Crisis Checklists for In-Hospital Emergencies - NEW PAPER
25-09-17
Mae'r digwyddiad hwn wedi dod o wefan allanol ac mae ar gael yn Saesneg yn unig
An international team, involving Public Health Wales Staff, have worked collaboratively to develop a new ‘crisis checklist’ system to be used by hospital staff for the care of in-hospital patients. The focus of the checklist is to providing urgent care to patients on general wards (i.e. not in the operating theatre or the intensive care unit) whose functions have deteriorated without warning in the course of their hospital stay, requiring urgent intervention. Members of the group were from France [1], Germany[3], Ireland [9], Netherlands [2], United Kingdom [17] and the United States of America [2].
Detecting and treating clinical deterioration from a medical condition or due to a complication of a surgical procedure can mean the difference between life and death in a hospital environment but there have been concerns that existing procedures used in hospitals do not provide sufficient prompts to staff, such as a list of issues for first responders to address (‘Checking In’) or for the thorough hand-over of patients at the ward (‘Checking Out’).
The approach taken in developing the new Crisis Checklist was to set up a 'learning collaborative': a multidisciplinary group that united researchers, clinicians and policy makers. The Crisis Checklists Learning Collaborative came together to share knowledge and promote best practices related to better care for deteriorating patients. The group consisted of 32 multidisciplinary experts with over 200 years of combined clinical experience.
The second meeting of the group included pilot-testing of the proposed checklist to ensure that it was fit for purpose using a simulation suite at the Ysbyty Gwynedd Hospital in Bangor. Various clinical scenarios were undertaken by teams of volunteer candidates comprised of doctors, nurses, medical and nursing students. The performance of teams and individual candidates, with and without, the checklists was observed, analysed and constructively criticized by the expert participants. A third meeting gave the group the opportunity to provide feedback and debate the checklist design.
Following the development of the Crisis Checklist, the team published their article in the BMC Health Services Research Journal, commenting that '[the] success of checklists will depend on uptake and acceptance by providers, supported by a strongly motivated and committed team ethos.'