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Developing Healthcare Team Observations for Patient Safety (HTOPS): senior medical students capture everyday clinical moments

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journal contribution
posted on 2021-09-29, 09:34 authored by ES Anderson, TRL Griffiths, T Forey, F Wobi, RI Norman, G Martin
Background
Aviation has used a real-time observation method to advance anonymised feedback to the front-line and improve safe practice. Using an experiential learning method, this pilot study aimed to develop an observation-based real-time learning tool for final-year medical students with potential wider use in clinical practice.

Methods
Using participatory action research, we collected data on medical students’ observations of real-time clinical practice. The observation data was analysed thematically and shared with a steering group of experts to agree a framework for recording observations. A sample of students (observers) and front-line clinical staff (observed) completed one-to-one interviews on their experiences. The interviews were analysed using thematic analysis.

Results
Thirty-seven medical students identified 917 issues in wards, theatres and clinics in an acute hospital trust. These issues were grouped into the themes of human influences, work environment and systems. Aviation approaches were adapted to develop an app capable of recording real-time positive and negative clinical incidents. Five students and eleven clinical staff were interviewed and shared their views on the value of a process that helped them learn and has the potential to advance the quality of practice. Concerns were shared about how the observational process is managed.

Conclusion
The study developed an app (Healthcare Team Observations for Patient Safety—HTOPS), for recording good and poor clinical individual and team behaviour in acute-care practice. The process advanced medical student learning about patient safety. The tool can identify the totality of patient safety practice and illuminate strength and weakness. HTOPS offers the opportunity for collective ownership of safety concerns without blame and has been positively received by all stakeholders. The next steps will further refine the app for use in all clinical areas for capturing light noise.

Funding

This work was funded by the Wellcome Trust via the University translational funds. Graham Martin’s contribution was supported by The Healthcare Improvement Studies Institute (THIS Institute), University of Cambridge. THIS Institute is supported by the Health Foundation, an independent charity committed to bringing about better health and healthcare for people in the UK.

History

Citation

Pilot Feasibility Stud 7, 164 (2021). https://doi.org/10.1186/s40814-021-00891-3

Author affiliation

Department of Health Sciences, University of Leicester

Version

  • VoR (Version of Record)

Published in

Pilot and Feasibility Studies

Volume

7

Issue

1

Publisher

BMC

issn

2055-5784

eissn

2055-5784

Acceptance date

2021-07-22

Copyright date

2021

Available date

2021-09-29

Language

English

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