Gap Analysis: Annotated Bibliography
Appendix 1. Annotated Bibliography of Key Articles Identified for Gap Analysis
Abraham, J., Kannampallil, T. G., & Patel, V. L. (2012). Bridging gaps in handoffs: A continuity of care based approach. Journal of biomedical informatics, 45(2), 240-254.
Application to Review: Nurse-Physician, Handoff, Work low, Continuity of Care Model, Clinician Centered Approach
Abstract
Handoff among healthcare providers has been recognized as a major source of medical errors. Most prior research has often focused on the communication aspects of handoff, with limited emphasis on the overall handoff process, especially from a clinician workflow perspective. Such a workflow perspective that is based on the continuity of care model provides a framework …show more content…
The influences on SA in inpatient medicine are unknown.
Methods We conducted seven focus groups with nurses, respiratory therapists and resident physicians using a standardised semistructured focus group guide to promote discussion. Recordings of the focus groups were transcribed verbatim, and transcripts were qualitatively analysed by two independent reviewers to identify convergent and divergent themes.
Results Three themes emerged: (1) team-based care, (2) availability of standardised data and (3) standardised processes and procedures. We categorised these into social, technological and organisational influences on SA. Subthemes that emerged from each focus group were shared language to describe at-risk patients, provider experience in critical care/deterioration and interdisciplinary huddles to identify and plan for at-risk patients. An objective early warning score, proactive assessment and planning, adequate clinician staffing and tools for entering, displaying and monitoring data trends were identified by six of seven groups. Our data better reflected the concepts of team SA and shared SA than individual …show more content…
The finalised pro forma was introduced on 25 July 2012.
RESULTS:
Introduction of the pro forma daily care plan was associated with marked and statistically significant improvements in nurses ' self-reported understanding of a list of the patient 's clinical problems, the management plan after the ward round, issues for discharge for the following day (all P < 0.001) and, to a lesser extent, the physiological targets and aims (P = 0.003) and interpretation of the daily chest x-ray (P < 0.001). In the post-intervention survey, only 4/118 free-text comments (3.4%) suggested that documentation of the plan was doctor-dependent, compared with 28/198 (14.1%) at baseline (P = 0.002).
CONCLUSIONS:
Introduction of a single-page, handwritten, structured daily care plan produced marked improvements in ICU nurses ' self-reported understanding of elements of the medical plan, and may have reduced practice variation in medical plan documentation. The effects of this intervention on patient outcomes remain
Abraham, J., Kannampallil, T. G., & Patel, V. L. (2012). Bridging gaps in handoffs: A continuity of care based approach. Journal of biomedical informatics, 45(2), 240-254.
Application to Review: Nurse-Physician, Handoff, Work low, Continuity of Care Model, Clinician Centered Approach
Abstract
Handoff among healthcare providers has been recognized as a major source of medical errors. Most prior research has often focused on the communication aspects of handoff, with limited emphasis on the overall handoff process, especially from a clinician workflow perspective. Such a workflow perspective that is based on the continuity of care model provides a framework …show more content…
The influences on SA in inpatient medicine are unknown.
Methods We conducted seven focus groups with nurses, respiratory therapists and resident physicians using a standardised semistructured focus group guide to promote discussion. Recordings of the focus groups were transcribed verbatim, and transcripts were qualitatively analysed by two independent reviewers to identify convergent and divergent themes.
Results Three themes emerged: (1) team-based care, (2) availability of standardised data and (3) standardised processes and procedures. We categorised these into social, technological and organisational influences on SA. Subthemes that emerged from each focus group were shared language to describe at-risk patients, provider experience in critical care/deterioration and interdisciplinary huddles to identify and plan for at-risk patients. An objective early warning score, proactive assessment and planning, adequate clinician staffing and tools for entering, displaying and monitoring data trends were identified by six of seven groups. Our data better reflected the concepts of team SA and shared SA than individual …show more content…
The finalised pro forma was introduced on 25 July 2012.
RESULTS:
Introduction of the pro forma daily care plan was associated with marked and statistically significant improvements in nurses ' self-reported understanding of a list of the patient 's clinical problems, the management plan after the ward round, issues for discharge for the following day (all P < 0.001) and, to a lesser extent, the physiological targets and aims (P = 0.003) and interpretation of the daily chest x-ray (P < 0.001). In the post-intervention survey, only 4/118 free-text comments (3.4%) suggested that documentation of the plan was doctor-dependent, compared with 28/198 (14.1%) at baseline (P = 0.002).
CONCLUSIONS:
Introduction of a single-page, handwritten, structured daily care plan produced marked improvements in ICU nurses ' self-reported understanding of elements of the medical plan, and may have reduced practice variation in medical plan documentation. The effects of this intervention on patient outcomes remain