Factors Associated with Effective Implementation of a Surgical Safety Checklist

与有效实施手术安全检查表相关的因素

• 批准号: 8284176
• 负责人: Sara Jean Singer
• 金额: $ 29.57万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-30 至 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8284176
• 关键词: Factors; Associated; Effective; Implementation; Surgical

PROJECT SUMMARY/ABSTRACT In 2009, strict adherence to the WHO Surgical Safety Checklist, an inexpensive and easy-to-use tool, was found to reduce 30-day mortality from 1.5% to 0.8% and overall complications from 11% to 7% in eight diverse hospitals from Tanzania to the United States. Since then, the Checklist has been adopted by 3,200 hospitals in 93 countries. The benefits of the Checklist, however, depend upon the individual hospitals' ability to implement it effectively. Implementation is the process by which adopting organizations introduce innovations and encourages their use. Implementation may or may not be effective at producing consistent, high-quality utilization of a target innovation. The proposed study will examine implementation processes in a large group of US and international hospitals and will identify factors supportive of effective implementation. The study will also examine the relationship of effective implementation to teamwork, as an explanation for how the Checklist improves outcomes. In order to achieve these aims, data will be collected from 75 surgical units. Data on Checklist implementation processes will be obtained from implementation leaders and surgeons using a survey developed by drawing on prior instruments and preliminary research. Data on implementation effectiveness, teamwork, and Checklist outcomes will be obtained by direct nurse manager, patient safety officer and circulating nurse observations of surgical procedures. Cross-sectional and longitudinal comparisons will relate implementation processes to effective implementation and effective implementation to teamwork and Checklist outcomes. This study will make significant theoretical, methodological, practical and contributions to the field of implementation science. We will contribute to theory about innovation implementation and teamwork by demonstrating that effective Checklist implementation can lead to a virtuous cycle, affecting team dynamics in ways that can continuously improve implementation effectiveness and thus the benefits of the innovation. We will employ novel evaluation tools and training methods that can be applied broadly to increase the likelihood of effective implementation of the Checklist and in future studies of the implementation of similar innovations. For practical purposes, we will identify specific contextual factors and activities that lead to effective Checklist implementation, which can be emulated by other organizations implementing the Checklist and similar innovations.

项目概要/摘要 2009 年，严格遵守世界卫生组织手术安全检查清单，这是一份廉价且 易于使用的工具，被发现可将 30 天死亡率从 1.5% 降低至 0.8%，总体死亡率 从坦桑尼亚到美国的八家不同医院，并发症发生率从 11% 到 7% 不等。 自此，该清单已被 93 个国家的 3,200 家医院采用。的好处 然而，清单取决于各个医院有效实施的能力。 实施是采用组织引入创新的过程 并鼓励它们的使用。实施可能会或可能不会有效地产生一致的、 高质量利用目标创新。拟议的研究将审查实施情况 大量美国和国际医院的流程，并将确定支持因素 的有效实施。该研究还将检验有效的关系 团队合作的实施，作为对清单如何改善结果的解释。 为了实现这些目标，将从 75 个手术室收集数据。数据于 清单实施流程将从实施领导者和外科医生处获得 使用通过利用先前的工具和初步研究进行的调查。数据于 实施有效性、团队合作和清单结果将通过直接获得 护士经理、患者安全官员和巡回护士对手术过程的观察。 横断面和纵向比较将实施过程与有效 团队合作和清单结果的实施和有效实施。 本研究将在理论、方法、实践等方面做出重大贡献 实施科学领域。我们将为创新理论做出贡献 通过证明有效的清单实施可以 形成良性循环，以持续改进的方式影响团队动力 实施有效性以及创新的好处。我们将采用新颖的 可广泛应用的评估工具和培训方法，以提高 清单的有效实施以及在未来研究中实施类似的措施 创新。出于实际目的，我们将确定具体的背景因素和活动 导致有效的清单实施，可供其他组织效仿 实施清单和类似的创新。

项目成果

Surgical team member assessment of the safety of surgery practice in 38 South Carolina hospitals.

外科团队成员对南卡罗来纳州 38 家医院的手术实践安全性进行评估。

• DOI: 10.1177/1077558715577479
• 发表时间: 2015
• 期刊: Medical care research and review : MCRR
• 作者: Singer,SaraJ;Jiang,Wei;Huang,LyenC;Gibbons,Lorri;Kiang,MathewV;Edmondson,Lizabeth;Gawande,AtulA;Berry,WilliamR
• 通讯作者: Berry,WilliamR