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安全巡视是否仍有必要?一项提出新模式的试点项目和方法回顾。

Is It Still Time for Safety Walkaround? Pilot Project Proposing a New Model and a Review of the Methodology.

机构信息

Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00185 Rome, Italy.

SIC Medicina Legale, Via Potito Petrone, 85100 Potenza, Italy.

出版信息

Medicina (Kaunas). 2024 May 29;60(6):903. doi: 10.3390/medicina60060903.

Abstract

: Healthcare facilities are complex systems due to the interaction between different factors (human, environmental, management, and technological). As complexity increases, it is known that the possibility of error increases; therefore, it becomes essential to be able to analyze the processes that occur within these contexts to prevent their occurrence, which is the task of risk management. For this purpose, in this feasibility study, we chose to evaluate the application of a new safety walkaround (SWA) model. : A multidisciplinary working group made up of experts was established and then the subsequent phases of the activity were divided into three stages, namely the initial meeting, the operational phase, and the final meeting, to investigate knowledge regarding patient safety before and subsequently through visits to the department: the correct compilation of the medical record, adherence to evidence-based medicine (EBM) practices, the overall health and the degree of burnout of the various healthcare professionals, as well as the perception of empathy of staff by patients. : This working group chose to start this pilot project in the vascular surgery ward, demonstrating the ability of the tool used to capture the different aspects it set out to collect. In detail, the new version of SWA proposed in this work has made it possible to identify risk situations and system vulnerabilities that have allowed the introduction of corrective tools; detect adherence to existing company procedures, reschedule training on these specific topics after reviewing, and possibly update the same procedures; record the patient experience about the doctor-patient relationship and communication to hypothesize thematic courses on the subject; evaluate workers' perception of their health conditions about work, and above all reassure operators that their well-being is in the interest of the management of the healthcare company, which is maintained. Therefore, the outcome of the present study demonstrates the versatility and ever-present usefulness of the SWA tool.

摘要

医疗机构是复杂的系统,因为不同因素(人为、环境、管理和技术)之间存在相互作用。随着复杂性的增加,错误发生的可能性增加是已知的;因此,能够分析这些环境中发生的过程以防止其发生是至关重要的,这就是风险管理的任务。为此,在这项可行性研究中,我们选择评估一种新的安全巡查(SWA)模型的应用。

一个由专家组成的多学科工作组成立,然后将活动的后续阶段分为三个阶段,即初始会议、运营阶段和最终会议,以调查患者安全知识,在访问部门之前和之后:正确编写病历、遵守循证医学(EBM)实践、各个医疗保健专业人员的整体健康状况和倦怠程度,以及患者对员工的同理心感知。

该工作组选择在血管外科病房开始这个试点项目,展示了所使用的工具捕捉其旨在收集的不同方面的能力。具体来说,本工作中提出的新版本 SWA 使得可以识别风险情况和系统漏洞,从而引入纠正工具;发现遵守现有公司程序,在审查后重新安排这些特定主题的培训,并可能更新相同程序;记录患者对医患关系和沟通的体验,以便假设关于该主题的专题课程;评估工作人员对工作健康状况的看法,最重要的是向操作人员保证他们的健康福利符合医疗保健公司管理层的利益,这一点得到了维护。

因此,本研究的结果证明了 SWA 工具的多功能性和始终存在的有用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e265/11205543/89c96ee450f1/medicina-60-00903-g001.jpg

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