Improving the Quality of Ward-based Surgical Care With a Human Factors Intervention Bundle.
Ann Surg
; 267(1): 73-80, 2018 Jan.
Article
em En
| MEDLINE
| ID: mdl-27906760
ABSTRACT
OBJECTIVE:
This study aimed to explore the impact of a human factors intervention bundle on the quality of ward-based surgical care in a UK hospital. SUMMARY OF BACKGROUND DATA Improving the culture of a surgical team is a difficult task. Engagement with stakeholders before intervention is key. Studies have shown that appropriate supervision can enhance surgical ward safety.METHODS:
A pre-post intervention study was conducted. The intervention bundle consisted of twice-daily attending ward rounds, a "chief resident of the week" available at all times on the ward, an escalation of care protocol and team contact cards. Twenty-seven junior and senior surgeons completed validated questionnaires assessing supervision, escalation of care, and safety culture pre and post-intervention along with interviews to further explore the impact of the intervention. Patient outcomes pre and postintervention were also analyzed.RESULTS:
Questionnaires revealed significant improvements in supervision postintervention (senior median pre 5 vs post 7, P = 0.002 and junior 4 vs 6, P = 0.039) and senior surgeon approachability (junior 5 vs 6, P = 0.047). Both groups agreed that they would feel safer as a patient in their hospital postintervention (senior 3 vs 4.5, P = 0.021 and junior 3 vs 4, P = 0.034). The interviews confirmed that the safety culture of the department had improved. There were no differences in inpatient mortality, cardiac arrest, reoperation, or readmission rates pre and postintervention.CONCLUSION:
Improving supervision and introducing clear protocols can improve safety culture on the surgical ward. Future work should evaluate the effect these measures have on patient outcomes in multiple institutions.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Cuidados Pós-Operatórios
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Cirurgia Geral
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Centro Cirúrgico Hospitalar
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Competência Clínica
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Centros Médicos Acadêmicos
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Melhoria de Qualidade
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Corpo Clínico Hospitalar
Tipo de estudo:
Observational_studies
Limite:
Humans
Idioma:
En
Revista:
Ann Surg
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Reino Unido