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Journal Article > Commentary
Development of "SWARM" as a model for high reliability, rapid problem solving, and institutional learning.
Williams EA, Nikolai DA, Ladwig L, Miller C, Fredeboelling E. Jt Comm J Qual Patient Saf. 2015;41:508-513.
Rapid teamwork has been highlighted as a mechanism to enhance response to patient deterioration, assess incidents, improve team feedback, and support high reliability. This commentary discusses the development and implementation of the SWARM tool—a unit-based mechanism to rapidly analyze problems and develop solutions—in a pediatric intensive care unit. The authors detail the results of the initiative and provide materials to enable organizations to implement a similar program.
Journal Article > Study
Does patient-centered design guarantee patient safety?: Using human factors engineering to find a balance between provider and patient needs.
France DJ, Throop P, Walczyk B, et al. J Patient Safety. 2005;1:145-153.
This study evaluated the impact of a newly designed children's hospital on patient safety and job function. The investigators begin with a detailed discussion of the contextual factors involved in their hospital redesign, drawing on human factors approaches in safety interventions. They follow by presenting their hospital design process, sharing both unit and floor layouts aimed to ensure family-centered ideals. Results from the 270 clinical faculty and staff surveys suggested that the majority reported a better overall new facility, more efficient information and patient flow, and high ratings for work environment factors such as lighting and equipment availability. However, providers in intensive care settings expressed concern about the negative impact new designs played in team communications, rates of interruptions, and work processes. As perhaps expected, the findings demonstrated many benefits and some unanticipated consequences of the redesign efforts but ultimately reinforced the need for human factors expertise.
Bostock L, Bairstow S, Fish S, Macleod F. London, England: Social Care Institute for Excellence; 2005. ISBN: 1904812279.
This report suggests that a systems approach to child social services in Great Britain would facilitate a fair and open culture and encourage learning from near misses.