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、未遂事件和不良事件的具体数据。最近医学研究所关于医疗差错的报告发现，急诊医学（EM）在医学专业中可预防的不良事件发生率最高。虽然尚未研究院前医疗护理，但可以合理预期EMS与EM相似，具有更多已知将EM置于高错误风险的特征，也具有较高的不良事件发生率。此外，在美国，每年有2500万患者接受EMS护理，因此美国公众在这种环境中暴露于医疗错误的风险是巨大的。消除不良事件必须是EMS系统的首要任务，以确保优质医疗护理。为了提高EMS中患者的安全性，必须清楚地了解EMS中发生的医疗错误、未遂事件和不良事件的性质。实时事件报告系统代表了以快速和可靠的方式获取关于此类事件的信息的一种经证实的有效手段。在成功的航空安全报告系统（ASRS）之后，使用报告系统已被证明在非航空、健康相关的环境（包括退伍军人管理局（VA）医院）中发挥这一作用是有效的。几个商业事件报告系统的医院已经变得非常成功。这些系统都不能满足环管系统的独特需要，但它们证明需要有商业系统，并有商业成功的潜力。医疗差错预防和报告系统（MEPARS）是唯一已知的商业差错报告系统，根据ASRS的原则设计，针对EMS。环境管理系统的一个机构专用的地方版本已经在一个环境管理系统机构进行了试点测试，在查明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大MEPARS，并通过在大型城市/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，将建立一个基础设施，使MEPARS系统能够在全国范围内方便地实施。由此产生的数据库将使研究人员能够更好地了解EMS中医疗错误的性质，从而设计干预措施和系统更改，以尽量减少这些错误导致的不良事件。

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.