Supporting patient safety: Examining communication within delivery suite teams through contrasting approaches to research observation.
Supporting patient safety: Examining communication within delivery suite teams through contrasting approaches to research observation.
复制标题
DOI：
10.1016/j.midw.2010.04.009
复制
发表时间：
2010-10-01
期刊：
影响因子：
2.7
通讯作者：
Freeth, Della S.
中科院分区：
文献类型：
--
作者：
Berridge, Emma-Jane;Mackintosh, Nicola J.;Freeth, Della S.
目标：探索产房内和专业间沟通的本质，特别关注患者安全。设计：使用对比观察形式的纵向研究：人种学方法以及高度结构化的交互过程分析（IPA）框架。设置：四个对比的产房，提供不同的护理模式并为不同人群提供服务：两个在英格兰北部，两个在伦敦。参与者：多学科产房团队和来自相关领域的来访专业人士。主要发现：人种学观察和定量研究结果相结合，突出了与沟通相关的四个主要领域：沟通支撑协作；工作量压力对沟通实践的影响；跨专业沟通；以及建筑对沟通的影响。背景因素（例如病例敏锐度、客户吞吐量、护理模式）强调了一些站点间差异，并关注对安全的影响。结论和对实践的影响：使用补充方法有助于探索交付套件复杂环境中的沟通。研究结果反映了沟通模式的复杂性以及对模式和规范的多重影响。专业间的紧张关系、工作量压力和环境设计可能会限制沟通，从而影响安全。因此，这些发现对政策具有影响，因为重点关注标准化通信的安全解决方案需要置于更广泛的战略中，这些战略也解决结构和组织网络和影响。 (C) 2010 Elsevier Ltd. 保留所有权利。
Objective: to explore the nature of intra- and interprofessional communication on delivery suites, with a particular focus on patient safety.Design: longitudinal study using contrasting forms of observation: ethnographic methods alongside the highly structured Interaction Process Analysis (IPA) framework.Setting: four contrasting delivery suites offering different models of care and serving different populations: two in the north of England and two in London.Participants: the multidisciplinary delivery suite teams and visiting professionals from related areas.Key findings: the ethnographic observations and quantitative findings combine to highlight four principal areas relating to communication: communication underpinning collaboration; effects of workload pressures on communication practices; interprofessional communication; and the influence of architecture on communication. Contextual factors (e.g. case acuity, client throughput, model of care) underscore some inter site differences and attention is drawn to implications for safety.Conclusions and implications for practice: the use of complementary methods aided exploration of communication in the complex environment of the delivery suite. The findings reflect the complexity of communication patterns and the multiple influences on patterns and norms. Interprofessional tensions, workload pressures and the design of the environment can restrict communication, with implications for safety. As such, these findings have implications for policy in that safety solutions which focus efforts on standardising communication need to be located within wider strategies that also address structural and organisational networks and influences. (C) 2010 Elsevier Ltd. All rights reserved.