Aldawood Fatima, Kazzaz Yasser, AlShehri Ali, Alali Hamza, Al-Surimi Khaled
Nursing Services, Ministry of National Guard Health Affairs, Riyadh, Central, Saudi Arabia
College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
BMJ Open Qual. 2020 Feb;9(1). doi: 10.1136/bmjoq-2019-000753.
Open communication between leadership and frontline staff at the unit level is vital in promoting safe hospital culture. Our hospital staff culture survey identified the failure to address safety issues as one of the areas where staff felt unable to express their concerns openly. Thus, this improvement project using the daily safety huddle tool has been developed to enhance teamwork communication and respond effectively to patient safety issues identified in a paediatric intensive care unit.
We used the TeamSTEPPS quality approach. TeamSTEPPS is an evidence-based set of teamwork tools developed by the US Agency of Healthcare Research and Quality to enhance teamwork and communication. We applied TeamSTEPPS using a tool called the Daily Safety Huddle, aiming at improving communication and interaction between healthcare workers and building trust by acting immediately when there is any patient safety issue or concern at the unit level.
During the period from April to December 2017, the interaction between frontline staff and unit leadership increased through compliance with the daily safety huddle. Initially, compliance was at 73%, but it increased to 97%, with a total of 340 safety issues addressed. The majority of these safety issues pertained to infection control and medication errors (109; 32.05%), followed by communication (83; 24.41%), documentation (59; 17.35%), other issues (37; 10.88%), procedure (20; 5.88%), patient flow (16; 4.7%) and equipment and supplies (16; 4.7%).
Systematic use of daily safety huddle is a powerful tool to create an equitable environment where frontline staff can speak up freely about daily patient safety concerns. The huddle leads to a more open and active discussion with unit leadership and to the ability to perform the right action at the right time.
在促进安全的医院文化方面，单位层面领导与一线员工之间的开放沟通至关重要。我们医院的员工文化调查发现，未能解决安全问题是员工感到无法公开表达担忧的领域之一。因此，已开发出使用每日安全碰头会工具的改进项目，以加强团队协作沟通，并有效应对儿科重症监护病房中发现的患者安全问题。
我们采用了团队策略与工具提升绩效（TeamSTEPPS）质量方法。TeamSTEPPS是美国医疗保健研究与质量局开发的一套循证团队协作工具，旨在加强团队协作与沟通。我们使用一种名为每日安全碰头会的工具来应用TeamSTEPPS，目的是改善医护人员之间的沟通与互动，并在单位层面出现任何患者安全问题或担忧时立即采取行动，从而建立信任。
在2017年4月至12月期间，通过遵守每日安全碰头会，一线员工与单位领导之间的互动有所增加。最初，合规率为73%，但后来提高到了97%，共解决了340个安全问题。这些安全问题大多与感染控制和用药错误有关（109个；32.05%），其次是沟通（83个；24.41%）、文件记录（59个；17.35%）、其他问题（37个；10.88%）、程序（20个；5.88%）、患者流程（16个；4.7%）以及设备和物资（16个；4.7%）。
系统使用每日安全碰头会是创造一个公平环境的有力工具，在这个环境中一线员工可以就日常患者安全问题自由发言。碰头会促使与单位领导进行更开放、积极的讨论，并能够在正确的时间采取正确的行动。
