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Mixed methods evaluation of a specialty-specific system to promote physician engagement in safety and quality reporting in a large academic health system.
Lessios, Anna Sophia; Vilendrer, Stacie; Peterson, Ashley; Brown-Johnson, Cati; Kling, Samantha M R; Veruttipong, Darlene; Arteaga, Michelle; Gessner, Daniel; Gostic, William John.
Afiliación
  • Lessios AS; Medicine, Primary Care and Population Health Division, Evaluation Sciences Unit, Stanford University School of Medicine, Stanford, California, USA aslessios@stanford.edu.
  • Vilendrer S; Medicine, Primary Care and Population Health Division, Evaluation Sciences Unit, Stanford University School of Medicine, Stanford, California, USA.
  • Peterson A; Department of Anesthesia, Perioperative and Pain Medicine, Stanford Health Care, Stanford, California, USA.
  • Brown-Johnson C; Medicine, Primary Care and Population Health Division, Evaluation Sciences Unit, Stanford University School of Medicine, Stanford, California, USA.
  • Kling SMR; Medicine, Stanford University School of Medicine, Stanford, California, USA.
  • Veruttipong D; Department of Medicine, Stanford University School of Medicine, Palo Alto, California, USA.
  • Arteaga M; Department of Anesthesiology, Perioperative & Pain Medicine, Stanford Health Care, Stanford, California, USA.
  • Gessner D; Internal Medicine, Stanford University Medical Center, Stanford, California, USA.
  • Gostic WJ; Department of Anesthesiology, Perioperative & Pain Medicine, Stanford Health Care, Stanford, California, USA.
BMJ Open Qual ; 13(3)2024 Jul 31.
Article en En | MEDLINE | ID: mdl-39089742
ABSTRACT

BACKGROUND:

Incident reporting systems (IRS) can improve care quality and patient safety, yet their impact is limited by clinician engagement. Our objective was to assess barriers to reporting in a hospital-wide IRS and use data to inform ongoing improvement of a specialty-specific IRS embedded in the electronic health record targeting anaesthesiologists.

METHODS:

This quality improvement (QI) evaluation used mixed methods, including qualitative interviews, faculty surveys and user data from the specialty-specific IRS. We conducted 24 semi-structured interviews from January to May 2023 in a large academic health system in Northern California. Participants included adult and paediatric anaesthesiologists, operating room nurses, surgeons and QI operators, recruited through convenience and snowball sampling. We identified key themes and factors influencing engagement, which were classified using the Systems Engineering Initiative for Patient Safety framework. We surveyed hospital anaesthesiologists in January and May 2023, and characterised the quantity and type of reports submitted to the new system.

RESULTS:

Participants shared organisation and technology-related barriers to engagement in traditional system-wide IRSs, many of which the specialty-specific IRS addressed-specifically those related to technological access to the system. Barriers related to building psychological safety for those who report remain. Survey results showed that most barriers to reporting improved following the specialty-specific IRS launch, but limited time remained an ongoing barrier (25 respondents out of 44, 56.8%). A total of 964 reports with quality/safety concerns were submitted over the first 8 months of implementation; 47-76 unique anaesthesiologists engaged per month. The top safety quality categories of concern were equipment and technology (25.9%), clinical complications (25.3%) and communication and scheduling (19.9%).

CONCLUSIONS:

These findings suggest that a specialty-specific IRS can facilitate increased physician engagement in quality and safety reporting and complement existing system-wide IRSs.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Mejoramiento de la Calidad / Seguridad del Paciente Límite: Adult / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: BMJ Open Qual Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Mejoramiento de la Calidad / Seguridad del Paciente Límite: Adult / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: BMJ Open Qual Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido