet the patient safety/QI expectations of clinical practice. This conflicts with other independent studies that indicate a majority of residents feel their patient safety/QI training is inadequate and lacks formal exposure to QI tools.

摘要

背景

医生和物理学家有望为放射肿瘤学(RO)的患者安全和质量改进(QI)做出贡献,但先前的研究表明,他们可能对此类培训的认识不足。RO 和医学物理(MP)项目主任(PD)接受了调查,以更好地了解他们住院医师培训计划中当前的患者安全/QI 培训情况。

方法

2017 年 1 月,PD 通过电子邮件接受调查。调查问题询问了当前培训、课程要素以及发展和/或改进安全和 QI 培训的障碍。

结果

对 89 名 RO PD 和 84 名 MP PD 进行了调查,有 21 名 RO PD(28%)和 31 名 MP PD(37%)做出了回应。RO 和 MP PD 对当前的安全和 QI 培训均持肯定态度,他们使用了各种资源来开发计划,尤其是安全和 QI 出版物。报告了各种课程要素。RO 和 MP PD 使用的课程要素相似,但 RO PD 比 MP PD 更有可能实施发病率和死亡率(M&M)会议(72%对 45%,p<0.05)。RO 和 MP PD 同样指出了各种障碍,但 RO PD 比 MP PD 更有可能缺乏经验(40%对 16%,p<0.05)。PD 的回应与他们是否报告使用部门事故学习系统(ILS)无关。

结论

PD 将患者安全/QI 视为住院医师教育的重要组成部分。大多数 PD 认为住院医师充分接触到了患者安全/QI,并准备好满足临床实践对患者安全/QI 的期望。这与其他独立研究相矛盾,这些研究表明大多数住院医师认为他们的患者安全/QI 培训不足,并且缺乏对 QI 工具的正式接触。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1006/6154943/7216049e7188/13014_2018_1128_Fig1_HTML.jpg

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