Perioperative Care Structures and Non-Routine Events: Network Analysis.
Perioperative Care Structures and Non-Routine Events: Network Analysis.
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DOI：
10.3233/shti220096
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发表时间：
2022-06-06
影响因子：
--
通讯作者：
France, Daniel
中科院分区：
文献类型：
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作者：
Chen, You;Alrifai, Mhd Wael;Gong, Yang;Evan, Rhodes;Slagle, Jason;Malin, Bradley;France, Daniel
非常规事件（NRE）是临床医生认为偏离最佳护理的任何护理方面。向同行（或护理团队）报告NRE可以帮助医疗保健组织提高高风险工作环境中的患者安全性（例如，外科手术）。虽然各种因素，包括护理结构和组织因素可能会影响临床医生的NRE报告行为，他们的作用还没有得到系统的研究。我们进行了一项回顾性研究，依靠NRE和电子健康记录，以确定临床医生之间的围手术期互动结构是否与大型学术医疗中心的NRE报告频率相关。数据涵盖2016年11月1日至2019年1月31日，包括295名围手术期临床医生，225例新生儿手术病例和543例NRE。使用网络分析，我们测量了临床医生的互动结构的社会计量学因素的程度，介数和特征向量中心的地位。我们应用比例优势模型来衡量每个社会计量因素和NRE报告频率之间的关系。我们的研究结果表明，临床医生的中心地位与每个手术病例的NRE数量直接相关。
Non-routine events (NREs) are any aspect of care perceived by clinicians as a deviation from optimal care. The reporting of NREs to peers (or care teams) may help healthcare organizations improve patient safety in high-risk work environments (e.g., surgery). While various factors, including care structure and organizational factors may influence a clinician’s NRE reporting behavior, their role has not been systematically studied. We conducted a retrospective study relying on NREs and electronic health records to determine if perioperative interaction structures among clinicians are associated with the frequency of NRE reporting in a large academic medical center. The data covers November 1, 2016, to January 31, 2019 and includes 295 perioperative clinicians, 225 neonatal surgical cases, and 543 NREs. Using network analysis, we measured a clinician’s status in interaction structures according to the sociometric factors of degree, betweenness, and eigenvector centrality. We applied a proportional odds model to measure the relationship between each sociometric factor and NRE reporting frequency. Our findings indicate that the centrality of clinicians is directly associated with the quantity of NREs per surgical case.