Learning From Lawsuits: Using Malpractice Claims Data to Develop Care Transitions Planning Tools.
Learning From Lawsuits: Using Malpractice Claims Data to Develop Care Transitions Planning Tools.
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从诉讼中学习：使用医疗事故索赔数据开发护理过渡规划工具。
DOI：
10.1097/pts.0000000000000238
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发表时间：
2020
影响因子：
2.2
通讯作者：
Boonyasai,Romsai
中科院分区：
文献类型：
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作者：
Arbaje,AliciaI;Werner,NicoleE;Kasda,EileenM;Wu,AlbertW;Locke,CharlesFS;Aboumatar,Hanan;Paine,LoriA;Leff,Bruce;Davis,RichardO;Boonyasai,Romsai
我们对从医院到家庭的护理过渡的理解是不完整的。医疗事故索赔是理解这种转变的重要且未充分使用的数据源。我们使用的医疗事故索赔数据（1）评估安全风险，在护理过渡和（2）帮助开发护理过渡规划工具和试点测试他们的能力，以评估从医院到家庭的护理过渡。MethodsClosed医疗事故索赔进行了分析，为230名成年患者出院4医院网站。利益攸关方参加了2个结构化重点小组，以审查关切问题。这导致了2个护理过渡规划工具的开发-一个用于患者/护理人员，一个用于一线护理提供者。两者都进行了测试的可行性53例discharge.ResultsQualitative分析产生了33个危险因素，对应于医院的工作系统元素，护理过渡过程，护理成果。供应商报告说，该工具易于使用，不会对工作流程产生不利影响。患者报告说，该工具在长度和响应负担方面是可以接受的。患者往往仍在等待信息的时候，他们应用的tool.ConclusionsMalpractice索赔提供的见解，丰富了我们的理解次优的护理过渡和指导发展的护理过渡规划工具。试点测试表明，这些工具在稍加调整后就可以使用。医疗事故数据可以补充其他方法来表征威胁患者安全的系统故障。
ObjectivesOur understanding of care transitions from hospital to home is incomplete. Malpractice claims are an important and underused data source to understand such transitions. We used malpractice claims data to (1) evaluate safety risks during care transitions and (2) help develop care transitions planning tools and pilot test their ability to evaluate care transitions from the hospital to home.MethodsClosed malpractice claims were analyzed for 230 adult patients discharged from 4 hospital sites. Stakeholders participated in 2 structured focus groups to review concerns. This led to the development of 2 care transitions planning tools—one for patients/caregivers and one for frontline care providers. Both were tested for feasibility on 53 patient discharges.ResultsQualitative analysis yielded 33 risk factors corresponding to hospital work system elements, care transitions processes, and care outcomes. Providers reported that the tool was easy to use and did not adversely affect workflow. Patients reported that the tool was acceptable in terms of length and response burden. Patients were often still waiting for information at the time they applied the tool.ConclusionsMalpractice claims provided insights that enriched our understanding of suboptimal care transitions and guided the development of care transitions planning tools. Pilot testing suggested that the tools would be feasible for use with minor adjustment. The malpractice data can complement other approaches to characterize systems failures threatening patient safety.