1
|
Haraldseid-Driftland C, Bø Lyng H, Guise V, Valen Wæhle H, Schibevaag L, Dombestein H, Ree E, Fagerdal B, Billett S, Wiig S. Designing a learning tool for translating resilience in healthcare into practice: A qualitative mixed methods study. APPLIED ERGONOMICS 2024; 119:104314. [PMID: 38759378 DOI: 10.1016/j.apergo.2024.104314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 05/08/2024] [Accepted: 05/10/2024] [Indexed: 05/19/2024]
Abstract
There is currently a lack of tools that focus on strengthening resilient performance of healthcare systems through learning from positive healthcare events. Such tools are needed to operationalize and translate resilience in healthcare and, thus, advance the field of patient safety by learning from both positive and negative events and outcomes. The purpose of this study is to describe the developmental process of one such tool to enable operationalization of resilient healthcare and aid future tool development. The development process featured a complex, multi-step, design through involvement of a range of different stakeholders. A combination of publicly available platforms, cross-sectional knowledge, step-by step instructions and a learning tool that engages participants in collaborative practice to facilitate discussions across stakeholders and system levels is proposed as a means to create awareness of when and what contributes to resilient performance is fundamental to understanding and improving healthcare system resilience.
Collapse
Affiliation(s)
- Cecilie Haraldseid-Driftland
- Centre Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Stavanger, Norway.
| | - Hilda Bø Lyng
- Centre Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Stavanger, Norway.
| | - Veslemøy Guise
- Centre Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Stavanger, Norway.
| | - Hilde Valen Wæhle
- Centre Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Stavanger, Norway; Haukeland University Hospital, Division of Patient Safety, Dept. of Research and Development, Bergen, Norway.
| | - Lene Schibevaag
- Centre Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Stavanger, Norway.
| | - Heidi Dombestein
- Centre Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Stavanger, Norway.
| | - Eline Ree
- Centre Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Stavanger, Norway.
| | - Birte Fagerdal
- Centre Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Stavanger, Norway.
| | - Stephen Billett
- Griffith University School of Education and Professional Studies, Mount Gravatt, QLD, 4122, Australia.
| | - Siri Wiig
- Centre Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Stavanger, Norway.
| |
Collapse
|
2
|
Halm MA. A Daily Dose of Communication to Improve Quality and Safety Outcomes. Am J Crit Care 2024; 33:305-310. [PMID: 38945817 DOI: 10.4037/ajcc2024318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Affiliation(s)
- Margo A Halm
- Margo A. Halm is a nurse scientist consultant in Portland, Oregon
| |
Collapse
|
3
|
Jelen A, Goldfarb R, Rosart J, Graham L, Rubin BB. A qualitative co-design-based approach to identify sources of workplace-related distress and develop well-being strategies for cardiovascular nurses, allied health professionals, and physicians. BMC Health Serv Res 2024; 24:246. [PMID: 38408946 PMCID: PMC10897985 DOI: 10.1186/s12913-024-10669-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 01/31/2024] [Indexed: 02/28/2024] Open
Abstract
OBJECTIVE Clinician distress is a multidimensional condition that includes burnout, decreased meaning in work, severe fatigue, poor work-life integration, reduced quality of life, and suicidal ideation. It has negative impacts on patients, providers, and healthcare systems. In this three-phase qualitative investigation, we identified workplace-related factors that drive clinician distress and co-designed actionable interventions with inter-professional cardiovascular clinicians to decrease their distress and improve well-being within a Canadian quaternary hospital network. METHODS Between October 2021 and May 2022, we invited nurses, allied health professionals, and physicians to participate in a three-phase qualitative investigation. Phases 1 and 2 included individual interviews and focus groups to identify workplace-related factors contributing to distress. Phase 3 involved co-design workshops that engaged inter-professional clinicians to develop interventions addressing drivers of distress identified. Qualitative information was analyzed using descriptive thematic analysis. RESULTS Fifty-one clinicians (24 nurses, 10 allied health professionals, and 17 physicians) participated. Insights from Phases 1 and 2 identified five key thematic drivers of distress: inadequate support within inter-professional teams, decreased joy in work, unsustainable workloads, limited opportunities for learning and professional growth, and a lack of transparent leadership communication. Phase 3 co-design workshops yielded four actionable interventions to mitigate clinician distress in the workplace: re-designing daily safety huddles, formalizing a nursing coaching and mentorship program, creating a value-added program e-newsletter, and implementing an employee experience platform. CONCLUSION This study increases our understanding on workplace-related factors that contribute to clinician distress, as shared by inter-professional clinicians specializing in cardiovascular care. Healthcare organizations can develop effective interventions to mitigate clinician distress by actively engaging healthcare workers in identifying workplace drivers of distress and collaboratively designing tailored, practical interventions that directly address these challenges.
Collapse
Affiliation(s)
- Ahlexxi Jelen
- Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, 585 University Avenue LPMB 119 K, M5G 2N2, Toronto, ON, Canada.
| | | | - Jennifer Rosart
- Healthcare Human Factors, Toronto General Hospital, University Health Network, Toronto, Canada
| | - Leanna Graham
- Office of Professional Practice & Policy, Toronto General Hospital, University Health Network, Toronto, Canada
| | - Barry B Rubin
- Division of Vascular Surgery, Peter Munk Cardiac Centre, University Health Network, Toronto, Canada
| |
Collapse
|
4
|
de Moraes MVA, de Almeida ÍLS, de Carvalho REFL. Patient safety culture assessment before and after safety huddle implementation. Rev Esc Enferm USP 2024; 57:e20230270. [PMID: 38358114 PMCID: PMC10868519 DOI: 10.1590/1980-220x-reeusp-2023-0270en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 11/28/2023] [Indexed: 02/16/2024] Open
Abstract
OBJECTIVE To identify whether safety huddle implementation enabled a change in patient safety culture. METHOD Quasi-experimental research that assessed patient safety culture before and after safety huddle implementation. RESULTS. The study revealed that 53.98% completed the two safety culture assessments, with 60.1% adherence from the nursing team, with a statistically significant difference in the second assessment regarding perception of patient safety and adverse events notified (p < 0.00). Regarding good practice indicators, a statistically significant difference (p < 0.00) was observed in item 43 and improvement in almost all dimensions in the second safety culture assessment. The huddles totaled 105 days, with 100% adherence from the nursing team. Regarding checklist items, all presented satisfactory responses (above 50%). CONCLUSION Safety huddles proved to be an effective tool for communication between healthcare professionals and managers, demonstrating positive impacts on good practice indicators and most safety culture dimensions.
Collapse
|
5
|
Degerman H, Wallo A. Conceptualising learning from resilient performance: A scoping literature review. APPLIED ERGONOMICS 2024; 115:104165. [PMID: 37948841 DOI: 10.1016/j.apergo.2023.104165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 10/29/2023] [Accepted: 10/31/2023] [Indexed: 11/12/2023]
Abstract
Resilient performance is a crucial characteristic of complex socio-technical systems, enabling them to sustain essential functionality during changing or stressful conditions. Resilience Engineering (RE), a sub-field of safety research, focuses on this perspective of resilience. RE emphasises its "cornerstone model", presenting the RE system goals of "anticipating, monitoring, responding and learning". The cornerstone of learning remains fragmented and undertheorized in the existing literature. This paper aims to enrich RE research and its practical implications by developing a nuanced and comprehensive understanding of the role of learning from resilient performance. To achieve this aim, a scoping literature review was conducted to assess how learning is conceptualised in the RE literature and the theoretical foundations on which previous work rest. The main findings show that RE researchers view learning as the process of understanding the system, sharing knowledge, and re-designing system properties. The application of established learning theories is limited. This paper contributes to research by proposing an organisational process for the RE cornerstone of learning, paving the way for deeper discussions in future studies about learning from resilient performance within complex socio-technical systems.
Collapse
Affiliation(s)
- Helene Degerman
- RISE Research Institutes of Sweden, Gothenburg, Sweden; Linköping University, Linköping, Sweden.
| | | |
Collapse
|
6
|
Disconzi CMDG, Abreu Saurin T. Principles and practices of designing for resilient performance: An assessment framework. APPLIED ERGONOMICS 2024; 114:104141. [PMID: 37748354 DOI: 10.1016/j.apergo.2023.104141] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/08/2023] [Accepted: 09/14/2023] [Indexed: 09/27/2023]
Abstract
Although resilient performance is intrinsic to socio-technical systems it might be supported by design, an idea known as Design for Resilient Performance (DfRP). Considering that such design is usually a re-design, learning from existing systems is crucial. This article introduces a framework for assessing the extent to which a system uses practices and principles of DfRP. The framework allows for the assessment of 24 attributes of the principles, the analysis of their relationships (a model was devised based on a survey with experts), and the investigation of practices that operationalize the principles. A scoring system sheds light on the effectiveness of using the principles. The framework application is exemplified based on the study of an emergency department in which daily huddles stood out as a practice of DfRP. This study involved interviews, observations, and documentary analysis. Based on this, a knowledge structure of DfRP is presented, comprised of concepts, principles, and practices. Six propositions to guide the framework application are set out, addressing themes such as the need for cost-effective DfRP, short control cycles, and customized designs that meet preferences of designers. The study contributes to DfRP theory and offers a new approach for resilience assessment.
Collapse
Affiliation(s)
- Claudia Maria Dias Guerra Disconzi
- Industrial Engineering Post-Graduate Program, Federal University of Rio Grande Do Sul, Av. Osvaldo Aranha, 99, Porto Alegre, RS, CEP 90035-190, Brazil.
| | - Tarcisio Abreu Saurin
- Industrial Engineering Post-Graduate Program, Federal University of Rio Grande Do Sul, Av. Osvaldo Aranha, 99, Porto Alegre, RS, CEP 90035-190, Brazil.
| |
Collapse
|
7
|
Haraldseid-Driftland C, Dombestein H, Le AH, Billett S, Wiig S. Learning tools used to translate resilience in healthcare into practice: a rapid scoping review. BMC Health Serv Res 2023; 23:890. [PMID: 37612671 PMCID: PMC10463810 DOI: 10.1186/s12913-023-09922-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 08/14/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Historically, efforts to improved healthcare provisions have focussed on learning from and understanding what went wrong during adverse events. More recently, however, there has been a growing interest in seeking to improve healthcare quality through promoting and strengthening resilience in healthcare, in light of the range of changes and challenges to which healthcare providers are subjected. So far, several approaches for strengthening resilience performance have been suggested, such as reflection and simulation. However, there is a lack of studies that appraise the range of existing learning tools, the purposes for which they are designed, and the types of learning activities they comprise. The aim of this rapid scoping review is to identify the characteristics of currently available learning tools designed to translate organizational resilience into healthcare practice. METHODS A rapid scoping review approach was used to identify, collect, and synthesise information describing the characteristics of currently available learning tools designed to translate organizational resilience into healthcare practice. EMBASE and Medline Ovid were searched in May 2022 for articles published between 2012 and 2022. RESULTS The review identified six different learning tools such as serious games and checklists to guide reflection, targeting different stakeholders, in various healthcare settings. The tools, typically, promoted self-reflection either individually or collaboratively in groups. Evaluations of these tools found them to be useful and supportive of resilience; however, what constitutes resilience was often difficult to discern, particularly the organizational aspect. It became evident from these studies that careful planning and support were needed for their successful implementation. CONCLUSIONS The tools that are available for review are based on guidelines, checklists, or serious games, all of which offer to prompt either self-reflection or group reflections related to different forms of adaptations that are being performed. In this paper, we propose that more guided reflections mirroring the complexity of resilience in healthcare, along with an interprofessional collaborative and guided approach, are needed for these tools to be enacted effectively to realise change in practice. Future studies also need to explore how tools are perceived, used, and understood in multi-site, multi-level studies with a range of different participants.
Collapse
Affiliation(s)
- Cecilie Haraldseid-Driftland
- Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, N-4036, Stavanger, Norway
| | - Heidi Dombestein
- Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, N-4036, Stavanger, Norway.
| | - Anh Hai Le
- School of Education and Professional Studies, Griffith University, Mount Gravatt, QLD, 4122, Australia
| | - Stephen Billett
- School of Education and Professional Studies, Griffith University, Mount Gravatt, QLD, 4122, Australia
| | - Siri Wiig
- Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, N-4036, Stavanger, Norway
| |
Collapse
|
8
|
Ellis LA, Saba M, Long JC, Lyng HB, Haraldseid-Driftland C, Churruca K, Wiig S, Austin E, Clay-Williams R, Carrigan A, Braithwaite J. The rise of resilient healthcare research during COVID-19: scoping review of empirical research. BMC Health Serv Res 2023; 23:833. [PMID: 37550640 PMCID: PMC10405417 DOI: 10.1186/s12913-023-09839-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 07/22/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has presented many multi-faceted challenges to the maintenance of service quality and safety, highlighting the need for resilient and responsive healthcare systems more than ever before. This review examined empirical investigations of Resilient Health Care (RHC) in response to the COVID-19 pandemic with the aim to: identify key areas of research; synthesise findings on capacities that develop RHC across system levels (micro, meso, macro); and identify reported adverse consequences of the effort of maintaining system performance on system agents (healthcare workers, patients). METHODS Three academic databases were searched (Medline, EMBASE, Scopus) from 1st January 2020 to 30th August 2022 using keywords pertaining to: systems resilience and related concepts; healthcare and healthcare settings; and COVID-19. Capacities that developed and enhanced systems resilience were synthesised using a hybrid inductive-deductive thematic analysis. RESULTS Fifty publications were included in this review. Consistent with previous research, studies from high-income countries and the use of qualitative methods within the context of hospitals, dominated the included studies. However, promising developments have been made, with an emergence of studies conducted at the macro-system level, including the development of quantitative tools and indicator-based modelling approaches, and the increased involvement of low- and middle-income countries in research (LMIC). Concordant with previous research, eight key resilience capacities were identified that can support, develop or enhance resilient performance, namely: structure, alignment, coordination, learning, involvement, risk awareness, leadership, and communication. The need for healthcare workers to constantly learn and make adaptations, however, had potentially adverse physical and emotional consequences for healthcare workers, in addition to adverse effects on routine patient care. CONCLUSIONS This review identified an upsurge in new empirical studies on health system resilience associated with COVID-19. The pandemic provided a unique opportunity to examine RHC in practice, and uncovered emerging new evidence on RHC theory and system factors that contribute to resilient performance at micro, meso and macro levels. These findings will enable leaders and other stakeholders to strengthen health system resilience when responding to future challenges and unexpected events.
Collapse
Affiliation(s)
- Louise A Ellis
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.
| | - Maree Saba
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Janet C Long
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Hilda Bø Lyng
- Centre Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Stavanger, Norway
| | - Cecilie Haraldseid-Driftland
- Centre Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Stavanger, Norway
| | - Kate Churruca
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Siri Wiig
- Centre Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Stavanger, Norway
| | - Elizabeth Austin
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Robyn Clay-Williams
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Ann Carrigan
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Jeffrey Braithwaite
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| |
Collapse
|
9
|
Haraldseid-Driftland C, Lyng HB, Guise V, Waehle HV, Schibevaag L, Ree E, Fagerdal B, Baxter R, Ellis LA, Braithwaite J, Wiig S. Learning does not just happen: establishing learning principles for tools to translate resilience into practice, based on a participatory approach. BMC Health Serv Res 2023; 23:646. [PMID: 37328864 PMCID: PMC10276446 DOI: 10.1186/s12913-023-09653-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 06/06/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Theories of learning are of clear importance to resilience in healthcare since the ability to successfully adapt and improve patient care is closely linked to the ability to understand what happens and why. Learning from both positive and negative events is crucial. While several tools and approaches for learning from adverse events have been developed, tools for learning from successful events are scarce. Theoretical anchoring, understanding of learning mechanisms, and establishing foundational principles for learning in resilience are pivotal strategies when designing interventions to develop or strengthen resilient performance. The resilient healthcare literature has called for resilience interventions, and new tools to translate resilience into practice have emerged but without necessarily stipulating foundational learning principles. Unless learning principles are anchored in the literature and based on research evidence, successful innovation in the field is unlikely to occur. The aim of this paper is to explore: What are key learning principles for developing learning tools to help translate resilience into practice? METHODS This paper reports on a two-phased mixed methods study which took place over a 3-year period. A range of data collection and development activities were conducted including a participatory approach which involved iterative workshops with multiple stakeholders in the Norwegian healthcare system. RESULTS In total, eight learning principles were generated which can be used to help develop learning tools to translate resilience into practice. The principles are grounded in stakeholder needs and experiences and in the literature. The principles are divided into three groups: collaborative, practical, and content elements. CONCLUSIONS The establishment of eight learning principles that aim to help develop tools to translate resilience into practice. In turn, this may support the adoption of collaborative learning approaches and the establishment of reflexive spaces which acknowledge system complexity across contexts. They demonstrate easy usability and relevance to practice.
Collapse
Affiliation(s)
- Cecilie Haraldseid-Driftland
- Centre Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Stavanger, Norway
| | - Hilda Bø Lyng
- Centre Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Stavanger, Norway
| | - Veslemøy Guise
- Centre Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Stavanger, Norway
| | - Hilde Valen Waehle
- Centre Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Stavanger, Norway
- Section for Patient Safety, Dept. of Research and Development, Haukeland University Hospital, Bergen, Norway
| | - Lene Schibevaag
- Centre Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Stavanger, Norway
| | - Eline Ree
- Centre Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Stavanger, Norway
| | - Birte Fagerdal
- Centre Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Stavanger, Norway
| | - Ruth Baxter
- School of Psychology, University of Leeds and the Yorkshire Quality and Safety Research group, Leeds, England
| | - Louise A. Ellis
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Jeffrey Braithwaite
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Siri Wiig
- Centre Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Stavanger, Norway
| |
Collapse
|
10
|
Ellis LA, Falkland E, Hibbert P, Wiig S, Ree E, Schultz TJ, Pirone C, Braithwaite J. Issues and complexities in safety culture assessment in healthcare. Front Public Health 2023; 11:1217542. [PMID: 37397763 PMCID: PMC10309647 DOI: 10.3389/fpubh.2023.1217542] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 05/30/2023] [Indexed: 07/04/2023] Open
Abstract
The concept of safety culture in healthcare-a culture that enables staff and patients to be free from harm-is characterized by complexity, multifacetedness, and indefinability. Over the years, disparate and unclear definitions have resulted in a proliferation of measurement tools, with lack of consensus on how safety culture can be best measured and improved. A growing challenge is also achieving sufficient response rates, due to "survey fatigue," with the need for survey optimisation never being more acute. In this paper, we discuss key challenges and complexities in safety culture assessment relating to definition, tools, dimensionality and response rates. The aim is to prompt critical reflection on these issues and point to possible solutions and areas for future research.
Collapse
Affiliation(s)
- Louise A. Ellis
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Faculty of Medicine, Health, and Human Sciences, Macquarie University, Macquarie Park, NSW, Australia
| | - Emma Falkland
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Faculty of Medicine, Health, and Human Sciences, Macquarie University, Macquarie Park, NSW, Australia
| | - Peter Hibbert
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Faculty of Medicine, Health, and Human Sciences, Macquarie University, Macquarie Park, NSW, Australia
- IIMPACT in Health, Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Siri Wiig
- SHARE—Centre for Resilience in Healthcare, Department of Quality and Health Technology, Universitetet i Stavanger, Stavanger, Norway
| | - Eline Ree
- SHARE—Centre for Resilience in Healthcare, Department of Quality and Health Technology, Universitetet i Stavanger, Stavanger, Norway
| | - Timothy J. Schultz
- Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, Australia
| | - Christy Pirone
- Southern Adelaide Department of Health, Adelaide, SA, Australia
| | - Jeffrey Braithwaite
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Faculty of Medicine, Health, and Human Sciences, Macquarie University, Macquarie Park, NSW, Australia
| |
Collapse
|
11
|
Abstract
PURPOSE OF REVIEW Learning from errors has been the main objective of patient safety initiatives for the last decades. The different tools have played a role in the evolution of the safety culture to a nonpunitive system-centered one. The model has shown its limits, and resilience and learning from success have been advocated as the key strategies to deal with healthcare complexity. We intend to review the recent experiences in applying these to learn about patient safety. RECENT FINDINGS Since the publication of the theoretical basis for resilient healthcare and Safety-II, there is a growing experience applying these concepts into reporting systems, safety huddles, and simulation training, as well as applying tools to detect discrepancies between the intended work as imagined when designing the procedures and the work as done when front-line healthcare providers face the real-life conditions. SUMMARY As part of the evolution in patient safety science, learning from errors has its function to open the mindset for the next step: implementing learning strategies beyond the error. The tools for it are ready to be adopted.
Collapse
Affiliation(s)
- Daniel Arnal-Velasco
- Unit of Anesthesiology and Reanimation, Hospital Universitario Fundacion Alcorcon, Alcorcon, Spain
| | | |
Collapse
|
12
|
Birkeli GH, Ballangrud R, Jacobsen HK, Tveter Deilkas EC, Lindahl AK. Green Cross method in a postanaesthesia care unit: a qualitative study of the healthcare professionals' experiences after 3 years, including the COVID-19 pandemic period. BMJ Open Qual 2023; 12:bmjoq-2022-002247. [PMID: 37225257 DOI: 10.1136/bmjoq-2022-002247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 05/08/2023] [Indexed: 05/26/2023] Open
Abstract
OBJECTIVES Unsafe medical care causes morbidity and mortality among the hospital patients. In a postanaesthesia care unit (PACU), increasing patient safety is a joint effort between different professions. The Green Cross (GC) method is a user-friendly incident reporting method that incorporates daily safety briefings to support healthcare professionals in their daily patient safety work. Thus, this study aimed to describe healthcare professionals' experiences with the GC method in a PACU setting 3 years after its implementation, including the period of the coronavirus disease 2019 pandemic's three waves. DESIGN An inductive, descriptive qualitative study was conducted. The data were analysed using qualitative content analysis. SETTING The study was conducted at a PACU of a university hospital in South-Eastern Norway. PARTICIPANTS Five semistructured focus group interviews were conducted in March and April 2022. The informants (n=23) were PACU nurses (n=18) and collaborative healthcare professionals (n=5) including physicians, nurses and a pharmacist. RESULTS The theme 'still active, but in need of revitalisation' was created, describing the healthcare professionals' experiences with the GC method, 3 years post implementation. The following five categories were found: 'continuing to facilitate open communication', 'expressing a desire for more interprofessional collaboration regarding improvements', 'increasing reluctance to report', 'downscaling due to the pandemic' and 'expressing a desire to share more of what went well'. CONCLUSIONS This study offers information regarding the healthcare professionals' experiences with the GC method in a PACU setting; further, it deepens the understanding of the daily patient safety work using this incident reporting method.
Collapse
Affiliation(s)
- Gørill Helen Birkeli
- Institute of Health and Society, Department of Health Management and Health Economics, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Surgery, Akershus University Hospital, Lorenskog, Norway
| | - Randi Ballangrud
- Department of Health Sciences, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Gjøvik, Norway
| | - Hilde Kristin Jacobsen
- Institute of Basic Medical Sciences, Department of Behavioural Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ellen Catharina Tveter Deilkas
- Health Services Research Unit, Akershus University Hospital, Lorenskog, Norway
- Department of Quality Improvement and Patient Safety, Norwegian Directorate of Health, Oslo, Norway
| | - Anne Karin Lindahl
- Institute of Health and Society, Department of Health Management and Health Economics, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Surgery, Akershus University Hospital, Lorenskog, Norway
| |
Collapse
|
13
|
Díaz-Agea JL, Macías-Martínez N, Leal-Costa C, Girón-Poves G, García-Méndez JA, Jiménez-Ruiz I. What can be improved in learning to care for people with autism? A qualitative study based on clinical nursing simulation. Nurse Educ Pract 2022; 65:103488. [DOI: 10.1016/j.nepr.2022.103488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/11/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022]
|