National EMS Patient Safety Reporting System

描述(由申请人提供)：不存在关于紧急医疗服务(EMS)护理期间发生的错误、险情和不良事件的具体数据。医学研究所最近关于医疗差错的报告发现，在医学专科中，急诊医学(EM)具有最高的可预防不良事件发生率。尽管院前医疗护理尚未被研究，但我们有理由预计，EMS与EM相似，甚至具有更多已知的将EM置于错误风险高风险的特征，也有很高的不良事件发生率。此外，美国每年有2500万名患者接受EMS护理，因此美国公众在这种环境下面临医疗差错风险的风险很大。消除不良事件必须是EMS系统的优先事项，以确保高质量的医疗护理。为了提高EMS患者的安全性，必须对EMS中发生的医疗差错、差错和不良事件的性质有一个清晰的了解。实时事件报告系统是以快速和可靠的方式获取有关此类事件的信息的一种经过验证的有效手段。在包括退伍军人管理局(VA)医院在内的非航空、与健康相关的环境中，仿照成功的航空安全报告系统(ASRS)使用报告系统已被证明有效地发挥了这一作用。医院的几个商业事件报告系统已经变得非常成功。这些系统都不能满足EMS的独特需求，但它们证明了商业系统的需求和商业成功的潜力。医疗差错预防和报告系统(MEPARS)是唯一已知的基于ASRS原则设计的、面向EMS的商业差错报告系统。一个地方的特定机构版本的MEPARS已经在一个EMS机构进行了试点测试，在识别和消除错误方面取得了显著的成功。拟议的第一阶段项目的总体目标是完善和扩展MEPARS，并通过在一个大型城市/郊区EMS系统中实施该系统来测试其可行性。在该项目结束时，基础设施将到位，使MEPARS系统能够在全国范围内轻松实施。由此产生的数据库将使研究人员能够更好地了解EMS中医疗差错的性质，从而设计干预措施和系统变化，将这些差错造成的不良事件降至最低。

DESCRIPTION (provided by applicant): Specific data on errors, near misses, and adverse events occurring during emergency medical services (EMS) care do not exist. The recent Institute of Medicine report on medical error found emergency medicine (EM) to have the highest rate of preventable adverse events among the medical specialties. Although prehospital medical care has not been studied, it is reasonable to expect that EMS, which is similar to EM and has even more of the characteristics that are known to place EM at high risk for error, also has a high rate of adverse events. Moreover, 25 million patients receive EMS care annually in the US, so that the exposure of the US public to risk of medical error in this environment is substantial. Eliminating adverse events must be a priority for EMS systems to ensure quality medical care. To improve patient safety in EMS a clear understanding of the nature of the medical errors, near misses, and adverse events that occur in EMS must be developed. Real-time event reporting systems represent one proven and effective means of acquiring information about such events in a rapid and reliable fashion. Use of a reporting system modeled after the successful Aviation Safety Reporting System (ASRS) has been demonstrated to be effective in this role in non-aviation, health-related settings including Veterans' Administration (VA) hospitals. Several commercial event reporting systems for hospitals have become very successful. None of these systems satisfy the unique needs of EMS, but they serve as evidence that there is a need for commercial systems and potential for commercial success. The Medical Error Prevention and Reporting System (MEPARS) is the only known commercial error reporting system designed on the principles of the ASRS and targeted for EMS. A local, agency-specific version of MEPARS has been pilot tested at one EMS agency, with notable successes in identifying and eliminating errors. The overall objective of the proposed Phase I project is to refine and expand MEPARS and test its feasibility by implementing the system in a large urban/suburban EMS system. At the conclusion of this project, an infrastructure will be in place that will allow the MEPARS system to easily be implemented nationwide. The resulting database will allow researchers to gain a better understanding of the nature of medical error in EMS, and thus design interventions and system changes to minimize adverse events as a result of these errors.