Development of the Huddle Observation Tool for structured case management discussions to improve situation awareness on inpatient clinical wards.
| Autor: | Edbrooke-Childs, Julian, Hayes, Jacqueline, Sharpies, Evelyn, Gondek, Dawid, Stapley, Emily, Sevdalis, Nick, Lachman, Peter, Deighton, Jessica |
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| Předmět: |
TEAMS in the workplace
CHILDREN'S hospitals COGNITION CONFIDENCE intervals DISCUSSION ECOLOGY EXPERIMENTAL design HEALTH care teams HOSPITAL wards RESEARCH methodology MEDICAL practice NATIONAL health services SCIENTIFIC observation PATIENT safety PSYCHOLOGICAL tests RESEARCH funding RISK management in business SCALE analysis (Psychology) STATISTICS SOCIAL services case management HUMAN services programs INTER-observer reliability RESEARCH personnel CROSS-sectional method DATA analysis software DESCRIPTIVE statistics INTRACLASS correlation |
| Zdroj: | BMJ Quality & Safety; May2018, Vol. 27 Issue 5, p365-372, 8p, 1 Diagram, 4 Charts |
| Abstrakt: | Background 'Situation Awareness For Everyone' (SAFE) was a 3-year project which aimed to improve situation awareness in clinical teams in order to detect potential deterioration and other potential risks to children on hospital wards. The key intervention was the 'huddle', a structured case management discussion which is central to facilitating situation awareness. This study aimed to develop an observational assessment tool to assess the team processes occurring during huddles, including the effectiveness of the huddle. Methods A cross-sectional observational design was used to psychometrically develop the 'Huddle Observation Tool' (HOT) over three phases using standardised psychometric methodology. Huddles were observed across four NHS paediatric wards participating in SAFE by five researchers; two wards within specialist children hospitals and two within district general hospitals, with location, number of beds and length of stay considered to make the sample as heterogeneous as possible. Inter-rater reliability was calculated using the weighted kappa and intraclass correlation coefficient. Results Inter-rater reliability was acceptable for the collaborative culture (weighted kappa=0.32, 95% CI 0.17 to 0.42), environment items (weighted kappa=0.78, 95% CI 0.52 to 1) and total score (intraclass correlation coefficient=0.87, 95% CI 0.68 to 0.95). It was lower for the structure and risk management items, suggesting that these were more variable in how observers rated them. However, agreement on the global score for huddles was acceptable. Conclusion We developed an observational assessment tool to assess the team processes occurring during huddles, including the effectiveness of the huddle. Future research should examine whether observational evaluations of huddles are associated with other indicators of safety on clinical wards (eg, safety climate and incidents of patient harm), and whether scores on the HOT are associated with improved situation awareness and reductions in deterioration and adverse events in clinical settings, such as inpatient wards. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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