| 研究課題/領域番号 |
15K16291
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| 研究機関 | 東京工業大学 |
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研究代表者 |
顧 秀珠 東京工業大学, 社会理工学研究科, 助教 (20632615)
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| 研究期間 (年度) |
2015-04-01 – 2018-03-31
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| キーワード | Patient handoff / Patient safety / Communication / Taxonomy |
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| 研究実績の概要 |
The objective of research in FY 2015 is exploring characteristics of communication in current patient handoffs. Corresponding to this objective, summary of achievements is as follows:
(1) To obtain the state-of-the-art information, a literature survey about effective patient handoff especially focusing on communication was conducted. As the results of literature survey, to handoff a patient smoothly, there are mainly five important aspects: information transfer, responsibility transfer, management goals, and handoff system for supporting.
(2) Based on the literature review and interviews with several physicians and nurses. A patient handoff questionnaire was developed that comprised two sections in addition to a demographic part. The first section is the main part about staff views of patient handoffs. The second section asks respondents their experience about frequency of handoffs lacking relevant information. It was translated to Chinese. Then, a prototype questionnaire was pretested by physicians and nurses in China, and revisions were made on the basis of the test results and discussions with hospital professionals.
(3) A draft of taxonomy system was developed for patient handoff incident and accident report analysis. Dimensions of the system include: patient handoff type, involved organization, failure type, and causal factor. In addition, there are several categories for each dimension.
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| 現在までの達成度 (区分) |
現在までの達成度 (区分)
3: やや遅れている
理由
The main reason for the delay is maternity and child care leave from May 2015 to March 2016. The objective of research in FY 2015 is exploring characteristics of communication in current patient handoffs. The research plan and current status are stated as follows:
(1) Plan: To conduct a literature survey and interviews with healthcare professionals to collect the state-of-the-art information related to this research projects. The Current status: A literature survey was conducted about communication in patient handoff. However, healthcare professionals have not been interviewed.
(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 not been conducted.
(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: Based on the information collected from literature survey, a draft of taxonomy system about patient handoff especially focus on communication has been developed. However, it still needs improvement and reliability of the system has not been tested.
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| 今後の研究の推進方策 |
As it is a bit behind schedule in FY 2015, there are several steps for the following year as:
(1) To contact Chinese, Taiwanese and Danish hospitals to cooperate in 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.
(2) For each of three types of patient handoffs (from ambulance to hospital, between departments in the hospital, and nurses’ shift changes), 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.
(3) As one of the most important properties, reliability of the taxonomy system will be examined by inter-rater agreements of application results between two judges. Applying the taxonomy system to actual reports of incidents and accidents related to patient handoffs in the past four years collecting from hospitals, latent factors behind communication failures will be explored.
(4) Corresponding to detected characteristics and latent factors of communication failures in handoffs, to propose some strategies for avoiding repeated occurrence of failures. On the basis of current protocols and survey results, new standard communication protocols will be developed for three common types of patient handoffs.
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| 次年度使用額が生じた理由 |
Basic environment for research is necessary such as computer related consumables and related software for analysis. Regarding knowledge in this topic, copies of papers from international journals and books are essential. The applicant should make domestic travels to make interviews and discussions with patients, healthcare professionals and management personnel, and to collect data from hospitals. In addition, expenses are also needed for questionnaire surveys to collect responses from patients and healthcare professionals. 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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| 次年度使用額の使用計画 |
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, too. In addition, as questionnaire survey will be conducted this year, expenses are needed for surveys. To make interviews and discussions with healthcare professionals, expense for domestic 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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