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《PSYCH-PASS:精神交接的开发、调整与实施》

"PSYCH-PASS": the Development, Adaptation, and Implementation of a Psychiatric Handoff.

机构信息

Montefiore/Albert Einstein School of Medicine, New York, NY, USA.

出版信息

Acad Psychiatry. 2019 Oct;43(5):503-506. doi: 10.1007/s40596-019-01068-0. Epub 2019 May 1.

Abstract

OBJECTIVE

The primary purpose of the study was to develop and implement a psychiatry mnemonic PSYCH-PASS for transitions of care in residency training programs.

METHODS

The authors examined areas of improvement in the handoff system with residency training administration, service directors, and psychiatry residents to create PSYCH-PASS, a novel mnemonic that could be integrated in the electronic medical record (EMR). The components of PSYCH-PASS are Patient summary, Situational awareness, "whY" is the patient here, Comorbidities, Hemodynamics, Pharmacology/PRNs, Action list, Specifics, and Synthesis. The authors developed a 14 question pre- and post-survey with a 4-point Likert scale measuring five categories.

RESULTS

Pre-survey and post-surveys completed by post-graduate year 2 and 3 residents at Montefiore Medical Center (n = 24) noted increased satisfaction, handoff efficiency, handoff efficiency, accessibility, accuracy, communication, awareness, and adherence to PSYCH-PASS, along with a decrease in frequency of errors.

CONCLUSIONS

With promising results across a range of metrics indicating resident-reported positive impacts on patient care, further research on the implementation of PSYCH-PASS and its integration into EMR systems is merited. Future directions include gathering objective data from Epic and expansion of the initiative to other psychiatric services and institutions.

摘要

目的

本研究的主要目的是开发和实施一个精神病学记忆术 PSYCH-PASS,以改善住院医师培训计划中的交接流程。

方法

作者与住院医师培训管理部门、服务主任和精神病住院医师一起检查交接系统的改进领域,以创建 PSYCH-PASS,这是一种新的记忆术,可以整合到电子病历(EMR)中。PSYCH-PASS 的组成部分包括:患者总结、情境意识、“为什么”患者在这里、合并症、血液动力学、药理学/PRN、行动清单、具体信息和综合信息。作者开发了一个包含 14 个问题的预调查和后调查,采用 4 分李克特量表测量五个类别。

结果

在 Montefiore 医疗中心完成的预调查和后调查(n=24),包括二年级和三年级住院医师,他们对满意度、交接效率、访问便捷性、准确性、沟通、意识和对 PSYCH-PASS 的依从性都有所提高,同时减少了错误的发生频率。

结论

从一系列指标来看,结果令人鼓舞,表明住院医师报告对患者护理产生了积极影响,因此值得进一步研究 PSYCH-PASS 的实施及其在 EMR 系统中的整合。未来的方向包括从 Epic 收集客观数据,并将该计划扩展到其他精神科服务和机构。

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