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个实践中的门诊病人护理失误的“指标”，这些实践是以实践为基础的研究网络(ResNet)的一部分。包括一名专科医生、普通内科医生和护士在内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被证明是有效的，我们建议前瞻性地测试这一特定的递送系统变化。我们还将测试将汇总的指标数据与“学术细节”一起提供给医生的价值，以及这种变化与CDSS之间的协同效应。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.