Alex Fauer1, Nathan Wright2, Megan Lafferty3, Molly Harrod4, Milisa Manojlovich5, Christopher R Friese2,6,7. 1. National Clinician Scholars Program, Division of General Internal Medicine and Health Services Research, School of Medicine, 8783University of California, Los Angeles, CA, USA. 2. Center for Improving Patient and Population Health, 16121School of Nursing, University of Michigan, Ann Arbor, MI, USA. 3. VA 94676Portland Health Care System, OR, USA. 4. 20034VA Ann Arbor Health Care System, MI, USA. 5. 16121School of Nursing, University of Michigan, Ann Arbor, MI, USA. 6. Rogel Cancer Center, Ann Arbor, MI, USA. 7. 16121School of Public Health, University of Michigan, Ann Arbor, MI, USA.
Abstract
OBJECTIVE: To examine how physical layouts and space in ambulatory oncology practices influence patient safety and clinician communication. BACKGROUND: Ambulatory oncology practices face unique challenges in delivering safe care. With increasing patient volumes, these settings require additional attention to support patient safety and efficient clinical work processes. METHODS: This study used a mixed methods design with sequential data collection. Eight ambulatory oncology practices (of 29 participating practices) participated in both the quantitative and qualitative phases. In surveys, clinicians (n = 56) reported on safety organizing and communication satisfaction measures. Qualitative data included observations and semistructured interviews (n = 46) with insight into how physical layout influenced care delivery. Quantitative analysis of survey data included descriptive and correlational statistics. Qualitative analysis used inductive and thematic content analysis. Quantitative and qualitative data were integrated using side-by-side comparison tables for thematic analysis. RESULTS: Safety organizing performance was positively correlated with clinician communication satisfaction, r(54 df) = .414, p = .002. Qualitative analyses affirmed that the physical layout affected communication around chemotherapy infusion and ultimately patient safety. After data integration, safety organizing and clinician communication were represented by two themes: visibility of patients during infusion and the proximity of clinicians in the infusion center to clinicians in the clinic where providers see patients. CONCLUSIONS: Physical layouts of ambulatory oncology practices are an important factor to promote patient safety. Our findings inform efforts to construct new and modify existing infusion centers to enhance patient safety and clinician communication.
OBJECTIVE: To examine how physical layouts and space in ambulatory oncology practices influence patient safety and clinician communication. BACKGROUND: Ambulatory oncology practices face unique challenges in delivering safe care. With increasing patient volumes, these settings require additional attention to support patient safety and efficient clinical work processes. METHODS: This study used a mixed methods design with sequential data collection. Eight ambulatory oncology practices (of 29 participating practices) participated in both the quantitative and qualitative phases. In surveys, clinicians (n = 56) reported on safety organizing and communication satisfaction measures. Qualitative data included observations and semistructured interviews (n = 46) with insight into how physical layout influenced care delivery. Quantitative analysis of survey data included descriptive and correlational statistics. Qualitative analysis used inductive and thematic content analysis. Quantitative and qualitative data were integrated using side-by-side comparison tables for thematic analysis. RESULTS: Safety organizing performance was positively correlated with clinician communication satisfaction, r(54 df) = .414, p = .002. Qualitative analyses affirmed that the physical layout affected communication around chemotherapy infusion and ultimately patient safety. After data integration, safety organizing and clinician communication were represented by two themes: visibility of patients during infusion and the proximity of clinicians in the infusion center to clinicians in the clinic where providers see patients. CONCLUSIONS: Physical layouts of ambulatory oncology practices are an important factor to promote patient safety. Our findings inform efforts to construct new and modify existing infusion centers to enhance patient safety and clinician communication.
Authors: Yu-Li Huang; Alan H Bryce; Tracy Culbertson; Sarah L Connor; Sherry A Looker; Kristin M Altman; James G Collins; Winston Stellner; Robert R McWilliams; Alvaro Moreno-Aspitia; Sikander Ailawadhi; Ruben A Mesa Journal: J Oncol Pract Date: 2017-12-22 Impact factor: 3.840
Authors: Bróna Nic Giolla Easpaig; Yvonne Tran; Teresa Winata; Klay Lamprell; Diana Fajardo Pulido; Gaston Arnolda; Geoff P Delaney; Winston Liauw; Kylie Smith; Sandra Avery; Kim Rigg; Johanna Westbrook; Ian Olver; David Currow; Jonathan Karnon; Robyn L Ward; Jeffrey Braithwaite Journal: BMC Health Serv Res Date: 2022-02-12 Impact factor: 2.655