Simulation-based Training Program to Augment EMR-based Handoff Tool

基于模拟的培训计划可增强基于 EMR 的切换工具

• 批准号: 7236327
• 负责人: John A Vozenilek
• 金额: $ 28.51万
• 依托单位: NORTHSHORE UNIVERSITY HEALTHSYSTEM
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-30 至 2008-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7236327
• 关键词: automated medical record system; behavioral /social science research tag; clinical research; communication; computer assisted patient care; computer simulation; cooperative study; curriculum; emergency care; health care personnel performance; human subject; training

DESCRIPTION (provided by the applicant): Medical error is a significant public health problem. Miscommunication between medical providers has been noted to be involved in > 60% of medical error. Accreditation organizations and expert reviews have both called for efforts to improve and standardize medical communication, following models that have been successful in other high-risk fields such as aeronautics. Patient handoffs, particularly in high-volume and high-acuity settings, are a particularly vulnerable point in the patient care system. Such handoffs occur in noisy, chaotic settings and are notable for their free-form and variable nature. In the National Patient Safety Goals for 2006, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has recommended standardization of handoff procedures. Our institution will attempt to satisfy JCAHO's request by implementing a patient handoff that uses the electronic medical record (EMR). The aim of this project is to integrate health information technology (IT) systems and simulation-based training to reduce communication errors between resident physicians in an emergency department (ED) setting. Initially, a 3-month observation of actual ED handoffs will provide baseline handoff characteristics. This data will be collected by direct observation using a structured checklist. Concurrent with the introduction of the handoff tool, we will conduct a 4-hour standardized patient and mannequin simulation-based training program to instruct residents in both the use of the handoff tool and the fundamentals of structured, consistent communication. This educational intervention will be offered to residents rotating in the 1st, 3rd, and 5th months after the implementation of the EMR tool. Direct observation of handoffs in the ED will continue for 6 months. This will allow discrimination of the effect of the training and the EMR-based tool on communications individually. We hypothesize that the combination of simulation-based training (with practice and feedback) and a health IT tool will provide the greatest benefit and result in significantly fewer communications errors, therefore increasing patient safety. This project is relevant to health care organizations, accreditation bodies, and governmental bodies. Consistency in communication is a necessary step to reduce communication error. Integration of on-the-job tools with robust training is necessary if improvement in communication is to be accomplished and maintained.

描述（由申请人提供）：医疗错误是一个重大的公共卫生问题。已经注意到，医疗提供者之间的沟通频率涉及> 60％的医疗错误。认证组织和专家评论都呼吁努力改善和标准化医疗沟通，遵循在其他高风险领域（如航空）中成功的模型。患者的交接，尤其是在大批量和高辛酸环境中，在患者护理系统中特别脆弱。这种交接发生在嘈杂，混乱的环境中，并以其自由形式和可变性质而闻名。在2006年的国家患者安全目标中，医疗保健组织认证联合委员会（JCAHO）建议对授课程序进行标准化。我们的机构将尝试通过实施使用电子病历（EMR）的患者交接来满足JCAHO的要求。该项目的目的是整合健康信息技术（IT）系统和基于模拟的培训，以减少急诊科（ED）设置中常驻医师之间的沟通错误。最初，对实际ED交接的3个月观察将提供基线交接特性。这些数据将通过使用结构化清单直接观察来收集。同时，我们将进行4小时标准化的患者和基于人体模拟的培训计划，以指导居民使用交接工具和结构化的，一致的沟通。实施EMR工具后，将向居民提供这种教育干预措施。直接观察急诊室中的交接将持续6个月。这将允许歧视培训的效果和基于EMR的工具对通信的分别歧视。我们假设，基于模拟的培训（带有实践和反馈）和健康IT工具的组合将为最大的好处，并导致沟通错误大大增加，从而提高患者的安全性。该项目与医疗保健组织，认证机构和政府机构有关。通信的一致性是减少通信错误的必要步骤。如果要完成和维护沟通的改进，则必须将在职工具与强大的培训相结合。