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在一家儿童医院实施创新的多单位事后反思计划。

Implementation of an Innovative, Multiunit, Postevent Debriefing Program in a Children's Hospital.

机构信息

From the Department of Emergency Medicine, The Icahn School of Medicine at Mount Sinai, New York, NY.

Section of Emergency Medicine, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX.

出版信息

Pediatr Emerg Care. 2020 Jul;36(7):345-346. doi: 10.1097/PEC.0000000000001898.

Abstract

BACKGROUND

Postevent debriefing has been associated with improved resuscitation outcomes and is recommended by the American Heart Association and the American Academy of Pediatrics to improve clinical performance.

OBJECTIVE

Despite the benefits of postevent debriefing, published debriefing programs have focused on single areas within a hospital. We are unaware of any hospital-wide debriefing programs implemented in a pediatric setting.

METHODS

We established a multidisciplinary, interprofessional debriefing collaborative at the Children's Hospital of Philadelphia to implement postevent debriefings in multiple areas of the hospital. The collaborative created a standardized debriefing form to capture data about the postevent debriefings.

RESULTS

From July 23, 2015 to December 31, 2017, the emergency department performed 153 debriefings (18%) for 850 resuscitations. The neonatal intensive care unit conducted 10 debriefings (9%) for 107 resuscitations, and the pediatric intensive care unit performed 5 debriefings (7%) for 73 resuscitations.

CONCLUSIONS

Several departments at the Children's Hospital of Philadelphia have incorporated hot and cold debriefings into their clinical practice as part of their continuous quality improvement programs. By disseminating the tools and lessons learned from the implementation process, the collaborative hopes that other institutions will benefit from their lessons learned to successfully create their own debriefing programs. Widespread adoption of debriefing programs will enable a more scientific approach to studying the outcomes of debriefing.

摘要

背景

事后总结已被证明与改善复苏结果相关,美国心脏协会和美国儿科学会均推荐采用事后总结来提高临床表现。

目的

尽管事后总结有诸多益处,但已发表的总结方案主要集中在医院内的单个领域。我们尚未发现儿科环境中有实施全院范围总结的方案。

方法

我们在费城儿童医院成立了一个多学科、多专业的总结协作组,以在医院的多个领域实施事后总结。该协作组创建了一个标准化的总结表格,以记录事后总结的数据。

结果

2015 年 7 月 23 日至 2017 年 12 月 31 日,急诊科对 850 例复苏进行了 153 次总结(占 18%),新生儿重症监护病房对 107 例复苏进行了 10 次总结(占 9%),儿科重症监护病房对 73 例复苏进行了 5 次总结(占 7%)。

结论

费城儿童医院的几个科室已将热总结和冷总结纳入其临床实践,作为其持续质量改进项目的一部分。通过传播实施过程中获得的工具和经验教训,协作组希望其他机构能够从这些经验教训中受益,成功创建自己的总结项目。总结项目的广泛采用将使人们能够更科学地研究总结的效果。

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