麻醉学术中升级规程的流程标准化

Shilen P. Thakrar, Christin Kim, Olga Suarez-Winowiski, Sergio B. Navarrete, Kenneth F. Potter, Praveen Prasanna, Jamie P. Graham, Mofya S. Diallo, Laura Lahaye, Alice A. Tolbert Coombs
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摘要

升级文化的原则已成功应用于航空、军事和制造等其他高可靠性行业。升级文化的原则已成功应用于航空、军事和制造等其他高可靠性行业。在此,我们将讨论如何引入一个独特而令人信服的思维过程,以制定专为本机构量身定制的术中升级方案。受一个关键术中事件的启发,我们在分析多科文献和专家意见的基础上制定了这一部门协议,以降低 SSE 的发生率。它包括一个循序渐进的方法,并结合了患者的具体信息,为遇到动态临床情况的团队成员提供指导。协议的实施通过反复教育、改善沟通和提高决策水平,促进了质量的持续改进。与此同时,我们还计划采用技术和电子决策支持工具来加强实时沟通、监控绩效并培养安全文化....。
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A Process-Based Standardization of an Intraoperative Escalation Protocol in Anesthesiology
ads to “near-misses,” adverse outcomes, and serious safety events (SSEs). The principles of an escalation culture have been used successfully in other highly reliable industries such as aviation, military, and manufacturing. We discuss here the introduction of a unique and compelling thought-process for developing an intraoperative escalation protocol that is specifically tailored for our institution. Inspired by a critical intraoperative event, this departmental protocol was developed based on an analysis of multispecialty literature and expert opinion to decrease the incidence of SSEs. It includes a stepwise approach and incorporates patient-specific information to guide team members who encounter dynamic clinical situations. The implementation of the protocol has facilitated continuous quality improvement through iterative education, improving communication, and enhancing decision-making. Concurrently, we have plans to incorporate technology and electronic decision support tools to enhance real-time communication, monitor performance, and foster a culture of safety....
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