Simulation-based Training Program to Augment EMR-based Handoff Tool

基于模拟的培训计划可增强基于 EMR 的切换工具

• 批准号: 7236327
• 负责人: John A Vozenilek
• 金额: $ 28.51万
• 依托单位: NORTHSHORE UNIVERSITY HEALTHSYSTEM
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-30 至 2008-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7236327
• 关键词: automated medical record system; behavioral /social science research tag; clinical research; communication; computer assisted patient care; computer simulation; cooperative study; curriculum; emergency care; health care personnel performance; human subject; training

DESCRIPTION (provided by the applicant): Medical error is a significant public health problem. Miscommunication between medical providers has been noted to be involved in > 60% of medical error. Accreditation organizations and expert reviews have both called for efforts to improve and standardize medical communication, following models that have been successful in other high-risk fields such as aeronautics. Patient handoffs, particularly in high-volume and high-acuity settings, are a particularly vulnerable point in the patient care system. Such handoffs occur in noisy, chaotic settings and are notable for their free-form and variable nature. In the National Patient Safety Goals for 2006, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has recommended standardization of handoff procedures. Our institution will attempt to satisfy JCAHO's request by implementing a patient handoff that uses the electronic medical record (EMR). The aim of this project is to integrate health information technology (IT) systems and simulation-based training to reduce communication errors between resident physicians in an emergency department (ED) setting. Initially, a 3-month observation of actual ED handoffs will provide baseline handoff characteristics. This data will be collected by direct observation using a structured checklist. Concurrent with the introduction of the handoff tool, we will conduct a 4-hour standardized patient and mannequin simulation-based training program to instruct residents in both the use of the handoff tool and the fundamentals of structured, consistent communication. This educational intervention will be offered to residents rotating in the 1st, 3rd, and 5th months after the implementation of the EMR tool. Direct observation of handoffs in the ED will continue for 6 months. This will allow discrimination of the effect of the training and the EMR-based tool on communications individually. We hypothesize that the combination of simulation-based training (with practice and feedback) and a health IT tool will provide the greatest benefit and result in significantly fewer communications errors, therefore increasing patient safety. This project is relevant to health care organizations, accreditation bodies, and governmental bodies. Consistency in communication is a necessary step to reduce communication error. Integration of on-the-job tools with robust training is necessary if improvement in communication is to be accomplished and maintained.

描述（由申请人提供）：医疗错误是一个重大的公共卫生问题。据指出，超过 60% 的医疗错误涉及医疗服务提供者之间的沟通不畅。认证组织和专家评审都呼吁效仿航空等其他高风险领域的成功模式，努力改善和标准化医疗沟通。患者交接，特别是在大容量和高危度环境中，是患者护理系统中特别脆弱的点。这种切换发生在嘈杂、混乱的环境中，并且以其自由形式和可变性而著称。在 2006 年国家患者安全目标中，医疗机构认证联合委员会 (JCAHO) 建议实现交接程序的标准化。我们的机构将尝试通过实施使用电子病历 (EMR) 的患者交接来满足 JCAHO 的要求。该项目的目的是整合健康信息技术 (IT) 系统和基于模拟的培训，以减少急诊科 (ED) 环境中住院医师之间的沟通错误。最初，对实际 ED 切换的 3 个月观察将提供基线切换特征。该数据将通过使用结构化检查表直接观察来收集。在推出交接工具的同时，我们将进行一个时长 4 小时的基于患者和人体模型模拟的标准化培训计划，指导住院医生如何使用交接工具以及结构化、一致沟通的基础知识。这项教育干预措施将在实施 EMR 工具后的第 1、3 和 5 个月内轮流向居民提供。对急诊室交接情况的直接观察将持续 6 个月。这将允许区分培训和基于 EMR 的工具对单独通信的影响。我们假设基于模拟的培训（结合实践和反馈）与健康 IT 工具的结合将提供最大的好处，并显着减少通信错误，从而提高患者的安全。该项目与医疗保健组织、认证机构和政府机构相关。沟通的一致性是减少沟通错误的必要步骤。如果要实现和维持沟通的改进，就必须将在职工具与强有力的培训相结合。