Key components of the safe surgical ward: international Delphi consensus study to identify factors for quality assessment and service improvement

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Title: Key components of the safe surgical ward: international Delphi consensus study to identify factors for quality assessment and service improvement
Authors: Hassen, YAM
Johnston, MJ
Singh, P
Pucher, PH
Darzi, A
Item Type: Journal Article
Abstract: Objective: The aim of this study was to prioritize key factors contributing to safety on the surgical ward Background: There is a variation in the quality and safety of postoperative care between institutions. These variations may be attributed to a combination of process-related issues and structural factors. The aim of this study is to reach a consensus, by means of Delphi methodology, on the most influential of these components that may determine safety in this environment. Methods: The Delphi questionnaire was delivered via an online questionnaire platform. The panel were blinded. An international panel of safety experts, both clinical and nonclinical, and safety advocates participated. Individuals were selected according to their expertise and extent of involvement in patient safety research, regulation, or patient advocacy. Results: Experts in patient safety from the UK, Europe, North America, and Australia participated. The panel identified the response to a deteriorating patient and the care of outlier patients as error-prone processes. Prioritized structural factors included organizational and environmental considerations such as use of temporary staff, out-of-hours reduction in services, ward cleanliness, and features of layout. The latter includes dedicated areas for medication preparation and adequate space around the patient for care delivery. Potential quality markers for safe care that achieved the highest consensus include leadership, visibility between patients and nurses, and nursing team skill mix and staffing levels. Conclusion: International consensus was achieved for a number of factors across process-related and structural themes that may influence safety in the postoperative environment. These should be championed and prioritized for future improvements in patient safety at the ward-level.
Issue Date: 1-Jun-2019
Date of Acceptance: 1-Feb-2018
URI: http://hdl.handle.net/10044/1/57333
DOI: https://doi.org/10.1097/SLA.0000000000002718
ISSN: 0003-4932
Publisher: Lippincott, Williams & Wilkins
Start Page: 1064
End Page: 1072
Journal / Book Title: Annals of Surgery
Volume: 269
Issue: 6
Copyright Statement: © 2018 Wolters Kluwer Health, Inc. All rights reserved. This is a non-final version of an article to be published in final form in Annals of Surgery: https://dx.doi.org/10.1097/SLA.0000000000002718.
Sponsor/Funder: Imperial College Healthcare NHS Trust
National Institute for Health Research (NIHR)
National Institute of Health Research
Funder's Grant Number: RDPSC 79560
RDPSC 79560
Keywords: Science & Technology
Life Sciences & Biomedicine
Surgery
adverse events
patient safety
postoperative care
quality improvement
surgery
ADVERSE EVENTS
PATIENT SAFETY
FAILURE
CARE
RESCUE
MORTALITY
OUTCOMES
IMPACT
IMPLEMENTATION
PERFORMANCE
Surgery
11 Medical and Health Sciences
Publication Status: Published
Conference Place: United States
Appears in Collections:Division of Surgery
Faculty of Medicine



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