Imperial College London
Alternate

DrMaximilianJohnston

Faculty of Medicine, Department of Surgery & Cancer

Honorary Clinical Research Fellow
 
 
 
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Contact

 

+44 (0)20 3312 1058m.johnston

 
 
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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{Hassen:2018:10.1016/j.surg.2017.12.003,
author = {Hassen, Y and Singh, P and Pucher, PH and Johnston, MJ and Darzi, A},
doi = {10.1016/j.surg.2017.12.003},
journal = {Surgery},
pages = {1226--1233},
title = {Identifying quality markers of a safe surgical ward: an interview study of patients, clinical staff, and administrators},
url = {http://dx.doi.org/10.1016/j.surg.2017.12.003},
volume = {163},
year = {2018}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Postoperative care quality is variable. Risk-adjusted mortality rates differ between institutions despite comparable complication rates. This indicates that there are underlying factors rooted in how care is delivered that determines patient safety. This study aims to evaluate systematically the surgical ward environment with respect to process-driven and structural factors to identify quality markers for safe care, from which new safety metrics may be derived. METHODS: Semistructured interviews of clinicians, nurses, patients and administrators were undertaken for the study. RESULTS: In the study, 97% of staff members recognized the existence of variation in patient safety between surgical wards. Four main error-prone processes were identified: ward rounds (57%), medication prescribing and administration (49%), the presence of outliers (43%), and deficiencies in communication between clinical staff (43%). Structural factors were categorized as organizational or environmental; organizational included shortage in staffing (39%) and use of temporary staff (27%). Environmental factors considered layout and patient visibility to nurses (49%) as well as cleanliness (29%). Safety indicators identified included staff experience level (31%), overall layout of the ward, cleanliness and leadership (all 27% each). The majority of patients (87%) identified staff attentiveness as a safety indicator. CONCLUSION: This study demonstrates that there are a number of factors that may contribute to safety on the surgical ward spanning multiple processes, organizational, and environmental factors. Safety indicators identified across all these categories presents an opportunity to develop broader and more effectual safety improvement measures focusing on multiple areas simultaneously.
AU  - Hassen,Y
AU  - Singh,P
AU  - Pucher,PH
AU  - Johnston,MJ
AU  - Darzi,A
DO  - 10.1016/j.surg.2017.12.003
EP  - 1233
PY  - 2018///
SN  - 0039-6060
SP  - 1226
TI  - Identifying quality markers of a safe surgical ward: an interview study of patients, clinical staff, and administrators
T2  - Surgery
UR  - http://dx.doi.org/10.1016/j.surg.2017.12.003
UR  - http://hdl.handle.net/10044/1/57051
VL  - 163
ER  -
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