2016 Fiscal Year Research-status Report
Improving communication for an effective and safe patient handoff
| Project/Area Number |
15K16291
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| Research Institution | Tokyo Institute of Technology |
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Principal Investigator |
顧 秀珠 東京工業大学, 工学院, 助教 (20632615)
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| Project Period (FY) |
2015-04-01 – 2018-03-31
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| Keywords | Patient handoff / Patient safety / Communication / Taxonomy |
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| Outline of Annual Research Achievements |
Primary objectives in FY 2016 are to discover crucial characteristics of staff communication and communication with patients for patient handoff. Corresponding to the characteristics, strategies are proposed for effective communication for a safe patient handoff. Based on the objectives, summary of achievements is as follows:
(1) A survey on professional views of patient handoffs was conducted. A five-dimensional structure forming performance assessment was acquired for inter-specialty handoffs. Based on the structure, Chinese health care professionals put a stress on patient involvement but stated extremely severe organizational conflicts. Nurses exhibited significantly higher acknowledgment than physicians.
(2) A hierarchical taxonomy system was developed for providing a framework of patient handoff incident characteristics. It comprised four sections: event outline, outcome severity, impact factors and preventative mechanisms. Each section included one or more dimensions, each of which had multiple categories. Based on the results of application to 609 patient handoff incident reports collecting from five general hospitals, we identified several important characteristics of handoff failures. Inter-rater reliability of this system was also proved.
(3) For each of three types of patient handoffs (from ambulance to hospital, between departments in the hospital, and nurses’shift changes), a comprehensive picture of current communication protocols in patient handoffs was drawn by semi-structured interviews with physicians and nurses in hospitals and focus group discussions.
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| Current Status of Research Progress |
Current Status of Research Progress
2: Research has progressed on the whole more than it was originally planned.
Reason
Primary objectives in FY 2016 are to discover crucial characteristics of staff communication and communication with patients for patient handoff. The research plan and current status are stated as follows:
(1) Plan: To conduct questionnaire surveys in China, Taiwan and Japan about patient handoffs focusing on communication. International comparison could be conducted to investigate weak and strong points in each country and learn from each other. The Current status: A questionnaire survey was conducted in China and comparison has been done with previous Japanese sample collected in 2011. We are still contacting hospitals in Taiwan and Japan to cooperate in the questionnaire survey.
(2) Plan: To conduct semi-structured interviews with physicians and nurses in hospitals to obtain self-experienced critical episodes in handoffs. To use focus group discussions including some physicians and nurses, and risk managers to draw a comprehensive picture of current communication protocols in patient handoffs. Current status: Such interviews and group discussion have been conducted with Chinese healthcare professionals after questionnaire survey.
(3) Plan: Based on the information collected above, to develop a human error taxonomy system specifically for communication in patient handoffs. Applying the taxonomy system to actual reports of incidents and accidents related to patient handoffs, latent factors behind communication failures will be explored. Current status: The taxonomy system has been developed and applied to patient handoff incidents from five Japanese general hospitals.
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| Strategy for Future Research Activity |
There are several steps for the following year as:
(1) To contact Taiwanese and Japanese hospitals to cooperate in the questionnaire survey about patient handoff focusing on communication. International comparison could be conducted to investigate weak and strong points in each country and learn from each other. After questionnaire survey, semi-structured interviews with physicians and nurses in hospitals will be conducted to obtain self-experienced critical episodes in handoffs.
(2) Regarding the protocols developed for each of three types of patient handoffs (from ambulance to hospital, between departments in the hospital, and nurses’ shift changes), it could be implemented for a period by several members in the hospital. And observations are planned to be conducted applying developed communication protocols.
(3) Based on the literature review results in FY 2015, to propose candidate indicators for handoff evaluation such as safety, efficiency and satisfactions of sender, receiver and patient. Then, to decide indicators included in the tool after discussions with management personnel, several patients, physicians and nurses. For satisfaction as a subjective indicator, a questionnaire will be designed.
(4) On the basis of the assessment tool, for some indicators, to collect data, transfer records from the hospital and to analyse conducted observations. For other indicators such as satisfaction of sender, receiver and patient, collect their responses to questionnaires after implementation of developed protocols.
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| Causes of Carryover |
Basic environment for research is necessary such as computer related consumables and software for analysis. Regarding knowledge in this topic, additional copies of papers from international journals and books are essential. Expenses are also needed for questionnaire surveys to collect responses from patients and healthcare professionals. To support the survey, research assistants are required. The applicant should also make travels to make interviews and discussions with patients, healthcare professionals and management personnel, and to collect data from hospitals. Finally, to disseminate the research results to the society and to gain experience and advice from international researchers, attending international conferences and meetings with foreign scholars are crucial.
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| Expenditure Plan for Carryover Budget |
First, computer related consumables and related software for analysis will be bought. Then, additional copies of papers from international journals and books will be bought as well. In addition, as questionnaire survey will be conducted this year, expenses are needed for surveys such as postage and payment to research assistants. To make interviews and discussions with healthcare professionals, expenses for domestic and international travels are needed. Finally, the applicant is willing to attend international conferences and have meetings with foreign scholars. Therefore, expenses for travels abroad are necessary.
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Research Products
(6 results)
