Improved Patient Safety With Information Technology

我们建议使用一个完善的临床信息系统来识别18个实践中门诊病人护理错误的“指标”，这些实践是基于实践的研究网络（ResNet）的一部分。由专科医生、普通内科医生和护士组成的临床重点小组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，以确定交付系统中可能减少“指标”的变化。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，我们建议对交付系统中的这一特定变化进行前瞻性测试。我们还将测试向医生提供汇总指标数据以及“学术细节”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”的数量。

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.