Using Broken Windows Theory to Examine Flow Disruptions in Surgical Care: A Multispecialty Comparison.

IF 0.9 4区 医学 Q4 HEALTH CARE SCIENCES & SERVICES
Asfandyar Khan, Scott A Shappell, Albert J Boquet
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引用次数: 0

Abstract

Introduction: Minimally invasive innovations enhance procedural technology. However, healthcare quality demands addressing mental and physical workloads. This study analyzes flow disruptions uncovering specialty-specific patterns and systemic weaknesses, to enhance quality, processes, and patient safety.

Methods: Twenty-five cardiovascular, 40 orthopedic, 65 trauma care, and 30 neurosurgical cases were examined. The data were categorized using human factor taxonomy, and descriptive statistics were applied.

Results: Comparing the four specialties using RIPCORD TWA taxonomy, cardiovascular and trauma care were translated into one disruption every 2.2 minutes, followed by neurosurgery with one disruption every 2.7 minutes and orthopedics with one disruption every 3.7 minutes. Interruptions were the highest percentage for cardiovascular and orthopedics, with 54% and 46% of flow disruptions. Trauma care was heavily affected by communication flow disruption with 33%. Layout and coordination issues accumulate 26% of flow disruptions in neurosurgery.

Conclusions: Cardiovascular, orthopedics, trauma care, and neurosurgery each feature distinct workflows, risks, and teamwork dynamics, demanding tailored process improvements. By analyzing flow disruptions and systemic weaknesses, this study highlights patterns unique to each specialty, advocating for tailored interventions to enhance communication, coordination, layout optimization, and equipment usability for improved surgical safety and quality.

用破窗理论检查外科护理中的血流中断:一项多专业比较。
导读:微创技术提高了手术技术。然而,医疗保健质量要求解决精神和身体工作量。本研究分析了流动中断,揭示了特殊模式和系统弱点,以提高质量,流程和患者安全。方法:对25例心血管、40例骨科、65例外伤、30例神经外科进行回顾性分析。采用人因分类法对数据进行分类,并采用描述性统计方法。结果:比较使用RIPCORD TWA分类的四个专科,心血管和创伤护理每2.2分钟中断一次,其次是神经外科每2.7分钟中断一次,骨科每3.7分钟中断一次。心血管和骨科的中断比例最高,分别为54%和46%。创伤护理受到沟通流程中断的严重影响,占33%。布局和协调问题占神经外科血流中断的26%。结论:心血管、骨科、创伤护理和神经外科各有不同的工作流程、风险和团队合作动态,需要量身定制的流程改进。通过分析流程中断和系统弱点,本研究突出了每个专科的独特模式,倡导量身定制的干预措施,以加强沟通、协调、布局优化和设备可用性,从而提高手术安全性和质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal for Healthcare Quality
Journal for Healthcare Quality HEALTH CARE SCIENCES & SERVICES-
CiteScore
2.10
自引率
0.00%
发文量
59
期刊介绍: The Journal for Healthcare Quality (JHQ), a peer-reviewed journal, is an official publication of the National Association for Healthcare Quality. JHQ is a professional forum that continuously advances healthcare quality practice in diverse and changing environments, and is the first choice for creative and scientific solutions in the pursuit of healthcare quality. It has been selected for coverage in Thomson Reuter’s Science Citation Index Expanded, Social Sciences Citation Index®, and Current Contents®. The Journal publishes scholarly articles that are targeted to leaders of all healthcare settings, leveraging applied research and producing practical, timely and impactful evidence in healthcare system transformation. The journal covers topics such as: Quality Improvement • Patient Safety • Performance Measurement • Best Practices in Clinical and Operational Processes • Innovation • Leadership • Information Technology • Spreading Improvement • Sustaining Improvement • Cost Reduction • Payment Reform
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