Presentation
Healthcare Human Factors Engineering In Practice: The Impact of Changes to the Obstetrical Triage Process in a Perinatal Neonatal Care Setting
DescriptionThe clinical area of obstetrics continues to be an area of high interest in terms of safety and medico-legal risk in Canada. Human factors informed safety practices and continuous evaluation present the opportunity to improve patient safety through the design of the obstetrical triage process. This presentation, facilitated by human factors and clinical practitioners, will provide practical considerations (successes, challenges, opportunities) in applying human factors engineering approaches in an applied patient safety initiative to improve the design of the obstetrical triage process in a Canadian perinatal/neonatal care setting.
Details of a patient safety initiative to enhance safety in a perinatal and neonatal care setting at Markham Stouffville Hospital (MSH), part of Oak Valley Health (OVH), a community healthcare organization in Markham, Ontario will be explored. In collaboration with Healthcare Insurance Reciprocal of Canada (HIROC), HIROC and OVH partnered on an initiative to identify opportunities to improve safety in the Childbirth and Children’s Service program at OVH.
In anticipation of significant changes to the triage environment and processes, as well as the inclusion of a new role (i.e., dedicated triage nursing role) OVH and HIROC completed a collaborative quality improvement initiative to better understand opportunities to enhance workflow and workload in obstetrical triage. In-unit observations were used to develop “spaghetti diagrams” to map nurses’ movement throughout the unit and identify opportunities to improve workflow and the physical environment. A spaghetti diagram is a visual representation of a workflow using a continuous flow line tracing the path of activity, to observe and to optimize workflow. As well, data on self-perceived workload assessment was collected using NASA-Task Load Index (NASA-TLX), to better understand changes in perceived task load before and after the change in the triage environment and triage nursing role. 11 nursing participants across three groups based on experience level and role were trained to use NASA-TLX tool and provided their paired comparison weightings of the six dimensions of workload. Participants were asked to self-report their perceived task load after completing their daily work shifts including triage, and labour and delivery for the different nursing levels on the unit. Approximately six months after the changes to the unit were made, data from 11 nursing participants was collected in the post-change data collection phase. The results of the NASA-TLX workload study are currently being analyzed and will be presented.
In addition, the presenters will detail several other quality improvement initiatives in the Childbirth and Children’s Service program aimed at improving sustainability and accountability, towards improving safety for staff and patients. This includes implementation of a standardized assessment tool through mandatory fields in the triage screen to improve compliance and to monitor response times.
Details of a patient safety initiative to enhance safety in a perinatal and neonatal care setting at Markham Stouffville Hospital (MSH), part of Oak Valley Health (OVH), a community healthcare organization in Markham, Ontario will be explored. In collaboration with Healthcare Insurance Reciprocal of Canada (HIROC), HIROC and OVH partnered on an initiative to identify opportunities to improve safety in the Childbirth and Children’s Service program at OVH.
In anticipation of significant changes to the triage environment and processes, as well as the inclusion of a new role (i.e., dedicated triage nursing role) OVH and HIROC completed a collaborative quality improvement initiative to better understand opportunities to enhance workflow and workload in obstetrical triage. In-unit observations were used to develop “spaghetti diagrams” to map nurses’ movement throughout the unit and identify opportunities to improve workflow and the physical environment. A spaghetti diagram is a visual representation of a workflow using a continuous flow line tracing the path of activity, to observe and to optimize workflow. As well, data on self-perceived workload assessment was collected using NASA-Task Load Index (NASA-TLX), to better understand changes in perceived task load before and after the change in the triage environment and triage nursing role. 11 nursing participants across three groups based on experience level and role were trained to use NASA-TLX tool and provided their paired comparison weightings of the six dimensions of workload. Participants were asked to self-report their perceived task load after completing their daily work shifts including triage, and labour and delivery for the different nursing levels on the unit. Approximately six months after the changes to the unit were made, data from 11 nursing participants was collected in the post-change data collection phase. The results of the NASA-TLX workload study are currently being analyzed and will be presented.
In addition, the presenters will detail several other quality improvement initiatives in the Childbirth and Children’s Service program aimed at improving sustainability and accountability, towards improving safety for staff and patients. This includes implementation of a standardized assessment tool through mandatory fields in the triage screen to improve compliance and to monitor response times.
Authors
the Vice President, Clinical Programs and Chief Nurse Executive (CNE)
Event Type
Oral Presentations
TimeTuesday, April 19:37am - 10:00am EDT
LocationQueens Quay
Patient Safety and Research Initiatives (PS)