Improved Patient Safety With Information Technology

我们建议使用一个完善的临床信息系统，以确定“指标”的错误，在门诊病人护理的18个做法的一部分，基于实践的研究网络（ResNet）。包括专科医生、普通内科医生和护士在内的临床焦点团队将使用根本原因和多维探索性数据分析方法分析这些指标数据，以确定可能降低“指标”的输送系统变化。由于临床决策支持系统（CDSS）在改变医生行为方面的有效性已得到证实，因此我们建议前瞻性地测试输送系统中的这种特定变化。我们还将测试将汇总的指标数据与“学术细节”一起沿着给医生的价值，以及这种变化与CDSS之间的协同作用。主要结果将是从临床信息系统中确定的“指标”数量。

We propose to use a well-established clinical information system to identify "indicators" of errors in ambulatory patient care in 18 practices which are part of a practice based research network (ResNet). A clinical focus team, including a specialty physician, general internist and nurse, will analyze these indicator data using root cause and multidimensional exploratory data analysis methods to identify changes in the delivery system that can potentially reduce the "indicators". Because of the demonstrated effectiveness of clinical decision support systems (CDSS) in changing physician behavior, we propose to prospectively test this specific change in the delivery system. We will also test the value of delivering summarized indicator data to the physicians along with "academic detailing" and the synergies between this change with CDSS. The primary outcome will be the number of "indicators" identified from the clinical information system.