Remote video auditing with real-time feedback in an academic surgical suite improves safety and efficiency metrics: a cluster randomised study
Remote video auditing with real-time feedback in an academic surgical suite improves safety and efficiency metrics: a cluster randomised study
复制标题
DOI：
10.1136/bmjqs-2015-004226
复制
发表时间：
2016-12-01
影响因子：
5.4
通讯作者：
DiCapua, John F.
中科院分区：
文献类型：
--
作者：
Overdyk, Frank J.;Dowling, Oonagh;DiCapua, John F.
在手术过程中遵守手术安全检查表的重要性已被证明可以减少住院死亡率和并发症，但手术团队仍然难以正确执行。目的我们评估远程视频审核和实时提供者反馈对签入、超时、注销和病例移交时间检查表遵从性的影响。设计、设置前瞻性、整群随机研究在23个手术室(OR)中。参与者外科医生、麻醉提供者、护士和支持人员。暴露者被随机接收或不接收关于安全检查表遵从性和效率指标的实时反馈，通过展板和短信，主要结果(S)和测量(S)在签到、超时和注销过程中的检查表遵从性(通过/不通过)表现为(1)检查表的使用，(2)团队注意力，(3)所需时间，(4)适当的顺序和案例移交时间的持续时间。结果签到、超时和注销的合格率从基线阶段(n=1886)的25%、16%和32%提高到反馈对象的、84%和68%，而反馈对象的合格率为40%，无反馈OR值分别为77%和51%(p
Importance Compliance with the surgical safety checklist during operative procedures has been shown to reduce inhospital mortality and complications but proper execution by the surgical team remains elusive.Objective We evaluated the impact of remote video auditing with real-time provider feedback on checklist compliance during sign-in, time-out and sign-out and case turnover times.Design, setting Prospective, cluster randomised study in a 23-operating room (OR) suite.Participants Surgeons, anaesthesia providers, nurses and support staff.Exposure ORs were randomised to receive, or not receive, real-time feedback on safety checklist compliance and efficiency metrics via display boards and text messages, followed by a period during which all ORs received feedback.Main outcome(s) and measure(s) Checklist compliance (Pass/Fail) during sign-in, time-out and sign-out demonstrated by (1) use of checklist, (2) team attentiveness, (3) required duration, (4) proper sequence and duration of case turnover times.Results Sign-in, time-out and sign-out PASS rates increased from 25%, 16% and 32% during baseline phase (n=1886) to 64%, 84% and 68% for feedback ORs versus 40%, 77% and 51% for no-feedback ORs (p