Patient Safety

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TU_27_3071 - Emoji-based Live Polling During Weekly Incident Report Review Meetings Reveals Wide Ranging Emotions Among Staff

Tuesday, October 23
1:00 PM - 2:30 PM
Location: Innovation Hub, Exhibit Hall 3

Emoji-based Live Polling During Weekly Incident Report Review Meetings Reveals Wide Ranging Emotions Among Staff
B. Eastman1, J. Zeng2, M. B. Spraker1, M. Nyflot1, E. C. Ford3, and P. Hartvigson1; 1University of Washington, Department of Radiation Oncology, Seattle, WA, 2University of Washington Medical Center Department of Radiation Oncology, Seattle, WA, 3University of Washington Medical Center, Seattle, WA

Purpose/Objective(s): Just culture is crucial for effective patient safety. Key components of just culture include flattening of hierarchy and open communication. Little is known about the real-time emotional states of staff members during live-review of patient safety incident reports, which may impact these key cultural components. Emojis are an efficient and effective way to communicate emotional states and are ubiquitous in modern telecommunication. We used an emoji-based real-time survey to characterize staff emotions and correlate them to specific features of incident reports.

Materials/Methods: We developed a web-based live polling tool using emojis representing a modified version of Ekman’s basic emotions (happiness, sadness, embarrassment, anger, surprise, disgust, impatience, fear, and confusion). To report emotions, staff selected emojis on their mobile devices during discussion of each near-miss incident during weekly incident report review meetings. Participants were blinded to poll results and included physicians, medical physicists, dosimetrists, radiation therapists, and nurses. Staff position, incident severity, and potential contributing factors discussed in the meeting were recorded independently. Univariate analysis was performed to analyze the relationship between reporting staff position, severity, contributing factors, and reported emotions. All non-happy emotions were considered negative. Results: 54 incident reports were discussed during 5 consecutive weekly incident report review meetings. The mean number of participants per poll was 6 and the average number of reported emotions during each event was 3. Participants most commonly reported feeling happy with the discussion (59%). Only 13% of reports had an unanimous emotional response. There was no association between reported emotion and reporting staff position (p=0.72) or severity of safety event (p=0.81). Certain contributing factors were enriched in incident reports with more negative emotions. Incidents that had >50% negative emotions were more likely to be associated with patient delays (21%), patient setup (17%), and simulation (17%). The most common contributing factor to error was communication (25% overall), but it was not associated with more negative emotions (p=0.2).

Conclusion: An emoji-based live poll found that staff report a wide range of emotions while reviewing incident reports. Staff most commonly reported negative emotions for particular categories of incidents, specifically patient setup, simulation, and delays, even though these were not the most common type of incident. Emoji-based surveys may be a helpful tool to identify emotionally negative subjects which can then be addressed in a positive collaborative manner, improving just and safety culture.

Author Disclosure: B. Eastman: None. J. Zeng: None. M.B. Spraker: None. M. Nyflot: None. E.C. Ford: Research Grant; National Cancer Institute (NCI). Board of directors member; AAPM. P. Hartvigson: None.

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