Lee Daniel D, Colwill Alyssa C, Teel Joseph, Srinivas Sindhu K
Departments of Obstetrics and Gynecology (Drs Lee and Srinivas) and Family Medicine (Dr Teel), University of Pennsylvania School of Medicine, Philadelphia; and Department of Obstetrics and Gynecology, Oregon Health & Sciences University, Portland (Dr Colwill).
Qual Manag Health Care. 2018 Oct/Dec;27(4):223-228. doi: 10.1097/QMH.0000000000000191.
The multifaceted nature of the transition of care from the triage unit to labor and delivery has historically led to confusion, delays, and errors in care. This study evaluated the effect of standardization of roles and communication on improving this transition.
A multidisciplinary team was assembled to define and standardize roles of team members. A huddle safety board was created as a visual aid to promote closed-loop communication during an admission bedside huddle. The primary metrics collected were duration of time from the admission decision in the triage unit to when the admission huddle was completed on labor and delivery, duration of time from the admission decision in the triage unit to initiation of the plan of care and documented completion of the admission huddle.
There was a 66-minute reduction in time from the admission decision to the huddle completion between the preintervention and postintervention periods. There was a 93-minute reduction in the time from the admission decision to when the plan of care was initiated between the preintervention and post-intervention periods. The weekly huddle compliance rate improved from 48% to 84% by the postintervention period.
The implementation of standardized roles and processes facilitating closed-loop communication decreases delays in communication and initiation of care in pregnant women transferred from the triage unit to labor and delivery.
从分诊单元到产房的护理交接具有多方面的性质，历来会导致护理过程中的混乱、延误和差错。本研究评估了角色和沟通标准化对改善这种交接的效果。
组建了一个多学科团队来定义和规范团队成员的角色。创建了一个碰头安全板作为视觉辅助工具，以促进入院床边碰头期间的闭环沟通。收集的主要指标包括从分诊单元做出入院决定到产房完成入院碰头的时间、从分诊单元做出入院决定到开始护理计划并记录入院碰头完成的时间。
干预前和干预后期间，从入院决定到碰头完成的时间减少了66分钟。干预前和干预后期间，从入院决定到开始护理计划的时间减少了93分钟。到干预后期，每周碰头合规率从48%提高到了84%。
实施标准化角色和流程以促进闭环沟通，可减少从分诊单元转至产房的孕妇在沟通和护理开始方面的延误。
