Five years after to err is human - What have we learned?
Five years after to err is human - What have we learned?
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DOI：
10.1001/jama.293.19.2384
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发表时间：
2005-05-18
影响因子：
120.7
通讯作者：
Berwick, DM
中科院分区：
文献类型：
--
作者：
Leape, LL;Berwick, DM
五年前，医学研究所（IOM）呼吁全国努力确保医疗保健安全。尽管自那时以来进展缓慢，但IOM的报告真正“改变了对话”，将重点放在了改变系统上，激励了广泛的利益相关者参与患者安全，并激励医院采用新的安全实践。变化的速度可能会加快，特别是在电子健康记录的实施，安全实践的传播，团队培训和受伤后向患者充分披露方面。如果针对的是实际实现高安全水平的医院，按绩效付费可以提供额外的激励。但是，国际移民组织所设想的改善规模需要国家承诺实现严格、雄心勃勃、量化和跟踪良好的国家目标。卫生保健研究和质量机构应该召集所有利益相关者，包括付款人，就2010年前实现的一系列明确而雄心勃勃的患者安全目标达成一致。
Five years ago, the Institute of Medicine (IOM) called for a national effort to make health care safe. Although progress since then has been slow, the IOM report truly "changed the conversation" to a focus on changing systems, stimulated a broad array of stakeholders to engage in patient safety, and motivated hospitals to adopt new safe practices. The pace of change is likely to accelerate, particularly in implementation of electronic health records, diffusion of safe practices, team training, and full disclosure to patients following injury. If directed toward hospitals that actually achieve high levels of safety, pay for performance could provide additional incentives. But improvement of the magnitude envisioned by the IOM requires a national commitment to strict, ambitious, quantitative, and well-tracked national goals. The Agency for Healthcare Research and Quality should bring together all stakeholders, including payers, to agree on a set of explicit and ambitious goals for patient safety to be reached by 2010.