M. Chignell, Trevor Hall, Lili Liu, M. Kastner, F. Razak
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引用次数: 0
摘要
2019冠状病毒病大流行扩大了患者安全方面的系统性差距,包括老年人等弱势群体的社会脆弱性(Briguglio et al., 2020)。公共卫生措施,如长期和频繁的封锁,限制访客和支持网络的接触,在极端情况下导致禁闭在一个房间内。这些限制的负面影响使人们重新关注社会脆弱性,这迄今为止一直是一个有点被忽视的患者安全问题。由于社会脆弱性是一个多方面的结构,它需要在各种环境和从一系列学科的角度来考虑。这个由医生领导的小组由一名内科医生、一名人为因素工程师、一名职业治疗师和一名实施科学家组成,研究大流行对三种不同环境(医院、长期护理院、社区)中老年人的社会互动和社会脆弱性的影响。通过一系列案例研究,小组成员就大流行对患者安全和特别是对社会脆弱性的影响提供了应用经验和观点。小组讨论了人因原理的理论和实际应用。如何设计安全纳入医疗保健系统的问题也进行了探讨。在本文中,我们回顾了社会脆弱的问题,列举了一些简短的案例研究,并讨论了可能的干预策略。
Patient Safety Challenges in the Pandemic: Applying Human Factors Principles to Embed Patient Safety and Experience at the Clinical Front Line
The COVID-19 pandemic has amplified systemic gaps in patient safety, including social frailty for vulnerable populations such as older adults (Briguglio et al., 2020). Public health measures, such as prolonged and frequent lockdowns, restricted access to visitors and support networks and in extreme cases led to confinement within a single room, The negative impact of these restrictions has focused new attention on social frailty, which has hitherto been a somewhat neglected patient safety issue. Since social frailty is a multifaceted construct, it needs to be considered in a variety of settings and from a range of disciplinary perspectives. This practitioner-led panel consisting of an internist, a human factors engineer, an occupational therapist, and an implementation scientist, examines the impact of the pandemic on social interaction, and social frailty amongst older people in three different settings (hospital, long term care home, community). Through a set of case studies, the panelists provided applied experiences and perspectives on the impact of the pandemic on patient safety and on social frailty in particular. The panel covered theory, and real-world application of human factors principles. The question of how to design safety into the healthcare system were also explored. In this paper we review the problem of social frailty, list some brief case studies and discuss possible intervention strategies.