Targeting Interventions to Reduce Errors

患者安全运动的发展势头提供了一个重要的机会，可以突出问题并合作改善患者的治疗效果。然而，可能很难就错误何时发生达成一致意见，更难的是制定可行的、成本效益高的系统性预防方法。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“定向干预以减少错误”（TITRE）突出了一个共同的重点是确定有效的方法，以减少通过定向错误。 “有针对性”一词体现了我们的决心，即确保我们将有限的时间和精力用于影响最大的问题，以及干预措施可能产生最大效益的问题。作为一个必然的结果，这种方法需要有能力在研究问题时识别出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反应能力饱和。TITRE DCERPS包括具有各种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。我们有八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。我们的规划阶段涉及多项战略和举措，包括围绕特定项目“提案请求”组织的一系列务虚会，以及一系列与我们的研究目标特别相关的患者安全相关主题。我们将邀请来自行业和非临床学术领域的医疗内容专家和减少错误专家参与。前者提出问题，后者提出解决方案。我们亦会成立一个跨专业的策划委员会，成员包括医学以外各学科的代表。我们相信，我们沿着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著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.