Who is Being Assessed or Evaluated?:
Observer-based (e.g., rubric, rating tool, 360 degree feedback)
Notes for Type:
This is an onsite (in situ) observational tool.
Source of Data:
Health care providers, staff
Notes for Data Sources:
Physicians, nurses, and nonclinical patient safety/quality improvement specialists have been used as observers.
Notes for Content:
Behaviors in four domains are rated by the observers:
- Situation awareness
Raters also record the date, start time, end time, and procedure being observed.
21 behaviors are rated; time varies with the scenario being rated.
Behaviors are marked in rows each time they occur and are rated for quality in columns labeled “Observed and Good,” “Variation in Quality” (meaning incomplete or of variable quality), and “Expected but not Observed.”
A glossary of behavior definitions is provided, and scores should reflect the degree to which behaviors match the definition. If two or more observers are used, a pre-observation checklist and review of glossary definitions is recommended. When in the operating room, observers should stand watching, listening, and taking notes, without interacting with staff. Feedback can then be provided to the surgeons, preoperative nursing directors, and chair of anesthesia. The tool has been administered in gastric bypass surgery, interdisciplinary rounds, and cesarean sections.
For each behavior, marks in the “Observed and Good” category are assigned a 1, marks in the “Variation in Quality” category are assigned .5, and those in the “Expected but not Observed” category are assigned a 0. The sum of these weighted marks divided by the total number of marks made is then adjusted to a 100 point scale. The scores for each behavior can then be averaged to create scores for the four domains or the total measure.
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