Medical communication at shift change and human error: Could a cognitive support make health care safer?
Gillet, Aline ; Ghuysen, Alexandre ; D'Orio, Vincenzo et al
Conference (2013, May 24)Detailed reference viewed: 33 (4 ULg)
Cognitive support for a better handoff: does it improve the quality of medical communication at shift change in an emergency department?
Gillet, Aline ; GHUYSEN, Alexandre ; BONHOMME, Suzanne et al
in European Journal of Emergency Medicine (2012)
AIM: To improve the communication during shift handover in an emergency department. METHODS: We observed the handover process and analysed the discourse between physicians at shift change first, and then ... [more ▼]
AIM: To improve the communication during shift handover in an emergency department. METHODS: We observed the handover process and analysed the discourse between physicians at shift change first, and then we created two cognitive tools and tested their clinical impact on the field. We used different measures to evaluate this impact on the health care process including the frequency and type of information content communicated between physicians, duration of the handoff, physician self-evaluation of the quality of the handoff and a posthandover study of patient handling. RESULTS: Our results showed that the patient's medical history, significant test results, recommendations (treatment plan) and patient follow-up were communicated to a greater extent when the tools are used. We also found that physicians spent more time at the bedside and less time consulting medical records using these tools. CONCLUSION: The present study showed how in-depth observations and analyses of real work processes can be used to better support the quality of patient care. [less ▲]Detailed reference viewed: 66 (16 ULg)
Systèmes de retour d'expérience : "Faut-il vraiment copier l'industrie?"
Nyssen, Anne-Sophie ; Gillet, Aline ; et al
in Risques & Qualité (2012), IX(2), 85-91Detailed reference viewed: 61 (12 ULg)
Emergency physicians’ communication: What about a standardized handover?
Gillet, Aline ; D'ORIO, Vincenzo ; Nyssen, Anne-Sophie
Poster (2011, May 27)
In health care organizations, the need for 24-hour care increases the number of patient’s transfer. Handover and shift changes are now recognized as particularly critical moments for the reliability of ... [more ▼]
In health care organizations, the need for 24-hour care increases the number of patient’s transfer. Handover and shift changes are now recognized as particularly critical moments for the reliability of care. However, few studies focused specifically on how physicians share relevant information during these moments. Moreover, emergency departments are known to be extremely vulnerable to error, because of high time pressure, frequent interruptions, high variability and number of patients, etc. Our study aimed to estimate how emergency physicians share information about a patient during handover, and to evaluate the impact of a procedure of medical handover standardization. To do this, we conducted a pre-post test on completeness of transmissions. We first performed observations of 50 physicians’ shift changes in an emergency department. All of these were video-recorded and then analyzed. We classified communications into seven categories (identifying information, current pathology, patient’s current status, significant patient’s tests results, priority medical interventions, diagnose and recommendations, and dispositions). After these observations, we elaborated and implemented a standardization procedure, according to literature, analyses of our observations and physicians’ recommendations. We finally assessed this procedure by observing and analyzing 40 handovers, using the same method as previously described. We also evaluated the physician’s opinion about the quality of the transmission with a 7-point Likert scale. Our results showed three significant differences before and after the standardization of communications. Physicians share more information about patient’s tests results, priority interventions and dispositions. Moreover, we found a significant difference of the perceived quality of the standardized handover. [less ▲]Detailed reference viewed: 51 (8 ULg)