Imperial College London
Alternate

Dr Sam Pannick

Faculty of Medicine, Faculty of Medicine Centre

 
 
 
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Contact

 

s.pannick

 
 
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Location

 

Medical SchoolSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Pannick:2017:10.1136/bmjopen-2016-014333,
author = {Pannick, SAJ and Athanasiou, T and Long, SJ and Beveridge, I and Sevdalis, N},
doi = {10.1136/bmjopen-2016-014333},
journal = {BMJ Open},
title = {Translating staff experience into organisational improvement: the HEADS-UP stepped wedge, cluster controlled, non-randomised trial},
url = {http://dx.doi.org/10.1136/bmjopen-2016-014333},
volume = {7},
year = {2017}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Objectives:Frontline insights into care delivery correlate with patients’ clinical outcomes. These outcomes might be improved through near-real time identification and mitigation of staff concerns. We evaluated the effects of a prospective frontline surveillance system on patient and team outcomes.Design:Prospective, stepped wedge, non-randomised, cluster controlled trial; pre-specified per protocol analysis for high fidelity intervention delivery.Participants:Seven interdisciplinary medical ward teams, from two hospitals in the United Kingdom.Intervention:Prospective clinical team surveillance (PCTS): structured daily interdisciplinary briefings to capture staff concerns, with organisational facilitation and feedback.Main measures:The primary outcome was excess length of stay (eLOS): an admission more than 24 hours longer than the local average for comparable patients. Secondary outcomes included safety and teamwork climates, and incident reporting. Mixed-effects models adjusted for time effects, age, comorbidity, palliation status, and ward admissions. Safety and teamwork climates were measured with the Safety Attitudes Questionnaire. High fidelity PCTS delivery comprised high engagement and high briefing frequency.Results:Implementation fidelity was variable, both in briefing frequency (median 80% working days/month, interquartile range 65-90%), and engagement (median 70 issues/ward/month, interquartile range 34-113). 1714/6518 (26.3%) intervention admissions had eLOS vs 1279/4927 (26.0%) control admissions, an absolute risk increase of 0.3%. PCTS increased eLOS in the adjusted intention-to-treat model (OR 1.32, 95% CI 1.10-1.58, p=0.003). Conversely, high fidelity PCTS reduced eLOS (OR 0.79, 95% CI 0.67-0.94, p=0.006). High fidelity PCTS also increased total, high yield, and non-nurse incident reports (incidence rate ratios 1.28-1.79, all p<0.002). Sustained PCTS significantly improved safety and teamwork climates over time.Conclusions:This study highli
AU  - Pannick,SAJ
AU  - Athanasiou,T
AU  - Long,SJ
AU  - Beveridge,I
AU  - Sevdalis,N
DO  - 10.1136/bmjopen-2016-014333
PY  - 2017///
SN  - 2044-6055
TI  - Translating staff experience into organisational improvement: the HEADS-UP stepped wedge, cluster controlled, non-randomised trial
T2  - BMJ Open
UR  - http://dx.doi.org/10.1136/bmjopen-2016-014333
UR  - http://hdl.handle.net/10044/1/47989
VL  - 7
ER  -
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