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Author Eleanor Cox, Alexandra Lang, Giulia Miles, Bryn Baxendale |
| Abstract This project investigates the use and usability of clinical documentation in support and delivery of patient safety in invasive procedures, in line with recent national strategy. This research aimed to understand how well recent National Safety Standards for Invasive Procedures 2 (NatSSIPs 2) is embedded in the endoscopy unit at an acute hospital. Investigating both the sequential steps and the organisational standards, including documentation use and design. Documentation includes policies, Standard Operating Procedures (SOPs), and Clinical Practice Guidelines (CPGs). A case study approach in an endoscopy department combined observation data, expert HFE review and heuristic usability analysis of clinical documentation with data from clinician interviews to elicit understanding about patient safety in this work environment. Findings were analysed against the Systems Initiative Engineering Initiative for Patient Safety 2.0 (SEIPS 2.0) framework. Clinical documentation supporting the safety strategy was largely usable however use and implementation was limited. The steps within the national strategy have to a large extent been integrated into processes and documentation, however qualitative accounts from clinicians disclosed that they are not fully embedded into daily clinical practice. Organisational challenges associated with staff resource and time, engagement and attitudes towards safety procedures/ checklists were a significant barrier to the embedding of the recommended steps from the national strategy. The analysis of experiential staff data coupled with heuristic analysis using a systems model, has resulted in recommendations that can be mapped to organisational structures as well as local work systems to support learning and implementation of patient safety. |
