Improving Patient Safety Through Provider Communication*

描述（由申请人提供）：本提案的首要目的是评估全面团队沟通策略的实施情况，从而形成一个可推广到其他护理环境的实施工具包。主要目标是通过减少医院环境中与团队沟通失败相关的错误来提高患者安全性。具体目标包括： 1.实施标准化沟通工具-SBAR（情景简报模型），作为沟通患者状态或需求变化的脚本指南。 2.开发和实施升级流程工具，以促进及时沟通患者病情变化。 3.实施以患者为中心的每日查房，包括患者护理中涉及的所有学科，包括使用每日目标表。 4.每班小组会议的实施-职能小组的快速简报/会议，通过与关键人员的评论来启动一天/一班的工作。 这项拟议的安全做法干预措施的预期结果是： 1.减少医疗团队成员之间的沟通失败，这是患者安全网报告的一个促成因素。 2.减少总体不良事件、错误或未遂事件，如大学健康系统联盟（UCH）患者安全网所跟踪。 3.减少需要医生和护士之间电话咨询的非紧急患者护理情况的治疗时间。 4.通过更有效的团队沟通改善患者安全文化。 本研究与公共卫生和安全相关，因为它有可能减少医疗保健环境中的医疗错误和患者伤害。积极主动地解决减少医疗差错的问题，作为促进患者安全的一种手段，这与该机构作为一家公共安全网医院的使命是一致的。

DESCRIPTION (provided by the applicant): The overarching purpose of this proposal is to evaluate the implementation of a comprehensive team communication strategy, resulting in an implementation toolkit that can be generalized to other settings of care. The primary goal is to improve patient safety by decreasing errors related to team communication failures in the hospital setting. The specific aims include: 1. Implementation of a standardized communication tool - the SBAR (a situational briefing model), as a scripting guide for communicating changes in patient status or needs. 2. Development and implementation of an escalation process tool to facilitate timely communication regarding changes in patient conditions. 3. Implementation of daily patient centered rounds to include all disciplines involved in the patient's care, including the use of a daily goals sheet. 4. Implementation of team huddles each shift - A quick briefing/meeting of a functional group to set the day/shift in motion by commentary with key personnel. The expected outcomes of this proposed safe practice intervention are: 1. Decreased communication failures among healthcare team members as a contributing factor in patient safety net reports. 2. Decreased overall adverse events, errors, or near misses as tracked by the University Healthsystems Consortium (UCH) Patient Safety Net. 3. Decrease time to treatment for non-emergent patient care situations that require phone consultation between physicians and nurses. 4. Improvement in a culture of patient safety through more effective team communication. This study is relevant to public health and safety as it has the potential to decrease medical errors and patient harm in the health care setting. Proactively addressing the reduction of medical errors as a means to facilitate patient safety is consistent with the mission of this agency which is a public safety net hospital.