多学科团队碰头会在医院医疗环境中的有效性。
The Effectiveness of Multidisciplinary Team Huddles in Healthcare Hospital-Based Setting.
作者信息
Lin Shih Ping, Chang Ching-Wein, Wu Chun-Yi, Chin Chun-Shih, Lin Cheng-Hsien, Shiu Sz-Iuan, Chen Yun-Wen, Yen Tsai-Hung, Chen Hui-Chi, Lai Yi-Hung, Hou Shu-Chin, Wu Ming-Ju, Chen Hsin-Hua
机构信息
Division of General Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Division of Infection, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
出版信息
J Multidiscip Healthc. 2022 Oct 6;15:2241-2247. doi: 10.2147/JMDH.S384554. eCollection 2022.
OBJECTIVE
Huddles are short, regular debriefings that are designed to provide frontline staff and bedside caregivers environments to share problems and identify solutions. Daily huddle implementation could improve medical safety work, problem identification and improvement, situation awareness and teamwork enhancement, the collaboration and communication between professionals and departments, and patient safety. This study aimed evaluated the effectiveness of a hospital-based huddle at a general medical ward in Taiwan.
METHODS
A Continuous Integration team was conducted by combining multidisciplinary frontline staff to huddle at a 74-bed general medical ward. Team Huddles started twice a week. A physical huddle run board was created, which contained four parts, including idea submitted, idea approved, working on an idea and standardizing. Problems were submitted to the board to be identified, and the solutions were evaluated through huddle discussion. We divided the problems into two groups: quick hits (resolved within 24-48hrs) and complex issues (resolved >48hrs). An anonymous questionnaire was designed to evaluate the huddle response.
RESULTS
A total of 44 huddles occurred from September 9th, 2020, to September 30th, 2021, and 81 issues were identified and resolved. The majority issues were policy documentation (n=23; 28.4%). Sixty-seven (82.7%) issues were defined as quick hits, and the other fourteen (17.3%) issues were complex. The mean hours to the resolution of quick hits was 5.17 hours, median 3.5 hours, and range from 0.01-15.4 hours. The mean days to resolve completion issues were 19.73 days, median 7.5 days, and range 3.57-26.14 days. An overwhelming 92.9% of staff responded that huddles help to expedite the process to reach treatment goals, reduce clinical mistakes, near misses, reduce patient incidences, and help teamwork enhancement, with rating of 4.52 (on a 5-point Likert scale).
CONCLUSION
Implementing of multidisciplinary team huddle improved the accountability of issue identification, problem-solving and teamwork enhancement.
目的
碰头会是简短、定期的情况汇报，旨在为一线工作人员和床边护理人员提供分享问题和确定解决方案的环境。每日召开碰头会可改善医疗安全工作、问题识别与改进、态势感知与团队协作、专业人员与部门之间的合作与沟通以及患者安全。本研究旨在评估台湾一家综合内科病房开展的基于医院的碰头会的效果。
方法
一个由多学科一线工作人员组成的持续整合团队在一个拥有74张床位的综合内科病房进行碰头会。团队碰头会每周进行两次。创建了一个实体的碰头会运行板，其包含四个部分，即提交的想法、批准的想法、正在处理的想法和标准化。问题提交到板子上进行识别，并通过碰头会讨论评估解决方案。我们将问题分为两组：快速解决问题（在24 - 48小时内解决）和复杂问题（解决时间超过48小时）。设计了一份匿名问卷来评估碰头会的反馈。
结果
从2020年9月9日至2021年9月30日共进行了44次碰头会，识别并解决了81个问题。大多数问题是政策文件方面的（n = 23；28.4%）。67个（82.7%）问题被定义为快速解决问题，另外14个（17.3%）问题是复杂问题。快速解决问题的平均时长为5.17小时，中位数为3.5小时，范围为0.01 - 15.4小时。解决复杂问题的平均天数为19.73天，中位数为7.5天，范围为3.57 - 26.14天。压倒性的92.9%的工作人员回应称碰头会有助于加快实现治疗目标的进程、减少临床失误、险些发生的失误、降低患者发生率，并有助于增强团队协作，评分为4.52（采用5分制李克特量表）。
结论
实施多学科团队碰头会提高了问题识别、解决问题的责任性以及团队协作能力。
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