The Impact of Semistructured Safety-Focused Site Visits Between Children's Hospital.

IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES
Sarah Kandil, Michelle Vonderhaar, Patsy Sisson, Lara Wood, Patrick W Brady, Anne Lyren
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Abstract

Background: Site visits are commonly used for accreditation and regulatory purposes, but little is known about how hospitals use them for safety improvement or their impact on clinical processes and outcomes.

Methods: This mixed methods study describes the key components of safety-focused site visits between hospitals and their impact on hospital safety outcomes, particularly for the visiting hospital. Hospitals were recruited via the Children's Hospitals' Solutions for Patient Safety (SPS) Network. A site visit guide was developed, covering pre-visit planning, visit execution, and post-visit debriefing. A post-visit survey and follow-up interviews (6 to 12 months later) were conducted. Themes were identified using a constant comparative approach, and statistical analysis compared rates of hospital-acquired conditions (HACs) between hospitals that participated in site visits and those that did not.

Results: From 2019 to 2021, 27 hospitals (19.6%) participated in site visits, with 14 in-person and 13 virtual. Key themes to drive a successful and useful visit highlighted the importance of peer rapport, interaction with frontline staff, structured planning, clear agendas, and thorough debriefing. Among hospitals that completed a follow-up interview, 76.5% completed at least one action item, with 56.8% of pre-determined SMART aims achieved. However, no significant difference in HAC rates, specifically central line-associated bloodstream infections (CLABSIs) and unplanned extubations (UEs), was found between site visit and non-site visit hospitals.

Conclusion: Safety-focused site visits between hospitals provide a valuable learning experience, fostering the development of improvement strategies and high rates of action item completion. However, no significant differences in safety outcomes were observed, likely due to the small sample size.

儿童医院间半结构化以安全为重点的实地考察的影响。
背景:实地考察通常用于认证和监管目的,但很少有人知道医院如何利用它们来提高安全性或它们对临床过程和结果的影响。方法:该混合方法研究描述了医院之间以安全为重点的现场访问的关键组成部分及其对医院安全结果的影响,特别是对访问医院而言。医院是通过儿童医院病人安全解决方案网络招募的。制定了一份实地考察指南,内容包括考察前规划、考察执行和考察后汇报。随访6 ~ 12个月,进行随访调查和随访访谈。使用持续比较方法确定主题,并通过统计分析比较参加和未参加实地考察的医院之间的医院获得性疾病(HACs)发生率。结果:2019 - 2021年,共有27家医院(19.6%)参加了现场访问,其中14家医院亲自访问,13家医院虚拟访问。成功和有用的访问重点是同事间的融洽关系、与前线员工的互动、有条理的计划、清晰的议程和详尽的汇报。在完成随访访谈的医院中,76.5%的医院至少完成了一项行动项目,达到了预定SMART目标的56.8%。然而,在现场访问医院和非现场访问医院之间,HAC率,特别是中心线相关血流感染(CLABSIs)和计划外拔管(ue)没有显著差异。结论:医院间以安全为重点的实地考察提供了宝贵的学习经验,促进了改进策略的制定和行动项目的高完成率。然而,没有观察到安全结果的显著差异,可能是由于样本量小。
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
CiteScore
3.80
自引率
4.30%
发文量
116
审稿时长
49 days
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