Goals, Recommendations, and the How-To Strategies for Developing and Facilitating Patient Safety and System Integration Simulations

2019 ◽  
Vol 13 (1) ◽  
pp. 94-105 ◽  
Author(s):  
Mirette Dubé ◽  
Jonas Shultz ◽  
Sue Barnes ◽  
Bobbi Pascal ◽  
Alyshah Kaba
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
System Integration ◽  
Delphi Technique ◽  
Healthcare Services ◽  
Healthcare Team ◽  
Delivery Of Healthcare ◽  
Team Members ◽  
Expert Opinions ◽  
Communication Technique

Purpose: The aim of this article is to outline overall goals, recommendations, and provide practical How-To strategies for developing and facilitating patient safety and system integration (PSSI) simulations for healthcare team members and organizations. Background: Simulation is increasingly being used as a quality improvement tool to better understand the tasks, environments, and processes that support the delivery of healthcare services. These PSSI simulations paired with system-focused debriefing can occur prior to implementing a new process or workflow to proactively identify system issues. They occur as part of a continuous cycle of quality improvement and have unique considerations for planning, implementation, and delivery of healthcare. Method: The Delphi technique was used to develop the recommendations and How-To strategies to guide those interested in conducting a PSSI simulations. The Delphi technique is a structured communication technique and systematic process of gathering information from a group of identified experts through a series of questionnaires to gain consensus regarding judgments on complex processes, where precise information is not available in the literature. The Delphi technique permitted an iterative and multistaged approach to transform expert opinions into group consensus. Results: The goals, recommendations, and How-To strategies include a focus on project management, stakeholder engagement, sponsorship, scenario design, prebriefing and debriefing, and evaluation metrics. The intent is to proactively identify system issues and disseminate actionable findings. Conclusions: This article highlights salient features to consider when using simulation as a strategy and tool for patient safety and quality improvement.

Resuscitating Team Roles within Wayburn Health System

2015 ◽  
pp. 921-931
Author(s):  
Jill E. Stefaniak
Keyword(s):  
Patient Safety ◽  
Health System ◽  
Instructional Designer ◽  
Administrative Leadership ◽  
Healthcare Team ◽  
Trauma Resuscitation ◽  
Emergency Center ◽  
Team Members ◽  
Communication Processes ◽  
Sentinel Events

Administrative leadership of Wayburn Health System decided to move forward with a training program to address communication between healthcare professionals within their emergency center. After a few sentinel events where errors had occurred that compromised patient safety due to miscommunication amongst healthcare team members, hospital administration decided that communication processes needed to be standardized within the emergency center during trauma resuscitations. Four hundred employees from various departments and disciplines would require training. An instructional designer was brought onto the project to ensure that training was customized to fit the specific needs of the trauma resuscitation team.

scholarly journals A Neonatal Intensive Care Unit’s Experience with Implementing an In-Situ Simulation and Debriefing Patient Safety Program in the Setting of a Quality Improvement Collaborative

Children ◽  
2020 ◽  
Vol 7 (11) ◽  
pp. 202
Author(s):  
Mary Eckels ◽  
Terry Zeilinger ◽  
Henry C. Lee ◽  
Janine Bergin ◽  
Louis P. Halamek ◽  
...  
Keyword(s):  
Patient Safety ◽  
Intensive Care ◽  
Quality Improvement ◽  
Neonatal Intensive Care ◽  
Quality Care ◽  
Neonatal Resuscitation ◽  
Healthcare Team ◽  
In Situ Simulation ◽  
Implementation Phase

Extensive neonatal resuscitation is a high acuity, low-frequency event accounting for approximately 1% of births. Neonatal resuscitation requires an interprofessional healthcare team to communicate and carry out tasks efficiently and effectively in a high adrenaline state. Implementing a neonatal patient safety simulation and debriefing program can help teams improve the behavioral, cognitive, and technical skills necessary to reduce morbidity and mortality. In Simulating Success, a 15-month quality improvement (QI) project, the Center for Advanced Pediatric and Perinatal Education (CAPE) and California Perinatal Quality Care Collaborative (CPQCC) provided outreach and training on neonatal simulation and debriefing fundamentals to individual teams, including community hospital settings, and assisted in implementing a sustainable program at each site. The primary Aim was to conduct two simulations a month, with a goal of 80% neonatal intensive care unit (NICU) staff participation in two simulations during the implementation phase. While the primary Aim was not achieved, in-situ simulations led to the identification of latent safety threats and improvement in system processes. This paper describes one unit’s QI collaborative experience implementing an in-situ neonatal simulation and debriefing program.

Working Effectively as Part of a Team

2018 ◽  
Author(s):  
David Metcalfe ◽  
Harveer Dev
Keyword(s):  
Patient Safety ◽  
Good Reason ◽  
General Medical Council ◽  
Healthcare Team ◽  
Medical Council ◽  
Public Concern ◽  
Team Members ◽  
Policies And Procedures ◽  
Professional Body ◽  
Significant Step

Teamworking is an inevitable part of working within a complex multidisciplinary environment. Thankfully, most interactions with other members of the healthcare team will be positive and constructive. Unfortunately, such happy circumstances do not make for particularly interesting SJT scenarios. The following section is therefore full of colleagues that are angry, rude, dishonest, unprofessional, and even intoxicated. In Raising and Acting on Concerns About Patient Safety (2012), the General Medical Council (GMC) states that ‘all doctors have a duty to raise concerns where they believe that patient safety or care is being compromised by the practice of colleagues or the systems, policies and procedures in the organizations in which they work’. The GMC proposes taking the following steps in sequence when you develop serious concerns about a colleague: ● Raise the concern with ‘your manager or an appropriate officer of the organisation . . . such as the consultant in charge of the team, the clinical or medical director’. Alternatively, a foundation doctor may raise their concern with an appropriate person responsible for training such as their Foundation Programme Director. ● Raise the concern with a regulator (such as the GMC), professional body (such as the British Medical Association), or charity (such as Public Concern at Work). This step should be taken if you have exhausted options for raising the concern internally and there is an ‘immediate serious risk to patients, and a regulator or other external body has responsibility to act or intervene’. ● Raise the concern publicly. This step should be taken when you have exhausted options for raising the concern internally and have ‘good reason to believe that patients are still at risk of harm’. Your usual duty is to avoid breaching patient confidentiality. This is a highly unusual and significant step to take and is unlikely to be appropriate without first having taken advice from an appropriate organization such as the GMC, BMA, or Public Concern at Work. The questions within this section highlight your ability and willingness to work with team members. You will need to work collaboratively and respectfully within a multi- disciplinary team, as well as provide advice and support to colleagues.

scholarly journals The impact of accreditation on healthcare quality improvement: a qualitative case study

2016 ◽  
Vol 30 (8) ◽  
pp. 1242-1258 ◽  
Author(s):  
Sara Melo
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
Large Scale ◽  
Positive Impact ◽  
Healthcare Quality ◽  
Healthcare Services ◽  
Content Type ◽  
Healthcare Quality Improvement ◽  
The Impact

Purpose Research on accreditation has mostly focused on assessing its impact using large scale quantitative studies, yet little is known on how quality is improved in practice through an accreditation process. Using a case study of an acute teaching hospital in Portugal, the purpose of this paper is to explore the dynamics through which accreditation can lead to an improvement in the quality of healthcare services provided. Design/methodology/approach Data for the case study was collected through 46 in-depth semi-structured interviews with 49 clinical and non-clinical members of staff. Data were analyzed using a framework thematic analysis. Findings Interviewees felt that hospital accreditation contributed to the improvement of healthcare quality in general, and more specifically to patient safety, as it fostered staff reflection, a higher standardization of practices, and a greater focus on quality improvement. However, findings also suggest that the positive impact of accreditation resulted from the approach the hospital adopted in its implementation as well as the fact that several of the procedures and practices required by accreditation were already in place at the hospital, albeit often in an informal way. Research limitations/implications The study was conducted in only one hospital. The design of an accreditation implementation plan tailored to the hospital’s context can significantly contribute to positive outcomes in terms of quality and patient safety improvements. Originality/value This study provides a better understanding of how accreditation can contribute to healthcare quality improvement. It offers important lessons on the factors and processes that potentiate quality improvements through accreditation.

Resuscitating Team Roles within Wayburn Health System

2013 ◽  
pp. 130-145
Author(s):  
Jill E. Stefaniak
Keyword(s):  
Patient Safety ◽  
Health System ◽  
Instructional Designer ◽  
Administrative Leadership ◽  
Healthcare Team ◽  
Trauma Resuscitation ◽  
Emergency Center ◽  
Team Members ◽  
Communication Processes ◽  
Sentinel Events

Administrative leadership of Wayburn Health System decided to move forward with a training program to address communication between healthcare professionals within their emergency center. After a few sentinel events where errors had occurred that compromised patient safety due to miscommunication amongst healthcare team members, hospital administration decided that communication processes needed to be standardized within the emergency center during trauma resuscitations. Four hundred employees from various departments and disciplines would require training. An instructional designer was brought onto the project to ensure that training was customized to fit the specific needs of the trauma resuscitation team.

scholarly journals Use of primary care and other healthcare services between age 85 and 90 years: longitudinal analysis of a single-year birth cohort, the Newcastle 85+ study

BMJ Open ◽  
2018 ◽  
Vol 8 (1) ◽  
pp. e019218 ◽  
Author(s):  
Mohammad Esmaeil Yadegarfar ◽  
Carol Jagger ◽  
Rachel Duncan ◽  
Tony Fouweather ◽  
Barbara Hanratty ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Health Assessment ◽  
Healthcare Services ◽  
Population Based ◽  
Community Dwelling ◽  
Healthcare Team ◽  
Ageing Society ◽  
Team Members ◽  
Using Data

ObjectiveTo describe, using data from the Newcastle 85+ cohort study, the use of primary care and other healthcare services by 85-year-olds as they age.DesignLongitudinal population-based cohort study.SettingNewcastle on Tyne and North Tyneside, UK.ParticipantsCommunity dwelling and institutionalised men and women recruited through general practices (n=845, 319 men and 526 women).ResultsContact was established with 97% (n=1409/1459) of eligible 85-year-olds, consent obtained from 74% (n=1042/1409) and 851 agreed to undergo the multidimensional health assessment and a general practice medical records review. A total of 845 participants had complete data at baseline for this study (319 male, 526 female), with 344 (118 male, 226 female) reinterviewed at 60 months. After adjusting for confounders, all consultations significantly increased over the 5 years (incidence rate ratio, IRR=1.03, 95% CI 1.01 to 1.05, P=0.001) as did general practitioner (GP) consultations (IRR=1.03, 95% CI 1.01 to 1.05, P=0.006). Significant increases were also observed in inpatient and day hospital use over time, though these disappeared after adjustment for confounders.ConclusionsOur study of primary, secondary and community care use by the very old reveals that, between the ages of 85 and 90 years, older people are much more likely to consult their GP than any other primary healthcare team members. With a rapidly ageing society, it is essential that both current and future GPs are appropriately skilled, and adequately supported by specialist colleagues, as the main healthcare provider for a population with complex and challenging needs.

Developing a Quality Improvement and Patient Safety Toolbox: The Curriculum

MedEdPORTAL ◽  
2016 ◽  
Vol 12 (1) ◽  
Author(s):  
Patricia Keefer ◽  
Kelly Orringer ◽  
Jennifer Vredeveld ◽  
Kavita Warrier ◽  
Heather Burrows
Keyword(s):  
Patient Safety ◽  
Quality Improvement

The Impact of Mobile Phone Technology in Bridging the Gaps in The Health Care Service Delivery in Kenya: A Case of Nairobi County. (Preprint)

2019 ◽  
Author(s):  
Alice Ndwiga
Keyword(s):  
Service Delivery ◽  
Mobile Phone ◽  
Care Service ◽  
Health Care Service ◽  
Informal Settlements ◽  
Healthcare Services ◽  
P Value ◽  
Delivery Of Healthcare ◽  
Mobile Phone Technology ◽  
The Impact

BACKGROUND INTRODUCTION: The Kenyan constitution seeks to guarantee every citizen the right to quality healthcare services. Quite often this delivery is hampered by geographical location, socio-economic statuses among other factors. The country has a high mobile phone penetration rate. Digitalization of the healthcare sector is a vital aspect that contributes to effective delivery of care services. This study set out to assess the impact of mobile technology in closing the gaps within the health care service delivery. The objective of the study was to investigate the impact of mobile phone technology in bridging the gap in healthcare service delivery in Kenya with a focus on Nairobi, Kibera informal settlements. Hypothesis testing using P-value of 0.05 also showed that use of mobile phone technology positively impacted the delivery of healthcare services. OBJECTIVE The objective of the study was to investigate the impact of mobile phone technology in bridging the gap in healthcare service delivery in Kenya with a focus on Nairobi, Kibera informal settlements. Hypothesis testing using P-value of 0.05 also showed that use of mobile phone technology positively impacted the delivery of healthcare services. METHODS The target population were patients visiting Médecins Sans Frontières (MSF) clinic in Kibera informal settlements. A cross-sectional study design was employed. Purposive and simple random sampling method was used to select the study sample of 210 participants and 3 healthcare providers. Data were collected using survey questionnaire that was provider-administered and Data were analyzed using SPSS version. RESULTS The characteristics of the respondents were general (mean age, education level, social economic status) to only patients who visited the clinics for HIV tests and other related services such as going for ARVs. The main findings showed that 66.12% of the respondents (14.29% strongly agreed + 55.24% agreed) that the use of mobile phone technology improved their access to healthcare services. Using chi square, there was a statistical difference due to the positive impact of mobile technology on healthcare delivery (p=0.05). CONCLUSIONS The study findings showed that 66.12% of the respondents agreed that the use of mobile phone technology and SMS improved their access to healthcare services. The results hypothesis also proved that use of mobile phone technology positively impacts the delivery of healthcare services.

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