Methodology for co-creating provider-centered interventions for mitigating interruptions in the emergency department
Methodology for co-creating provider-centered interventions for mitigating interruptions in the emergency department
复制标题
共同创建以提供者为中心的干预措施以减少急诊科中断的方法
DOI：
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发表时间：
2018
期刊：
影响因子：
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通讯作者：
Hunter J. Hawthorne
中科院分区：
文献类型：
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作者：
Renaldo C. Blocker;Katherine L. Forsyth;Hunter J. Hawthorne
急诊科（艾德）的高度不确定性和间歇性的时间关键活动造成了不可预测的工作量。频繁的中断是这种急性护理工作环境所固有的，增加了对临床医生的要求。实施可持续的干预措施以减少中断一直是一项挑战。本研究探讨了急诊科的中断，并提供了一种方法，共同创造干预措施，以消除和/或管理中断对护理过程的影响。观察员在临床医生的整个轮班期间使用经验证的基于平板电脑的工具收集和分类中断。焦点小组被用来制定和选择以提供者为中心的干预措施。在91个班次中，共发现7889例中断。总共选择了24项干预措施供可能实施。干预措施涉及（1）方案、程序和政策，（2）信息共享，（3）器械和（4）角色明确。制定可持续的中断解决方案有可能减少患者的脆弱性。
The high uncertainty of the emergency department (ED) and intermittent time-critical activities creates unpredictable staff workloads. Frequent interruptions are inherent to this acute care work environment adding to the demands placed on clinicians. Implementing sustainable interventions to mitigate interruptions has been a challenge. This study examined interruptions in the emergency department and provides a methodology for co-creating interventions to eliminate and/or manage interruptions impact on the care process. Observers collected and categorized interruptions using a validated tablet PC-based tool during clinicians’ entire shifts. Focus groups were used to develop and select provider-centered interventions. A total of 7889 interruptions were identified across 91 shifts. A total of 24 interventions were selected for potential implementation. The interventions were related to (1) protocol, procedures and policy, (2) information sharing, (3) devices and (4) role clarity. Developing sustainable solutions to interruptions has the potential to reduce patients’ vulnerability.