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首页> 外文期刊>BMC Health Services Research >Fidelity and the impact of patient safety huddles on teamwork and safety culture: an evaluation of the Huddle Up for Safer Healthcare (HUSH) project
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Fidelity and the impact of patient safety huddles on teamwork and safety culture: an evaluation of the Huddle Up for Safer Healthcare (HUSH) project

机译：富达和患者安全忍住对团队合作和安全文化的影响：对更安全的医疗保健（HUSH）项目的蜷缩的评价

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The Patient Safety Huddle (PSH) is a brief multidisciplinary daily meeting held to discuss threats to patient safety and actions to mitigate risk. Despite growing interest and application of huddles as a mechanism for improving safety, evidence of their impact remains limited. There is also variation in how huddles are conceived and implemented with insufficient focus on their fidelity (the extent to which delivered as planned) and potential ways in which they might influence outcomes. The Huddle Up for Safer Healthcare (HUSH) project attempted to scale up the implementation of patient safety huddles (PSHs) in five hospitals – 92 wards - across three UK NHS Trusts. This paper aims to assess their fidelity, time to embed, and impact on teamwork and safety culture. A multi-method Developmental Evaluation was conducted. The Stages of Implementation Checklist (SIC) was used to determine time taken to embed PSHs. Observations were used to check embedded status and fidelity of PSH. A Teamwork and Safety Climate survey (TSC) was administered at two time-points: pre- and post-embedding. Changes in TSC scores were calculated for Trusts, job role and clinical speciality. Observations confirmed PSHs were embedded in 64 wards. Mean fidelity score was 4.9/9. PSHs frequently demonstrated a ‘fear free’ space while Statistical Process Control charts and historical harms were routinely omitted. Analysis showed a positive change for the majority (26/27) of TSC questions and the overall safety grade of the ward. PSHs are feasible and effective for improving teamwork and safety culture, especially for nurses. PSH fidelity criteria may need adjusting to include factors deemed most useful by frontline staff. Future work should examine inter-disciplinary and role-based differences in TSC outcomes.
机译：患者安全遍布（PSH）是一个简短的多学科每日会议，讨论患者安全和采取风险的患者安全和行动的威胁。尽管伴随着伴随着提高了安全的机制，但仍然存在兴趣和应用，但其影响的证据仍然有限。还有变化，如何构思和实施，不足以关注他们的保真度（按计划交付的程度）以及它们可能影响结果的潜在方式。遍布安全的医疗保健（HUSH）项目的蜷缩试图扩大五家医院的患者安全忍住（PSHS） - 92个病房 - 三个英国NHS信托。本文旨在评估他们的忠诚，时间嵌入，以及对团队合作和安全文化的影响。进行多方法发育评估。实现核对表（SIC）的阶段用于确定嵌入PSH的时间。观察用于检查PSH的嵌入式状态和保真度。在两次指点管理团队合作和安全气候调查（TSC）：嵌入前和嵌入后。为信任，工作角色和临床专业计算TSC分数的变化。观察结果确认为64个病房嵌入了PSH。平均保真度得分为4.9 / 9。 PSHS经常展示了一个“恐惧自由”空间，而统计过程控制图和历史危害是常规的。分析表明，TSC问题的大多数（26/27）和病房整体安全等级的积极变化。 PSHS对改善团队合作和安全文化，特别是护士进行了可行的。 PSH保真度标准可能需要调整，包括由前线工作人员最有用的因素。未来的工作应该审查TSC结果的间际和基于角色的差异。

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