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常规临床汇报与事件报告的对比分析:对患者安全及团队协作提升的启示

Comparative analysis of routine clinical debriefings and incident reports: insights for patient safety and teamwork enhancement.

作者信息

Paquay Méryl, Kolbe Michaela, Klenkenberg Sophie, Buléon Clément, Bertrand Audrey, Simon Robert, Ghuysen Alexandre

机构信息

Emergency Department, University Hospital of Liege, Avenue de l'hopital, 1, Liege 4000, Belgium.

Center for Medical Simulation of Liege, Public Health Department, University of Liege, Quartier Hôpital, Av. Hippocrate 13, CHU B23, Liege 4000, Belgium.

出版信息

Int J Qual Health Care. 2025 Feb 18;37(1). doi: 10.1093/intqhc/mzaf010.

Abstract

BACKGROUND

Routine clinical debriefings (RCDs) have been shown to improve communication, team reflexivity, and safety in clinical settings. When combined with incident reports (IRs), RCDs offer a potential tool for enhancing quality improvement frameworks. This study aimed to identify and compare healthcare safety-related information captured through RCDs and IRs in a Belgian emergency department operating across two distinct facilities.

METHODS

This study employed a quasi-mixed-method design with a monostrand conversion approach. Information was collected from 90 RCDs and 263 IRs. Data were analyzed using two frameworks: the World Health Organization's Incident Report Classification Grid and the Debriefing and Organizational Lessons Learned Grid.

RESULTS

The findings revealed significant differences in the types of information captured by RCDs and IRs. RCDs predominantly highlighted teamwork, internal organization, and procedural issues, while IRs focused more on care processes, patient concerns, and patient flow. These complementary insights demonstrate the value of integrating RCDs and IRs to create a comprehensive understanding of patient and clinician safety.

CONCLUSIONS

This study highlights the complementary nature of RCDs and IRs in addressing healthcare safety. RCDs foster team reflexivity and promote open discussions about systemic challenges, directly improving team cohesion, resilience, and learning. Combining RCDs and IRs provides actionable insights for enhancing safety and driving organizational improvements.

摘要

背景

常规临床汇报(RCDs)已被证明可改善临床环境中的沟通、团队反思能力和安全性。当与事件报告(IRs)相结合时,RCDs为加强质量改进框架提供了一种潜在工具。本研究旨在识别和比较在比利时一家跨两个不同机构运营的急诊科中,通过RCDs和IRs获取的与医疗安全相关的信息。

方法

本研究采用了一种带有单链转换方法的准混合方法设计。从90份RCDs和263份IRs中收集信息。使用两个框架对数据进行分析:世界卫生组织的事件报告分类网格和汇报与组织经验教训网格。

结果

研究结果显示,RCDs和IRs所获取的信息类型存在显著差异。RCDs主要突出团队合作、内部组织和程序问题,而IRs更关注护理流程、患者关切和患者流程。这些互补的见解表明了整合RCDs和IRs以全面了解患者和临床医生安全的价值。

结论

本研究强调了RCDs和IRs在解决医疗安全问题上的互补性。RCDs促进团队反思,并推动关于系统性挑战的公开讨论,直接改善团队凝聚力、适应力和学习能力。将RCDs和IRs相结合可为提高安全性和推动组织改进提供可操作的见解。

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