Mixed-Methods Evaluation of Real-Time Safety Reporting by Hospitalized Patients and Their Care Partners: The MySafeCare Application.
Mixed-Methods Evaluation of Real-Time Safety Reporting by Hospitalized Patients and Their Care Partners: The MySafeCare Application.
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DOI：
10.1097/pts.0000000000000493
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发表时间：
2020-06
影响因子：
2.2
通讯作者：
Bates DW
中科院分区：
文献类型：
--
作者：
Collins SA;Couture B;Smith AD;Gershanik E;Lilley E;Chang F;Yoon C;Lipsitz S;Sheikh A;Benneyan J;Bates DW
与其他报告机制相比，评估患者和护理伙伴使用实时电子安全工具报告的数据数量和内容，并了解他们对医院安全问题和报告的看法。混合方法研究包括20个月的实施前和实施后试验，评估MySafeCare，一个基于网络的应用程序，允许住院患者/护理伙伴实时报告安全问题。比较三个医院单位（肿瘤急症护理、血管中级护理、医疗重症护理）的MySafeCare提交率与患者家属关系（PFR）部门的提交率，PFR是一项解决患者/家庭问题的医院服务。对提交的安全问题进行专题分析，并对患者/护理伙伴进行访谈，对定量数据进行三角测量，以了解提交的内容和对安全报告的看法。收到32份MySafeCare提交的申请，平均每1000患者日提交1.7份申请，所有单位每1000患者日提交0.3至4.8份申请，表明各单位之间存在显着差异。干预后血管单元的MySafeCare提交率显著高于PFR提交率（4.3 [95% CI 2.8 - 6.5]对1.5 [95% CI 0.7 - 3.1]，泊松）（P=0.01）。总体趋势表明，在MySafeCare实施后，PFR提交量有所下降。三角数据表明，患者倾向于匿名报告，不希望直接向他们的护理团队提交担忧。MySafeCare的评估证实了在医院提供电子匿名报告工具以实时捕捉安全问题的潜在价值。此类应用应作为患者安全计划的一部分进行进一步测试。
To evaluate the amount and content of data patients and carepartners reported using a real-time electronic safety tool compared to other reporting mechanisms, and understand their perspectives on safety concerns and reporting in the hospital. Mixed-methods study including 20 month pre- and post-implementation trial evaluating MySafeCare, a web-based application which allows hospitalized patients/carepartners to report safety concerns in real-time. Comparison of MySafeCare submission rates for three hospital units (oncology acute care; vascular intermediate care; medical intensive care) to submissions rates of Patient Family Relations (PFR) Department, a hospital service to address patient/family concerns. Triangulation of quantitative data with thematic analysis of safety concern submissions and patient/carepartner interviews to understand submission content and perspectives on safety reporting. Thirty-two MySafeCare submissions were received with an average rate of 1.7 submissions per 1,000 patient-days and a range of 0.3 to 4.8 submissions per 1,000 patient-days across all units, indicating notable variation between units. MySafeCare submission rates were significantly higher than PFR submission rates during the post-intervention period on the vascular unit (4.3 [95% CI 2.8 – 6.5] versus 1.5 [95% CI 0.7 – 3.1], Poisson) (P=0.01). Overall trends indicated a decrease in PFR submissions after MySafeCare implementation. Triangulated data indicated patients preferred to report anonymously and did not want concerns submitted directly to their care team. MySafeCare evaluation confirmed the potential value of providing an electronic, anonymous reporting tool in the hospital to capture safety concerns in real-time. Such applications should be tested further as part of patient safety programs.