Anaesthetics, NHS Highland, Inverness, UK
Medicine, NHS Lanarkshire, Bothwell, South Lanarkshire, UK.
BMJ Open Qual. 2021 Feb;10(1). doi: 10.1136/bmjoq-2020-001274.
Effective communication between members of the multidisciplinary team is imperative for patient safety. Within the Medicine for the Elderly wards at Royal Victoria Hospital (RVH) in Dundee, we identified an inefficient process of information-sharing between the orthopaedics outpatient department (OPD) at the main teaching hospital and our hospital's rehabilitation teams, and sought to improve this by introducing several changes to the work system. Our aim was for all patients who attended the OPD clinic to have a plan communicated to the RVH team within 24 hours.Before our intervention, clinic letters containing important instructions for ongoing rehabilitation were dictated by the OPD team, transcribed and uploaded to an electronic system before the RVH team could access them. We analysed clinic attendances over a 4-week period and found that it took 15 days on average for letters to be shared with the RVH teams. We worked with both teams to develop a clinical communication tool and new processes, aiming to expedite the sharing of key information. Patients attended the OPD with this form, the clinician completed it at the time of their appointment and the form returned with the patient to RVH on the same day.We completed multiple Plan-Do-Study-Act cycles; before our project was curtailed by the COVID-19 pandemic. During our study period, seven patients attended the OPD with a form, with all seven returning to RVH with a completed treatment plan documented by the OPD clinician. This allowed rehabilitation teams to have access to clinic instructions generated by orthopaedic surgeons almost immediately after a patient attended the clinic, essentially eliminating the delay in information-sharing.The introduction of a simple communication tool and processes to ensure reliable transfer of information can expedite information-sharing between secondary care teams and can potentially reduce delays in rehabilitation.
多学科团队成员之间的有效沟通对患者安全至关重要。在邓迪皇家维多利亚医院（RVH）老年医学病房，我们发现矫形外科门诊（OPD）与我们医院康复团队之间的信息共享流程效率低下，并试图通过对工作系统进行几项更改来改进这一流程。我们的目标是让所有在 OPD 诊所就诊的患者在 24 小时内将计划传达给 RVH 团队。在我们的干预措施之前，OPD 团队口述了包含正在进行康复重要说明的门诊信件，将其转录并上传到电子系统中，然后 RVH 团队才能访问这些信件。我们分析了为期 4 周的门诊就诊情况，发现平均需要 15 天才能将信件与 RVH 团队共享。我们与两个团队合作开发了一种临床沟通工具和新流程，旨在加快关键信息的共享。患者带着这张表格去 OPD，医生在预约时填写表格，当天患者带着表格返回 RVH。我们完成了多个计划-执行-研究-行动循环；在 COVID-19 大流行之前，我们的项目被缩短了。在我们的研究期间，有 7 名患者带着表格去了 OPD，所有 7 名患者都带着 OPD 医生记录的完整治疗计划返回了 RVH。这使得康复团队在患者就诊后几乎可以立即获得骨科医生生成的门诊说明，从而基本上消除了信息共享的延迟。引入简单的沟通工具和流程来确保信息的可靠传递，可以加快二级保健团队之间的信息共享，并有可能减少康复延迟。
