Imperial College London
Alternate

Professor the Lord Darzi of Denham PC KBE FRS FMedSci HonFREng

Faculty of Medicine, Department of Surgery & Cancer

Co-Director of the IGHI, Professor of Surgery
 
 
 
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Contact

 

+44 (0)20 3312 1310a.darzi

 
 
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Location

 

Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Johnston:2016:10.1097/SLA.0000000000002089,
author = {Johnston, MJ and Arora, S and King, D and Darzi, A},
doi = {10.1097/SLA.0000000000002089},
journal = {Annals of Surgery},
pages = {73--80},
title = {Improving the Quality of Ward-based Surgical Care With a Human Factors Intervention Bundle.},
url = {http://dx.doi.org/10.1097/SLA.0000000000002089},
volume = {267},
year = {2016}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Objective: This study aimed to explore the impact of a human factors intervention bundle on the quality of ward-based surgical care in a UK hospital.Summary of Background Data: Improving the culture of a surgical team is a difficult task. Engagement with stakeholders before intervention is key. Studies have shown that appropriate supervision can enhance surgical ward safety.Methods: A pre-post intervention study was conducted. The intervention bundle consisted of twice-daily attending ward rounds, a "chief resident of the week" available at all times on the ward, an escalation of care protocol and team contact cards. Twenty-seven junior and senior surgeons completed validated questionnaires assessing supervision, escalation of care, and safety culture pre and post-intervention along with interviews to further explore the impact of the intervention. Patient outcomes pre and postintervention were also analyzed.Results: Questionnaires revealed significant improvements in supervision postintervention (senior median pre 5 vs post 7, P = 0.002 and junior 4 vs 6, P = 0.039) and senior surgeon approachability (junior 5 vs 6, P = 0.047). Both groups agreed that they would feel safer as a patient in their hospital postintervention (senior 3 vs 4.5, P = 0.021 and junior 3 vs 4, P = 0.034). The interviews confirmed that the safety culture of the department had improved. There were no differences in inpatient mortality, cardiac arrest, reoperation, or readmission rates pre and postintervention.Conclusion: Improving supervision and introducing clear protocols can improve safety culture on the surgical ward. Future work should evaluate the effect these measures have on patient outcomes in multiple institutions.
AU  - Johnston,MJ
AU  - Arora,S
AU  - King,D
AU  - Darzi,A
DO  - 10.1097/SLA.0000000000002089
EP  - 80
PY  - 2016///
SN  - 0003-4932
SP  - 73
TI  - Improving the Quality of Ward-based Surgical Care With a Human Factors Intervention Bundle.
T2  - Annals of Surgery
UR  - http://dx.doi.org/10.1097/SLA.0000000000002089
UR  - http://hdl.handle.net/10044/1/48312
VL  - 267
ER  -
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