Identifying quality markers of a safe surgical ward: An interview study of patients, clinical staff, and administrators
| العنوان: | Identifying quality markers of a safe surgical ward: An interview study of patients, clinical staff, and administrators |
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| المؤلفون: | Yasmin A. M. Hassen, Philip H. Pucher, Ara Darzi, Pritam Singh, Maximilian J. Johnston |
| المصدر: | S110 S109 |
| بيانات النشر: | Elsevier BV, 2018. |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Attitude of Health Personnel, media_common.quotation_subject, MEDLINE, Staffing, 03 medical and health sciences, Patient safety, 0302 clinical medicine, Patient satisfaction, Humans, Medicine, Quality (business), 030212 general & internal medicine, Aged, Quality of Health Care, media_common, Aged, 80 and over, Postoperative Care, Science & Technology, business.industry, Communication, Mortality rate, 1103 Clinical Sciences, Middle Aged, Personnel, Hospital, Patient Satisfaction, 030220 oncology & carcinogenesis, Family medicine, Interview study, Clinical staff, 030211 gastroenterology & hepatology, Female, Surgery, Patient Safety, business, Life Sciences & Biomedicine |
| الوصف: | Background Postoperative care quality is variable. Risk-adjusted mortality rates differ between institutions despite comparable complication rates. This indicates that there are underlying factors rooted in how care is delivered that determines patient safety. This study aims to evaluate systematically the surgical ward environment with respect to process-driven and structural factors to identify quality markers for safe care, from which new safety metrics may be derived. Methods Semistructured interviews of clinicians, nurses, patients and administrators were undertaken for the study. Results In the study, 97% of staff members recognized the existence of variation in patient safety between surgical wards. Four main error-prone processes were identified: ward rounds (57%), medication prescribing and administration (49%), the presence of outliers (43%), and deficiencies in communication between clinical staff (43%). Structural factors were categorized as organizational or environmental; organizational included shortage in staffing (39%) and use of temporary staff (27%). Environmental factors considered layout and patient visibility to nurses (49%) as well as cleanliness (29%). Safety indicators identified included staff experience level (31%), overall layout of the ward, cleanliness and leadership (all 27% each). The majority of patients (87%) identified staff attentiveness as a safety indicator. Conclusion This study demonstrates that there are a number of factors that may contribute to safety on the surgical ward spanning multiple processes, organizational, and environmental factors. Safety indicators identified across all these categories presents an opportunity to develop broader and more effectual safety improvement measures focusing on multiple areas simultaneously. |
| تدمد: | 0039-6060 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1fd1708e04b77dad657b080fc1b746b5Test https://doi.org/10.1016/j.surg.2017.12.003Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....1fd1708e04b77dad657b080fc1b746b5 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 00396060 |
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