A better way: training for direct observations in healthcare
A better way: training for direct observations in healthcare
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DOI：
10.1136/bmjqs-2021-014171
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发表时间：
2022-08-19
影响因子：
5.4
通讯作者：
Cohen, Tara
中科院分区：
文献类型：
--
作者：
Alfred, Myrtede;Del Gaizo, John;Cohen, Tara
直接观察对于识别潜在威胁和阐明临床环境中的系统复杂性是有价值的。这种方法有助于前瞻性风险评估，并揭示了难以回顾性诊断或仅通过结局数据诊断的变通方法，未遂事件和复发性安全问题。由于观察员是收集数据的工具，开展有效和全面的观察员培训对于确保数据收集的可靠性和研究的可重复性至关重要。然而，确保这些数据收集属性的方法学严谨性仍然是医疗保健直接观察研究的关键挑战。尽管先前的文献为医疗保健中的观察性研究提供了关键考虑因素，但实施这些建议可能会带来挑战，除非还提供观察员培训方面的指导。在这篇文章中，我们提供了培训非临床观察员进行直接观察的指导方针，包括进行培训需求分析，纳入实践观察和评估观察员和评分员之间的可靠性。这些指南的操作性描述的背景下，5年的多站点的观察性研究，调查技术集成在手术室。我们还讨论了在我们的项目过程中开发的新工具，以支持数据收集和检查直接观察研究中观察员之间的评价者可靠性。
Direct observation is valuable for identifying latent threats and elucidating system complexity in clinical environments. This approach facilitates prospective risk assessment and reveals workarounds, near-misses and recurrent safety problems difficult to diagnose retrospectively or via outcome data alone. As observers are an instrument of data collection, developing effective and comprehensive observer training is critical to ensuring the reliability of the data collection and reproducibility of the research. However, methodological rigour for ensuring these data collection properties remains a key challenge in direct observation research in healthcare. Although prior literature has offered key considerations for observational research in healthcare, operationalising these recommendations may pose a challenge and unless guidance is also provided on observer training. In this article, we offer guidelines for training non-clinical observers to conduct direct observations including conducting a training needs analysis, incorporating practice observations and evaluating observers and inter-rater reliability. The operationalisation of these guidelines is described in the context of a 5-year multisite observational study investigating technology integration in the operating room. We also discuss novel tools developed during the course our project to support data collection and examine inter-rater reliability among observers in direct observation studies.