Generic Handover Investigation (GHandI)

通用切换调查 (GHandI)

• 批准号: EP/D078636/1
• 负责人: Stephanie Wilson
• 金额: $ 63.18万
• 依托单位: City, University of London
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2007
• 资助国家: 英国
• 起止时间: 2007 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=EP%2FD078636%2F1
• 关键词: Generic; Handover; Investigation; GHandI

Handover of responsibility for a system from one individual or team to another makes a vital contribution to the safety and effectiveness of the work. Poor handovers have been identified as contributory causal factors in high profile disasters such as the Piper Alpha Disaster. Recently, handovers in the healthcare sector have come under scrutiny with the implementation in 2004 of the European Working Time Directive, which resulted in the introduction of shift working for junior hospital doctors in order to reduce their working hours. This saw a corresponding increase in the frequency of shift changeovers and made effective clinical handover all the more imperative. Yet current practice is highly variable: it varies from ward to ward and hospital to hospital. Handovers are often impromptu, informal and supported by ad hoc artefacts such as paper-based notes. This is a reflection of the fact that there has been surprisingly little research into this crucial aspect of patient safety.While there have been small-scale studies of clinical handover in specific settings, including our own study of a paediatric ward on the ACE project, there is a lack of basic research. We will address this shortcoming in the GHandI project with an extensive investigation of handover as it is only by achieving a clear understanding of the 'work' that handover accomplishes that we will be able to improve the practice. For example, there is evidence that handover contributes to patient safety by accomplishing work other than the immediate transfer of responsibility for care of the patient. It is within this context that the current proposal is situated, the overall aim of which is to conduct a detailed investigation of clinical handover and its contribution to patient safety by developing and evaluating a generic theoretical model of handover and deriving detailed recommendations and prototypes for innovative handover support technology. This is decomposed into the following objectives:1. To develop a generic model of clinical handover from a socio-technical system perspective that will capture its many commonalities and variations. This will be achieved at both practical and theoretical levels.2. To design and evaluate prototypes for innovative handover support technologies, integrating results from 1 and 3.3. To investigate the role of simple codes and graphic languages in improving communication and reducing ambiguity in information resources used in clinical handover.4. To investigate the nature of an effective handover and determine how this can be measured.In order to ground the modelling and design activities in a genuine understanding of the work, we will undertake a detailed study of clinical handover in a range of very different settings. With the support of our collaborators, we plan to study handovers in ten clinical settings, ranging from ambulance 'retrieval' services to inter-specialty transfers to shift handovers in paediatric intensive care units. This in itself will be an important contribution from GHandI.The outcomes of this research will be of direct benefit to the healthcare sector, both the field study settings and the NHS more generally. They will benefit from an improved understanding of handover, from guidance on effective practice and from the prototype handover technologies. Improved handovers will enhance patient safety, and therefore the quality of life, and improved working practices will be of benefit to clinical staff. The results, particularly the modelling work, will also be of relevance to other critical domains where handovers between operators make an important contribution to the safety and effectiveness of the work, e.g. the continuous process industries. Finally, the HCI and CSCW academic communities will benefit from the theoretical modelling work, from the detailed study of this particular form of collaborative work and from the investigation of graphical communication tools.

将系统从一个人或团队移交给另一个团队为工作的安全性和有效性做出了重要贡献。较差的移交已被确定为诸如Piper Alpha灾难之类的引人注目的因果因素。最近，随着2004年的欧洲工作时间指令的实施，医疗保健部门的移交受到了审查，这导致引入了为初级医院医生工作以减少工作时间的转变。这看到了转移频率的相应增加，并使有效的临床移交更加急切。然而，当前的做法是高度可变的：它因病房到病房和医院而异。切换通常是即兴的，非正式的，并得到了诸如纸质笔记之类的临时人工制品的支持。这反映了以下事实：令人惊讶的是，对患者安全的这一关键方面的研究很少。尽管在特定情况下进行了小规模研究，包括我们对ACE项目的儿科病房的研究，但缺乏基础研究。我们将通过对移交的广泛调查来解决Ghandi项目中的这一缺点，因为只有通过对“工作”的清晰了解，我们将能够改善实践的“工作”。例如，有证据表明，除了立即转移对患者护理的责任之外，移交通过完成工作来促进患者的安全。正是在这种情况下，当前的提案就位于现有建议的情况下，其总体目的是通过开发和评估对临床移交的详细研究及其对患者安全的贡献，通过开发和评估一种通用的移交理论模型，并为创新的移交支持技术提供详细的建议和原型。这被分解为以下目标：1。从社会技术系统的角度来开发临床移交的通用模型，该模型将捕获其许多共同点和变化。这将在实际和理论层面上实现。2。设计和评估创新移交支持技术的原型，并将结果整合为1和3.3。调查简单代码和图形语言在改善沟通和减少临床移交中使用的信息资源的歧义的作用。4。为了研究有效的移交的性质，并确定如何衡量这一点。为了在对工作的真正理解中进行建模和设计活动，我们将在一系列非常不同的环境中进行详细研究临床移交的详细研究。在我们的合作者的支持下，我们计划在十个临床环境中研究切换，从救护车“检索”服务到专业间转移，再到切换儿科重症监护病房的交接。这本身将是Ghandi的重要贡献。这项研究的结果将对医疗保健部门（现场研究环境和NHS）的直接益处。他们将从对移交，有效实践的指南和原型切换技术的改进理解中受益。改进的移交将提高患者的安全性，因此生活质量和改进的工作实践对临床人员有益。结果，尤其是建模工作，也将与其他关键领域相关，在这些领域中，操作员之间的交接对工作的安全性和有效性做出了重要贡献，例如连续的过程行业。最后，HCI和CSCW学术社区将从理论建模工作中受益，从对这种特定形式的协作工作的详细研究以及对图形交流工具的调查。

项目成果

Reconceptualising Clinical Handover: Information Sharing for Situation Awareness

重新概念化临床交接：信息共享以提高情况意识

• 发表时间: 2009
• 作者: Wilson S

Evaluating new interactions in healthcare

评估医疗保健领域的新互动

• DOI: 10.1145/1520340.1520737
• 发表时间: 2009
• 作者: Randell R

PaperChain: A Collaborative Healthcare System Grounded in Field Study Work,

PaperChain：基于实地研究工作的协作医疗系统，

• 发表时间: 2010
• 作者: Wilson S