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创新解决方案应对老问题:利用可及的数字解决方案提高重症监护中应急设备配置的可靠性。

Novel solutions to old problems: improving the reliability of emergency equipment provision in critical care using accessible digital solutions.

机构信息

Anaesthetics and Critical Care, Musgrove Park Hospital, Taunton, UK

Anaesthetics and Critical Care, Musgrove Park Hospital, Taunton, UK.

出版信息

BMJ Open Qual. 2022 Jul;11(3). doi: 10.1136/bmjoq-2022-001953.

Abstract

Reliable provision of emergency equipment in Critical Care is key to ensure patient safety during medical emergencies and transfers. A problem was identified in incident reports and external inspections of processes that ensured the provision of such equipment for use by critical care teams in non-critical care areas in the form of grab bags. A comprehensive project was undertaken to tackle this including the provision of a bespoke digital system.Existing systems were reliant on staff remembering to check equipment and document checks on paper and there was no formal ability to hand over ongoing problems. A local project management approach, '7 Steps to Quality Improvement', which integrated many of the philosophies and tools from Healthcare Improvement was used. A bespoke digital system was designed and implemented with integrated improvements in equipment stocking ergonomics.The reliability of documented equipment checks improved significantly, there was a significant reduction in the number of incident reports regarding emergency equipment and the time spent by staff doing equipment checks was reduced substantially with significant cost and resource improvements. This was so successful the format has been rapidly translated and spread to other areas such as operating theatres' difficult airway trolleys.Undertaking a structured quality improvement approach, using appropriate stakeholder engagement, digitalisation of systems and improvements in basic system ergonomics can have a substantial impact on the reliability and safety of emergency equipment provided for use by members of the critical care team.

摘要

在危重病护理中,可靠地提供急救设备是确保患者在医疗紧急情况和转院期间安全的关键。在事件报告和外部检查过程中发现了一个问题,即确保以抢提袋形式为非危重病区的危重病护理团队提供此类设备的供应存在问题。为此,开展了一项全面的项目来解决这个问题,包括提供定制的数字系统。现有系统依赖于员工记住检查设备并在纸上记录检查,并且没有正式的能力来移交正在发生的问题。采用了一种本地项目管理方法,“7 步质量改进”,该方法整合了医疗保健改进中的许多理念和工具。设计并实施了定制的数字系统,对设备库存的人体工程学进行了综合改进。记录设备检查的可靠性显著提高,有关急救设备的事件报告数量显著减少,员工进行设备检查的时间大大减少,同时显著提高了成本和资源效率。这项工作非常成功,其格式已迅速被翻译成并推广到其他领域,如手术室的困难气道推车。采用结构化的质量改进方法,利用适当的利益相关者参与、系统的数字化和基本系统人体工程学的改进,可以对危重病护理团队成员使用的急救设备的可靠性和安全性产生重大影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6549/9345090/4dfa38bd76e9/bmjoq-2022-001953f01.jpg

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