Getting the Science Right

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来自 Johns Hopkins University 的课程

Planning a Patient Safety or Quality Improvement Project (Patient Safety III)

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Johns Hopkins University

Planning a Patient Safety or Quality Improvement Project (Patient Safety III)

44 个评分

课程 3（共 7 门，Specialization Patient Safety）

This course provides students with a set of tools and methodologies to plan and initiate a Problem Solving or Quality Improvement project. The first module presents methods for selecting, scoping and structuring a project before it is even initiated. It also introduces the project classifications of implementation and discovery. The second module describes the A3 problem solving methodology and the tool itself. Further in that same module, the student is shown tools to identify problems in flow, defects, and waste and to discover causes, brainstorm, and prioritize interventions. Module 3 shows a methodology within the implementation class. These methods are designed to overcome emotional and organizational barriers to translating evidence-based interventions into practice. The fourth and last module looks at one more way to approach improvement projects in the discovery class. These tools are specifically for new, out-of-the-box design thinking.

从本节课中

Translating Research Into Practice

This module explains the Translating Research into Practice (TRiP) model. It is a methodology to facilitate the adoption and use of evidence-based therapies. This model itself uses a collaborative knowledge translation model for wider sharing of knowledge into practice.

Translating Evidence Into Practice6:06

Summarizing the Evidence9:13

Identifying Local Barriers6:04

The Four E's6:35

Lessons Learned11:40

Getting the Science Right4:48

CUSP As Adaptive Work11:19

与讲师见面

Bob Hody

[MUSIC]

In this video, we'll continue talking about our practical model for

translating evidence into practice.

And specifically, we want to focus on getting the science right.

We previously shared with you some of the lessons learned from our efforts to apply

the translating evidence into practice model working with thousands of hospitals

across the country for the prevention of healthcare associated infections and

other preventable harm.

And we've learned that much of this harm, indeed, is preventable, and

that they need to be viewed as a defect within our healthcare system.

We learn that to be successful, we can't focus on individual providers,

asking them to try harder or to be more vigilant.

But rather, we need to focus on the system of care within our organizations,

because every system is perfectly designed to achieve the results that it does.

And we've talked about how this effort is much more complex than simply

implementing a checklist.

To be successful we need to do a better job of engaging our frontline staff to

identify and to fix these local defects.

For any quality improvement effort there are two

really important areas that we need to get right.

The first was what we would call the technical work.

The second is what we would call the adaptive work.

The technical work is that long list of evidence based therapies that we know

that patients should receive.

For many healthcare organizations, we work for decades to try to incorporate

these evidence based recommendations into a number of checklists, and policies and

protocols, trying to make it easier for providers to do the right thing.

But there's also, importantly, that adaptive work.

Adaptive work is that intangible component of work,

like ensuring team members speak up with concerns and hold each other accountable.

What happens within your organization if somebody's inserting a central line?

You're using a central line insertion checklist, but yet

providers aren't complying?

Is that nurse comfortable speaking up to remind the provider that

they've missed an important evidence based therapy?

Or what happens within your organization if a frontline staff member watches

another person not wash their hand after they've had contact with a patient?

Is that provider comfortable speaking up?

If providers do speak up, what kind of response do they get?

Do they get words of encouragement, like thanks, I really appreciate that reminder.

Or more often, unfortunately, do they get a scowl and

are providers angry that they've been reminded?

It's this adaptive work or the values, attitudes and

beliefs on behalf of our frontline staff that are exceedingly important and

play an important role in the success of any quality improvement program.

To be successful, we need to get the balance between this technical work and

this adaptive work, both have underlying science,

we need to get that science right.

We know that there have been some epic fails in healthcare policy

related to just focusing on the technical work.

We know for many years now organizations have required us within in hospital,

as well as the outpatient setting, prior to any surgical procedure, thou shalt stop

and verify that we have the right patient, the right procedure and the right side.

But yet, unfortunately, we now know that this universal time out

has done little to nothing to prevent wrong sided surgeries in this country.

Far too often, our efforts focus just on the technical work like implementing

a checklist, when we don't spend enough time beginning to address some of

the values, attitudes and beliefs, or the adaptive work, within our organizations.

And we know that this adaptive work, by far, is equally as important, if not more

important, than the technical work in the success of a quality improvement project.

In future videos, we'll talk about our approach to addressing this adaptive work

called the Comprehensive Unit-based Safety Program, or CUSP.

CUSP is perhaps one of the most successful and validated approaches to

address frontline teamwork and safety culture within our organizations.

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