Can using the functional resonance analysis method, as an intervention, improve patient safety in hospitals?: a stepped wedge design protocol

Abstract Background Healthcare professionals are sometimes forced to adjust their work to varying conditions leading to discrepancies between hospital protocols and daily practice. We will examine the discrepancies between protocols, ‘Work As Imagined’ (WAI), and daily practice ‘Work As Done’ (WAD) to determine whether these adjustments are deliberate or accidental. The discrepancies between WAI and WAD can be visualised using the Functional Resonance Analysis Method (FRAM). FRAM will be applied to three patient safety themes: risk screening of the frail older patients; the administration of high-risk medication; and performing medication reconciliation at discharge. Methods A stepped wedge design will be used to collect data over 16 months. The FRAM intervention consists of constructing WAI and WAD models by analysing hospital protocols and interviewing healthcare professionals, and a meeting with healthcare professionals in each ward to discuss the discrepancies between WAI and WAD. Safety indicators will be collected to monitor compliance rates. Additionally, the potential differences in resilience levels among nurses before and after the FRAM intervention will be measured using the Employee Resilience Scale (EmpRes) questionnaire. Lastly, we will monitor whether gaining insight into differences between WAI and WAD has led to behavioural and organisational change. Discussion This article will assess whether using FRAM to reveal possible discrepancies between hospital protocols (WAI) and daily practice (WAD) will improve compliance with safety indicators and employee resilience, and whether these insights will lead to behavioural and organisational change. Trial registration Netherlands Trial Register NL8778; https://www.trialregister.nl/trial/8778. Registered 16 July 2020. Retrospectively registered.

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Safety Performance in Acute Medical Care: A Qualitative, Explorative Study on the Perspectives of Healthcare Professionals

Healthcare ◽

10.3390/healthcare9111543 ◽

2021 ◽

Vol 9 (11) ◽

pp. 1543

Author(s):

Lina Heier ◽

Donia Riouchi ◽

Judith Hammerschmidt ◽

Nikoloz Gambashidze ◽

Andreas Kocks ◽

...

Keyword(s):

Patient Safety ◽

Nursing Students ◽

Healthcare Professionals ◽

Improve Patient Safety ◽

Safety Performance ◽

Structured Interviews ◽

Performance Skills ◽

Work Environment Factors ◽

Improve Patient

Healthcare professionals need specific safety performance skills in order to maintain and improve patient safety. The purpose of this study is to get a deeper understanding of healthcare professionals’ perspective in acute care on the topic of safety performance. This study was conducted using a qualitative approach. Healthcare professionals working in nursing were interviewed using semi-structured interviews. Using content analyzing, categories were identified which present aspects of safety performance; subcategories were developed deductively. A total of 23 healthcare professionals were interviewed, of which 15 were registered nurses, five were nursing students and three were pedagogical personnel. Nine (39.1%) were <30 years old, 17 (73.9%) were female, and 9 (39.1%) had a leadership function. Results highlight the importance of safety performance as a construct of occupational health rather than of patient safety, and the role of the organization, as well as the self-responsibility of healthcare professionals. Healthcare professionals should be more conscious of their role, have a deeper understanding of the interaction of individual, team, patient, organization and work environment factors.

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Second life in healthcare education: Virtual environment's potential to improve patient safety

Knowledge Management & E-Learning: An International Journal ◽

10.34105/j.kmel.2011.03.003 ◽

2011 ◽

pp. 17-23

Keyword(s):

Patient Safety ◽

Virtual Environments ◽

Virtual Environment ◽

Medical Errors ◽

Second Life ◽

Healthcare Professionals ◽

Improve Patient Safety ◽

Healthcare Education ◽

Healthcare Profession ◽

Improve Patient

Research has shown that a large portion of healthcare cost is due to medical errors. There are many factors that cause medical errors but one major factor is linked to healthcare professionals who are not adequately trained with the appropriate skills. Virtual environments and simulations are being used to help improve training in many different areas, including the healthcare profession. This paper explores the usage of Second Life in healthcare education and its ability to improve patient safety. The conclusion is that much progress and development still needs to be made before Second Life will make a significant impact on improved patient safety through healthcare education. There is a need to make the virtual environment more realistic to adequately train healthcare professionals.

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Cesarean Section in the Delivery Room: An Exploration of the Viewpoint of Midwives, Anaesthesiologists, and Obstetricians

Journal of Pregnancy ◽

10.1155/2018/1017572 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5

Author(s):

Jansegers Jolien ◽

Jacquemyn Yves

Keyword(s):

Patient Safety ◽

Cesarean Section ◽

Operating Room ◽

Formal Education ◽

Improve Patient Safety ◽

Daily Practice ◽

Delivery Room ◽

Cesarean Sections ◽

Job Description ◽

Logistic Support

Aim. To explore the attitude and vision of midwives, anaesthesiologists, and obstetricians concerning a dedicated operating room for cesarean sections within the delivery ward versus cesarean sections within the general operating room. Method. A descriptive qualitative study using a constructive paradigm. Face-to-face semistructured interviews were performed in 3 different hospitals, one without operating theatre within the delivery ward, one with a recently built cesarean section room within the delivery ward, and one with a long time tradition of cesarean section in the delivery room. Interviews have been analysed thematically. Results. Three themes have been identified: organization, role of the midwife, and safety. Although identical protocols for the degree of emergency of a cesarean section are used, infrastructure and daily practice differ between hospitals. Logistic support, medical and midwife staffing, and hospital infrastructure are systematically mentioned as needing improvement. Realizing cesarean section within the delivery ward was considered as an improvement for the patient’s experience. Midwives need a clear and new job description and delineation and mention a lack of formal education to assist surgical procedures. To increase patient safety continuous education and communication are considered necessary. Conclusion. A detailed job description and education of all those involved in cesarean section at the delivery ward are necessary to improve patient safety. Patient experience is improved, but our knowledge on this is hampered by lack of studies.

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An Exploration of the Gross National Happiness Approach to Assure Patient Safety and Healthcare Quality in Bhutan

Journal of Social Change ◽

10.5590/josc.2020.12.1.01 ◽

2020 ◽

Vol 12 (1) ◽

Author(s):

Rinchen Pelzang ◽

Alison M Hutchinson

Keyword(s):

Patient Safety ◽

Healthcare System ◽

Healthcare Professionals ◽

Improve Patient Safety ◽

Healthcare Services ◽

Development Programs ◽

Policy Makers ◽

Gross National Happiness ◽

National Happiness ◽

The Relationship

Although the principles of Gross National Happiness (GNH) are currently being used as the overall framework for Bhutan’s development programs (including healthcare services), little is known about how Bhutanese healthcare professionals perceive the relationship between GNH and patient safety or how the GNH principles could help in improving patient safety in Bhutan’s healthcare system. The aim of this study was to explore how Bhutanese healthcare professionals, educators, managers, and policy makers perceive the relationship between GNH and patient safety and what they believe should be done to improve patient safety in Bhutan. A qualitative exploratory descriptive study using in-depth interviews was undertaken. All audio-recordings were transcribed verbatim and analyzed using content and thematic analysis strategies. Four major themes were identified: patient safety being important for GNH; incorporating the concept of GNH in healthcare; adopting the GNH values, whereby everyone believes that “someone’s happiness would be our happiness”; and educating healthcare professionals about GNH. Incorporation of the concept of GNH in healthcare could help transform the attitudes and behaviors of healthcare professionals toward patient care by producing a “Bhutanized” doctors and healthcare professionals and creating a Bhutanized healthcare system.

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Patient Safety Analysis in General Practitioner’s Work Using Functional Resonance Analysis Method (FRAM)

Journal of Konbin ◽

10.2478/jok-2020-0059 ◽

2020 ◽

Vol 50 (3) ◽

pp. 217-236

Author(s):

Jan Magott ◽

Irena Wikiera-Magott

Keyword(s):

Patient Safety ◽

General Practitioner ◽

System Approach ◽

Safety Analysis ◽

Adverse Outcomes ◽

Analysis Method ◽

Medical Specialist ◽

Resonance Analysis

AbstractThe problem considered in the paper is as follows. The patient with lumbal pain is coming to General Practitioner (GP). The undesirable result is GP’s decision to treat the patient by him/herself in spite of the patient should be directed to medical specialist or hospital. In order to find the ways how the adverse outcomes occur, a system approach called Functional Resonance Analysis Method (FRAM) has been applied. The examples of emerging the unwanted GP’s decision, as a consequence of functional resonance have been given. Proposals how to avoid unwanted outcomes have been suggested.

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Using the Functional Resonance Analysis Method to explore how elastic compression therapy is organised and could be improved from a multistakeholder perspective

BMJ Open ◽

10.1136/bmjopen-2020-048331 ◽

2021 ◽

Vol 11 (10) ◽

pp. e048331

Author(s):

Rachel Hellen Petra Schreurs ◽

Manuela A Joore ◽

Hugo ten Cate ◽

Arina J ten Cate-Hoek

Keyword(s):

Occupational Therapists ◽

Compression Therapy ◽

Daily Practice ◽

Compression Stocking ◽

Analysis Method ◽

Structured Interviews ◽

Elastic Compression ◽

Resonance Analysis ◽

Stakeholder Perspective

ObjectivesElastic compression stocking (ECS) therapy is an important treatment for patients with deep venous thrombosis (DVT) and chronic venous insufficiency (CVI). This study aimed to provide insight into the structure and variability of the ECS therapy process, its effects on outcomes, and to elicit improvement themes from a multiple stakeholder perspective.DesignThirty semi-structured interviews with professionals and patients were performed. The essential functions for the process of ECS therapy were extracted to create two work-as-done models using the Functional Resonance Analysis Method (FRAM). These findings were used to guide discussion between stakeholders to identify improvement themes.SettingTwo regions in the Netherlands, region Limburg and region North-Holland, including an academic hospital and a general hospital and their catchment region.ParticipantsThe interviewees were purposely recruited and included 25 healthcare professionals (ie, general practitioners, internists, dermatologists, nurses, doctor’s assistants, occupational therapists, home care nurses and medical stocking suppliers) and 5 patients with DVT or CVI.ResultsTwo FRAM models were created (one for each region). The variability of the functions and their effect on outcomes, as well as interdependencies between functions, were identified. These were presented in stakeholder meetings to identify the structure of the process and designated variable and uniform parts of the process and its outcomes. Ultimately, six improvement themes were identified: dissemination of knowledge of the entire process; optimising and standardising initial compression therapy; optimising timing to contact the medical stocking supplier (when oedema has disappeared); improving the implementation of assistive devices; harmonising follow-up duration for patients with CVI; personalising follow-up and treatment duration in patients with DVT.ConclusionsThis study provided a detailed understanding of how ECS therapy is delivered in daily practice by describing major functions and variability in performances and elicited six improvement themes from a multistakeholder perspective.

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Herbal medicines

10.1093/med/9780198735823.003.0008 ◽

2017 ◽

Author(s):

Philip Wiffen ◽

Marc Mitchell ◽

Melanie Snelling ◽

Nicola Stoner

Keyword(s):

Patient Safety ◽

Healthcare Professionals ◽

Improve Patient Safety ◽

Healthcare Providers ◽

Herbal Medicines ◽

General Information ◽

Chinese Herbs ◽

The Public ◽

Potential Interactions ◽

Improve Patient

This chapter is aimed at all healthcare professionals, patients, and the general public to provide a brief insight to the importance of herbal medicines. The six sections provide a summary into the efficacy, general information relating to commonly used herbal medicines and Chinese herbs, including side effects and potential interactions with other medicines and surgical considerations that should improve patient safety. New to this edition is a section aimed at healthcare providers on sourcing evidence for herbal medicines enquiries from patients and the public.

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Laboratory testing of extravascular body fluids

Biochemia Medica ◽

10.11613/bm.2020.010502 ◽

2020 ◽

Vol 30 (1) ◽

pp. 31-59 ◽

Cited By ~ 1

Author(s):

Lara Milevoj Kopcinovic ◽

Jelena Culej ◽

Anja Jokic ◽

Marija Bozovic ◽

Irena Kocijan

Keyword(s):

Patient Safety ◽

Healthcare Professionals ◽

Improve Patient Safety ◽

Body Fluids ◽

Healthcare Outcomes ◽

Serous Fluid ◽

Fluid Analysis ◽

Unique Nature ◽

Total Testing Process ◽

Improve Patient

Extravascular body fluids (EBF) analysis can provide useful information in the differential diagnosis of conditions that caused their accumulation. Their unique nature and particular requirements accompanying EBF analysis need to be recognized in order to minimize possible negative implications on patient safety. This recommendation was prepared by the members of the Working group for extravascular body fluid samples (WG EBFS). It is designed to address the total testing process and clinical significance of tests used in EBF analysis. The recommendation begins with a chapter addressing validation of methods used in EBF analysis, and continues with specific recommendations for serous fluids analysis. It is organized in sections referring to the preanalytical, analytical and postanalytical phase with specific recommendations presented in boxes. Its main goal is to assist in the attainment of national harmonization of serous fluid analysis and ultimately improve patient safety and healthcare outcomes. This recommendation is intended to all laboratory professionals performing EBF analysis and healthcare professionals involved in EBF collection and processing. Cytological and microbiological evaluations of EBF are beyond the scope of this document.

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