Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, U.S.A.
Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A.
Laryngoscope. 2021 Jun;131(6):E1811-E1815. doi: 10.1002/lary.29384. Epub 2021 Jan 13.
OBJECTIVE/HYPOTHESIS: Our department sought to develop a quality improvement initiative in the interest of promoting resident involvement within the departmental safety culture. Specifically, we aimed to identify any barriers to incident reporting among residents and to create an approach to rectify this problem.
Patient Safety/Quality Improvement.
This is a descriptive, qualitative study taking place at a large teaching hospital. A brief survey was administered to all Otorhinolaryngology residents and based on feedback a two-pronged approach to creating a patient safety and quality improvement curriculum was undertaken. This entailed implementation of 1) a formalized online curriculum and 2) a resident-driven forum for discussion of safety concerns termed a "Resident Safety Huddle."
The survey identified three main barriers to incident reporting among residents, including increased workload, the punitive nature of the system, and fear of retribution. During the study period, the residents completed the curriculum required to obtain the Institute for Healthcare Improvement Basic Certificate of Quality and Safety and participated in 10 Resident Safety Huddles. Each huddle was dedicated to discussion of a unique safety concern and frequently led to sustainable solutions. After implementation of this curriculum, an increase in the number of safety events reported by residents was recognized.
In building an educational foundation for incident reporting and further bolstering it with a resident-driven forum for discussion of safety concerns, we were able to achieve a recognizable and meaningful impact on our residents and the greater departmental safety culture.
4 (single descriptive or qualitative study) Laryngoscope, 131:E1811-E1815, 2021.
目的/假设：为了促进住院医师在部门安全文化中的参与度，我们部门寻求开展一项质量改进计划。具体来说，我们旨在确定住院医师报告事件时存在的障碍，并制定解决方案。
患者安全/质量改进。
这是一项在大型教学医院进行的描述性、定性研究。我们向所有耳鼻喉科住院医师发放了一份简短的调查问卷，根据反馈信息，我们采取了双管齐下的方法来制定患者安全和质量改进课程。这包括实施 1）正式的在线课程和 2）一个由住院医师主导的安全问题讨论论坛，称为“住院医师安全会议”。
该调查确定了住院医师报告事件时存在的三个主要障碍，包括工作量增加、制度的惩罚性性质以及对报复的恐惧。在研究期间，住院医师完成了获得改善医疗保健研究所基本质量和安全证书所需的课程，并参加了 10 次住院医师安全会议。每次会议都专门讨论一个独特的安全问题，经常能找到可持续的解决方案。在实施该课程后，住院医师报告的安全事件数量有所增加。
通过为事件报告建立教育基础，并通过住院医师主导的安全问题讨论论坛进一步加强，我们成功地对住院医师和更大的部门安全文化产生了可识别和有意义的影响。
4（单描述性或定性研究）喉镜，131：E1811-E1815，2021 年。
