Changing Practice in Gastrointestinal Endoscopy: Reducing Distractions for Patient Safety.

Abstract

Failure in communication during the process of delivering healthcare can have dangerous repercussions. Specifically, failure in interdisciplinary team communication contributes to lapses in patient care. Distractions in procedural areas disrupt team communication. Application of a structured communication algorithm creates agreed-upon cues that promote team communication and facilitate clinical decision making. Frequent disruptions before, during, and after gastro-intestinal endoscopy procedures place veterans at risk for an error. A hierarchical culture promotes intimidation and reduces the likelihood that staff will speak up for patient safety. An endoscopy procedure area implemented a "sterile cockpit" methodology to reduce the number of distractions during procedures. Data collected from a self-reported safety awareness were measured by two different questionnaires and collected through observation of actual practice. Improved awareness of distraction and the impact on patient safety was reported, with a reduction from 24 observed interruptions to zero in 9 months. After reducing distractions in the procedural area, there is a perception of improved nursing quality of care. Additional support is required to consistently remove electronic distractions during a procedure.