Improving Patient Safety Through Provider Communication*

说明(由申请人提供)：本提案的主要目的是评估一个全面的团队沟通战略的实施情况，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与医院环境中的团队沟通失败相关的错误来提高患者的安全。具体目标包括： 1.实施标准化沟通工具--SBAR(一种情况简报模式)，作为沟通病人状况或需求变化的脚本指南。 2.开发和实施上报流程工具，以促进及时沟通患者情况的变化。 3.实施每日以患者为中心的查房，包括患者护理所涉及的所有学科，包括使用每日目标表。 4.实行班次分组--通过与关键人员进行评论，快速召开一个职能小组的简报会/会议，启动当天/班次。 这一拟议的安全做法干预的预期结果是： 1.减少了医疗团队成员之间的沟通失败，这是患者安全网报告中的一个促成因素。 2.根据大学卫生系统联盟(UCH)患者安全网的跟踪，减少了总体不良事件、错误或险些发生的事故。 3.对于需要医生和护士之间电话咨询的非紧急病人护理情况，缩短治疗时间。 4.通过更有效的团队沟通，改善患者安全文化。 这项研究与公共健康和安全有关，因为它有可能减少医疗差错和医疗保健环境中患者的伤害。作为促进患者安全的一种手段，积极处理减少医疗差错符合本机构的使命，因为它是一家公共安全网医院。

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.