Patient- and Team-Level Characteristics Associated with Handoff Protocol Fidelity in a Hybrid Implementation Study: Results from a Qualitative Comparative Analysis.
Standardization is an evidence-based approach to improve handoffs. The factors underpinning fidelity (that is, adherence) to standardized handoff protocols are not well specified, which hampers implementation and sustainability efforts. The Handoffs and Transitions in Critical Care (HATRICC) study (...
| Publicado en: | Joint Commission Journal on Quality & Patient Safety Vol. 49; no. 8; pp. 356 - 365 |
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| Autores principales: | , , , , |
| Formato: | research Journal Article |
| Publicado: |
Elsevier B.V.
Aug2023
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=164961528&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 164961528 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15537250 17W5 jtl: Joint Commission Journal on Quality & Patient Safety issn: 15537250 maglogo: N pubinfo: dt: Aug2023 vid: 49 iid: 8 pid: 82545 pub: Elsevier B.V. place: Philadelphia, Pennsylvania artinfo: ui: 164961528 164961528 164961528 10.1016/j.jcjq.2023.04.003 164961528 ppf: 356 ppct: 9 formats: tig: atl: Patient- and Team-Level Characteristics Associated with Handoff Protocol Fidelity in a Hybrid Implementation Study: Results from a Qualitative Comparative Analysis. aug: au: Lane-Fall, Meghan B. Koilor, Christopher B. Givan, Kathleen Klaiman, Tamar Barg, Frances K. sug: subj: Hand Off (Patient Safety) Standards Multidisciplinary Care Team Implementation Science Methods Human Qualitative Studies Patient Safety Intensive Care Units Health Care Delivery Quality of Health Care Descriptive Statistics Comparative Studies ab: Standardization is an evidence-based approach to improve handoffs. The factors underpinning fidelity (that is, adherence) to standardized handoff protocols are not well specified, which hampers implementation and sustainability efforts. The Handoffs and Transitions in Critical Care (HATRICC) study (2014–2017) involved the creation and implementation of a standardized protocol for operating room (OR)–to-ICU handoffs in two mixed surgical ICUs. The present study used fuzzy-set qualitative comparative analysis (fsQCA) to characterize combinations of conditions associated with fidelity to the HATRICC protocol. Conditions were derived from postintervention handoff observations yielding quantitative and qualitative data. Sixty handoffs had complete fidelity data. Four conditions from the SEIPS 2.0 model were used to explain fidelity: (1) whether the patient was newly admitted to the ICU; (2) presence of an ICU provider; (3) observer ratings of attention-paying by the handoff team; and (4) whether the handoff took place in a quiet environment. None of the conditions were singly necessary or sufficient for high fidelity. Three combinations of conditions were sufficient for fidelity: (1) presence of the ICU provider and high attention ratings; (2) a newly admitted patient, presence of the ICU provider, and quiet environment; and (3) a newly admitted patient, high attention ratings, and quiet environment. These three combinations explained 93.5% of the cases demonstrating high fidelity. In a study of OR-to-ICU handoff standardization, multiple combinations of contextual factors were associated with handoff protocol fidelity. Handoff implementation efforts should consider multiple fidelity-promoting strategies that support these combinations of conditions. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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