Targeting Interventions to Reduce Errors

患者安全运动的发展势头为突出问题和合作改善患者预后提供了重要机会。然而，要在错误发生的时候达成一致意见可能是困难的，而制定可行的和成本有效的系统方法来预防错误则更加困难。为了响应医疗保健研究和质量机构的RFA，我们提议建立一个患者安全评估和研究发展中心（DCERPS）。我们中心的名称“靶向干预以减少错误”（TITRE）强调了一个共同的重点，即通过靶向确定有效的方法来减少错误。“目标明确”一词反映了我们致力于确保将有限的时间和精力用于影响最大的问题以及干预措施可能发挥最大作用的问题。作为必然结果，这种方法要求在研究问题时能够识别既具体又常见的模式，并确保改善问题的干预措施不会使系统的响应能力饱和。TITRE DCERPS包括具有广泛研究技能的研究人员，包括卫生服务研究、临床流行病学、医学社会学、运筹学和高可靠性系统、认知心理学、伦理学、医学教育和经济学。我们有8个附属研究单位和组织，包括密歇根大学医学中心、VA国家患者安全中心、加州太平洋卫生系统和圣约瑟夫医疗中心。我们的计划阶段涉及几个策略和举措，包括围绕项目特定的“提案请求”组织的一系列务静会，以及与我们的研究目标特别相关的一系列患者安全相关主题。我们将包括来自工业界和非临床学术领域的医疗内容专家和减少错误的专家。前者提出问题，后者提出解决办法。我们还将成立一个多学科计划委员会，由医学以外各学科的代表组成。我们相信，我们已经确定的研究人员和组织以及提案中概述的战略和举措将使我们能够显着提高我们在患者安全方面的研究能力。

The momentum developed in the patient safety movement presents an important opportunity to highlight problems and work cooperatively to improve patient outcomes. It may be difficult, however, to agree when errors occur, and even more difficult to develop workable and cost- effective systematic approaches to their prevention. In response to an RFA from the Agency for Healthcare Research and Quality, we are proposing a Developmental Center for Evaluation and Research in Patient Safety (DCERPS). The name of our center "Targeting Interventions to Reduce Errors" (TITRE) highlights a common focus on identifying efficient approaches to reduce errors through targeting. The term targeting captures our dedication to ensuring that we spend our limited time and energy on problems that have the greatest impact and where interventions are likely to do the most good. As a corollary, this approach requires the ability to identify patterns that are both specific and common when studying problems and ensuring that interventions to ameliorate problems do not saturate the ability of the system to respond. The TITRE DCERPS includes investigators with a wide variety of research skills including health services research, clinical epidemiology, medical sociology, operations research and high reliability systems, cognitive psychology, ethics, medical education, and economics. We have eight affiliated research units and organizations including the University of Michigan Medical Center, the VA National Center for Patient Safety, the California Pacific Health System, and St. Joseph's Medical Center. Our planning phase involves several strategies and initiatives, including a series of retreats organized around project-specific "Requests for Proposals" and a series of patient safety related topics that are particularly relevant to our research objectives. We will involve both medical content experts and error-reduction specialists from industry and non-clinical academic areas. Problems will be presented by the former and solutions proposed by the latter. We will also have a multi-disciplinary planning committee with representatives from a wide variety of disciplines outside of medicine. We believe that the researchers and organizations that we have identified along with the strategies and initiatives outlined in the proposal will allow us to significantly enhance our research capacity in patient safety.