Role of Champions in the Implementation of Patient Safety Practice Change
Notice bibliographique
Résumé
D espite an intensified research focus and concerted efforts to achieve high reliability in healthcare, patient safety leaders have charged that progress has been "frustratingly slow" (Leape and Berwick 2005).This is not to say that healthcare organizations have not made concerted efforts; over 4,000 organizations voluntarily joined the Institute for Healthcare Improvement (IHI) 5 Million Lives patient safety campaign, and nearly 300 joined Canada's Safer Healthcare Now! campaign.The slow pace of improvement is more likely due to the fact that achieving successful change, which is difficult in any organization, can prove especially challenging in organizations as large and complex as those that provide healthcare.Considering the investments in resources, energy and time that patient safety initiatives often require and the importance of these changes to quality of care, it is in the best interest of healthcare organizations to maximize their chances of successful implementation by having as many facilitating factors in place as possible.The presence of clinical champions has been promoted as one such success factor for patient safety practice change.These clinicians, dubbed "special people" by some authors, are thought by some to be a driving force behind the implementation of a wide range of change initiatives in healthcare settings (Ash et al. 2003).For example, a study of the adoption of safer alternatives to blood transfusion in hospitals found that "the presence of local clinicians who advocated or Abstract Practitioners of patient safety practice change agree that champions are central to the success of implementation.The clinical champion role is a concept that has been widely promoted yet empirically underdeveloped in health services literature.Questions remain as to who these champions are, what roles they play in patient safety practice change and what contexts serve to facilitate their efforts.This investigation used a multiple-case study design to critically examine the role of champions in the implementation of rapid response teams (RRTs), an innovative complex patient safety intervention, in two large urban acute care facilities.An analysis of interviews with key individuals involved in the RRT implementation process revealed a typology of the patient safety practice champion that extended beyond clinical personnel to include managerial and executive staff.Champions engaged to a varying extent in a number of core activities, including education, advocacy, relationship building and boundary spanning.Individuals became champions both through informal emergence and a combination of formal appointment and informal emergence.By identifying and elaborating upon specific features of the champion role, this study aims to expand the dialogue about champions for patient safety practice change.
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Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,022 | 0,047 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,007 | 0,010 |
| Communication savante | 0,007 | 0,005 |
| Science ouverte | 0,002 | 0,007 |
| Intégrité de la recherche | 0,002 | 0,003 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».