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JMED 2024, 16(52): 27-36 |
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Ethics code: (IEC/ HMPCMCE/ 114/faculty 13, 7/08/2020)
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Mehta T, Patel S, Kumar A, Trivedi B, Ganjiwale J, Chaudhary M et al . Development, implementation, and evaluation of structured Performa in the initial assessment of sick children at the emergency department: A third level Kirkpatrick’s evaluation model. JMED 2024; 16 (52) :27-36
URL: http://edujournal.zums.ac.ir/article-1-1899-en.html
URL: http://edujournal.zums.ac.ir/article-1-1899-en.html
Tanvi Mehta 
, Shradha Patel , Amit Kumar , Bhadra Trivedi , Jaishree Ganjiwale , Manoj Chaudhary , Krutika Tandon *
, Shradha Patel , Amit Kumar , Bhadra Trivedi , Jaishree Ganjiwale , Manoj Chaudhary , Krutika Tandon *
Professor and Head, Department of Pediatrics, Pramukhswami Medical college, Bhaikaka university, Karamsad, Gujarat
Abstract: (1117 Views)
Background & Objective: At emergency department (ED) at different point of time different teams are involved in management of patients as per their posting/duty roster. So, a robust system should be in place to avoid major mishaps. The current study was an attempt to improve pediatric care at our Emergency Department through third-level Kirkpatrick’s evaluation model after training of pediatric resident doctors to use newly developed structured proforma while doing initial assessment of sick children at ED.
Materials & Methods: This Quasi-experimental study included all departmental pediatric resident doctors and as per sample size calculation, 36 (pre-intervention) and 36 (post-intervention) computer-generated random selection records were reviewed from the total of serially arranged admissions of pediatric patients. The intervention was the implementation of a Structured proforma, and training of all departmental residents. All raters scored the records of patients on 47 & 51 items of documentation pre-and post-intervention periods respectively on a scale 0-2, 0 meaning ‘no mention’, 1-incomplete/improper mention and 2-complete/proper mention. Mean, standard deviation (SD) of scores were calculated item-wise, raters-wise and overall. Bland Altman analysis was done to find agreement in scoring among raters both in pre-and post-intervention.
Results: The mean (SD) and percentage of mean score were 32.93 (4.50) and 35.03% before intervention whereas 89.64 (4.35) and 87.88% post-intervention. This indicated 53.5% improvement post-intervention. Bland Altman analysis found good agreement post-intervention.
Conclusion: The introduction of Educational tool along with the training of pediatric resident doctors to implement it, has improved documentation process significantly.
Materials & Methods: This Quasi-experimental study included all departmental pediatric resident doctors and as per sample size calculation, 36 (pre-intervention) and 36 (post-intervention) computer-generated random selection records were reviewed from the total of serially arranged admissions of pediatric patients. The intervention was the implementation of a Structured proforma, and training of all departmental residents. All raters scored the records of patients on 47 & 51 items of documentation pre-and post-intervention periods respectively on a scale 0-2, 0 meaning ‘no mention’, 1-incomplete/improper mention and 2-complete/proper mention. Mean, standard deviation (SD) of scores were calculated item-wise, raters-wise and overall. Bland Altman analysis was done to find agreement in scoring among raters both in pre-and post-intervention.
Results: The mean (SD) and percentage of mean score were 32.93 (4.50) and 35.03% before intervention whereas 89.64 (4.35) and 87.88% post-intervention. This indicated 53.5% improvement post-intervention. Bland Altman analysis found good agreement post-intervention.
Conclusion: The introduction of Educational tool along with the training of pediatric resident doctors to implement it, has improved documentation process significantly.
Article Type : Orginal Research |
Subject:
Medical Education
Received: 2023/03/31 | Accepted: 2023/08/8 | Published: 2024/03/16
Received: 2023/03/31 | Accepted: 2023/08/8 | Published: 2024/03/16
References
1. Macias CG. Quality improvement in pediatric emergency medicine. Academic Pediatrics. 2013 Nov 1; 13(6): S61-8. [DOI]
2. Borland ML, Shepherd M. Quality in paediatric emergency medicine: Measurement and reporting. Journal of Pediatrics and Child health. 2016 Feb; 52(2): 131-6. [DOI]
3. Moy AJ, Schwartz JM, Chen R et al. Measurement of clinical documentation burden among physicians and nurses using electronic health records: a scoping review. Journal of the American Medical Informatics Association. 2021 May; 28(5): 998-1008. [DOI]
4. Fouquet SD, Fitzmaurice L, Chan YR et al. Doctors documenting: an ethnographic and informatics approach to understanding attending physician documentation in the pediatric emergency department. Journal of the American Medical Informatics Association. 2021 Feb 15; 28(2): 239-48. [DOI]
5. Kirkpatrick JD, Kirkpatrick WK. Kirkpatrick's four levels of training evaluation. Association for Talent Development; 2016 Oct 1. [ISBN: 9781607280088] [Article]
6. Alhassan AI. Implementing faculty development programs in medical education utilizing kirkpatrick’s model. Advances in Medical Education and Practice. 2022 Jan 1: 945-54. [DOI] [PubMed]
7. Holt N, Crowe K, Lynagh D et al. Is there a need for formal undergraduate patient handover training and could an educational workshop effectively provide this? A proof-of-concept study in a Scottish Medical School. BMJ Open. 2020 Feb 1; 10(2): e034468. [Article] [DOI]
8. Rouse M, Jones M, Zogleman B et al. Resident integration with inpatient clinical documentation improvement: a quality improvement project. BMJ Open Quality. 2022 Jun 1; 11(2): e001300. [DOI]
9. Nyman SJ, Vogel ME, Heller GM et al. Development and evaluation of a health behavior change clinic in primary care: an interdisciplinary partnership. Journal of Clinical Psychology in Medical Settings. 2023 Mar 4: 1-5. [DOI]
10. Mizumoto J, Son D, Izumiya M et al. Experience of residents learning about social determinants of health and an assessment tool: Mixed‐methods research. Journal of General and Family Medicine. 2022 Sep; 23(5): 319-26. [DOI]
11. Tan XH, Foo MA, Lim SL et al. Teaching and assessing communication skills in the postgraduate medical setting: a systematic scoping review. BMC Medical Education. 2021 Dec; 21: 1-9. [DOI]
12. Gordon M, Hill E, Stojan JN et al. Educational interventions to improve handover in health care: an updated systematic review. Academic Medicine. 2018 Aug; 93(8): 1234. [DOI] [PubMed]
13. Rodenbarger AL, Maa T, Chase M et al. Effectiveness of pediatric fundamentals of critical care support (PFCCS) in enhancing resident self-efficacy and skills. Academic Pediatrics. 2016 Aug 1;16(6): e54. [Article] [DOI]
14. Mejίa R, Fields A, Greenwald BM et al. Pediatric fundamental critical care support (PFCCS). 2nd ed. Mount Prospect, IL (USA): Society of Critical Care Medicine, 2011: 1-17 [ISBN: 978-1-620750-09-4] [Google Scholar]
15. Khilnani P, Uttam R, Chugh K. Manual of basic pediatric intensive care course.3rd ed. New Delhi: IAP Intensive Care Chapter, 2015: 1-8. [Article]
16. Jayashree M, Kulgod V, Sharma AK. IAP ALS handbook. New Delhi: Iap, national publication house, 2018: 10-27.
17. Karunakara BP, Shrivastav K, Buche V et al. Manual of essential pediatric intensive care course. New Delhi: IAP Intensive Care Chapter, 2017: 1-13.
18. Travers DA, Waller AE, Katznelson J et al. Reliability, and validity of the emergency severity index for pediatric triage. Academic Emergency Medicine. 2009 Sep; 16(9): 843-9. [Article] [DOI]
19. Mistry B, De Ramirez SS, Kelen G et al. Accuracy and reliability of emergency department triage using the emergency severity index: an international multicenter assessment. Annals of Emergency Medicine. 2018 May 1; 71(5): 581-7. [DOI]
20. Schumacher DJ, Holmboe ES,Van Der Vleuten C et al. Developing resident-sensitive quality measures: A model from pediatric emergency medicine. Academic Medicine. 2018 Jul 1; 93(7): 1071-8. [DOI]
21. Kalet AL, Gillespie CC, Schwartz MD Bruno JH et al. New measures to establish the evidence base for medical education: identifying educationally sensitive patient outcomes. Academic Medicine. 2010 May 1; 85(5): 844-51. [DOI]
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