The human factor: the critical importance of effective teamwork and communication in providing safe care

Leonard, M

doi:10.1136/qhc.13.suppl_1.i85

Cited by 902 publications

(962 citation statements)

References 4 publications

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“…Leonard et al [18] reported that surgical teams who implemented a perioperative team briefing process at a nonprofit hospital in the United States achieved positive results. More detailed results were presented by DeFontes [19].…”

Section: Checklist Use In the Operating Roommentioning

confidence: 99%

Requirements for the design and implementation of checklists for surgical processes

et al. 2008

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Background The use of checklists is a promising strategy for improving patient safety in all types of surgical processes inside and outside the operating room. This article aims to provide requirements and implementation of checklists for surgical processes. Methods The literature on checklist use in the operating room was reviewed based on research using Medline, Pubmed, and Google Scholar. Although all the studies showed positive effects and important benefits such as improved team cohesion, improved awareness of safety issues, and reduction of errors, their number still is limited. The motivation of team members is considered essential for compliance. Currently, no general guidelines exist for checklist design in the surgical field. Based on the authors' experiences and on guidelines used in the aviation industry, requirements for the checklist design are proposed. The design depends on the checklist purpose, philosophy, and method chosen. The methods consist of the ''call-doresponse'' approach,'' the ''do-verify'' approach, or a combination of both. The advantages and disadvantages of paper versus electronic solutions are discussed. Furthermore, a step-by-step strategy of how to implement a checklist in the clinical situation is suggested. ConclusionsThe use of structured checklists in surgical processes is most likely to be effective because it standardizes human performance and ensures that procedures are followed correctly instead of relying on human memory alone. Several studies present promising and positive first results, providing a solid basis for further investigation. Future research should focus on the effect of various checklist designs and strategies to ensure maximal compliance.

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Section: Checklist Use In the Operating Roommentioning

confidence: 99%

Requirements for the design and implementation of checklists for surgical processes

et al. 2008

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“…Communication failure is a major contributor to medical errors. 2,3 Recognizing such findings, a growing body of literature addresses handoff techniques for learners. [4][5][6][7] Vidyarthi described the handoff process as ''traditionally informal, unstructured, and idiosyncratic,'' 4 and many believe efforts to formalize and structure this process are important for patient safety.…”

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confidence: 99%

Gaining efficiency and satisfaction in the handoff process

Burton

Kashiwagi

Kirkland

et al. 2010

Journal of Hospital Medicine

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BACKGROUND:Handoffs, or transfers of patient care responsibility, occur frequently on hospitalist teams. The reliability and efficiency of the handoff process is a national and local concern. Most studies in the literature regard physicians‐in‐training. We studied the morning handoff process of hospitalist teams comprised of staff physicians and nurse practitioner and/or physician assistants.METHODS:An improvement team observed morning handoffs. Four problems were identified: unpredictable start and finish times, inefficiency, poor environment (hallway noise and distracting in‐room conversations), and poor communication. The team restructured the process and observed post‐intervention behavior at 15 and 90 days. A participant‐provider survey was conducted before and after the intervention regarding wasted time, total time‐in‐report, and satisfaction with the process.RESULTS:Pre‐intervention 60.5% of providers (23/38) believed morning handoff was performed in a timely fashion compared to 100% (15/15) post‐intervention (P = 0.005). Average time spent in morning report was 11 minutes, compared to 5 minutes after the intervention (P < 0.0028). Pre‐intervention 6.5 minutes were believed wasteful, compared to 0.5 minutes post‐intervention (P < 0.0001).CONCLUSIONS:This study identifies deficiencies in the handoff process that were addressed by enhancing the physical environment (smaller room, noise reduction, closed door), assigned seating (visual cues by table tent cards), non‐clinicians providing printed materials, standardization of written updates, team times (consistent & precise daily time for each team report), culture change including deference of attention to team receiving report with opportunity for questions, and minimization of side conversations. This intervention package resulted in an improvement in satisfaction and timeliness of clinicians involved. Journal of Hospital Medicine 2010. © 2010 Society of Hospital Medicine.

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“…Betweenness centrality is the number of the shortest paths from all nodes in the network to all others that pass through a given node. All data manipulation and conversion to a network compliant set of nodes and edges were performed using R v3.3.0 (Development Core Team 2011) and all network properties, visualization and components structure were evaluated using the open source software Gephi v0.8.2 (Leonard et al 2004).…”

Section: Methodsmentioning

confidence: 99%

Animal movement network analysis as a tool to map farms serving as contamination source in cattle cysticercosis

et al. 2017

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Bovine cysticercosis is a problem distributed worldwide that result in economic losses mainly due to the condemnation of infected carcasses. One of the difficulties in applying control measures is the identification of the source of infection, especially because cattle are typically acquired from multiple farms. Here, we tested the utility of an animal movement network constructed with data from a farm that acquires cattle from several other different farms to map the major contributors of cysticercosis propagation. Additionally, based on the results of the network analysis, we deployed a sanitary management and drug treatment scheme to decrease cysticercosis’ occurrence in the farm. Six farms that had commercial trades were identified by the animal movement network and characterized as the main contributors to the occurrence of cysticercosis in the studied farm. The identification of farms with a putative risk of Taenia saginata infection using the animal movement network along with the proper sanitary management and drug treatment resulted in a gradual decrease in cysticercosis prevalence, from 25% in 2010 to 3.7% in 2011 and 1.8% in 2012. These results suggest that the animal movement network can contribute towards controlling bovine cysticercosis, thus minimizing economic losses and preventing human taeniasis.

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The human factor: the critical importance of effective teamwork and communication in providing safe care

Cited by 902 publications

References 4 publications

Requirements for the design and implementation of checklists for surgical processes

Requirements for the design and implementation of checklists for surgical processes

Gaining efficiency and satisfaction in the handoff process

Animal movement network analysis as a tool to map farms serving as contamination source in cattle cysticercosis

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