Multi-Method Proactive Risk Assessment

多方法主动风险评估

• 批准号: 7363467
• 负责人: Wilson Douglas Pace
• 金额: $ 19.99万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-01 至 2009-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7363467
• 关键词: Multi; Method; Proactive; Risk; Assessment

DESCRIPTION (provided by the applicant): Despite increased attention to the safety of the medical system over the past 5 to 10 years, clear evidence of improvements in safety has been sporadic. Selected institutions appear to have made great gains in specific areas. While technology offers much to improve safety, human factors failures in well intended systems have been repeatedly noted. The national movement towards a safer health care system continues to have strong support from the Federal government and the Agency for Healthcare Research and Quality (AHRQ), but it has become apparent that much still needs to be done at the local level. Organizations cannot expect that the work of others will automatically translate to safer care across the entire healthcare system. The inpatient component of the health care system has received the most attention in understanding the source of errors and interventions to improve care. Nonetheless, in any given month approximately one quarter of the American public are seen in an ambulatory care facility while approximately 1% will be cared for in the inpatient setting. Furthermore, errors in ambulatory care have been well documented. Thus, the need for a safer ambulatory system is clear. Developing interventions to reduce errors and harm requires local information concerning not only system failures but also local care processes, practice level readiness to change, and a commitment to the provision of safe care at all levels of an institution. The specific aims of the project are to: 1) Collect practice level data using the instruments listed below from 12 University of Colorado Hospital (UCH) ambulatory clinics to help inform a proactive risk analysis: a) AHRQ Medical Office Survey on Healthcare Quality and Patient Safety; b) AHRQ-supported Office Vital Signs instrument; c) Medical Group Management Association's office risk assessment instrument; and d) Proactive risk assessment through a visual process map and group reflection; 2) Analyze data from UCH-specific two ambulatory error database to corroborate specific ambulatory high risk areas identified in Aim 1; and 3) Develop a data driven risk reduction plan for one of three areas (laboratory management, imaging management, medication management) using participatory methods within the UCH ambulatory system using a Strengths, Weaknesses, Opportunities, Threats (SWOT) analysis.

描述（由申请人提供）：尽管在过去5至10年中对医疗系统的安全性越来越关注，但安全性改善的明确证据零星存在。选定的机构似乎在具体领域取得了很大进展。虽然技术可以大大提高安全性，但人们一再注意到，在设计良好的系统中，人为因素会导致故障。国家朝着更安全的医疗保健系统的运动继续得到联邦政府和医疗保健研究和质量机构（AHRQ）的大力支持，但很明显，在地方一级仍有许多工作要做。组织不能指望其他人的工作会自动转化为整个医疗保健系统的更安全的护理。在了解错误来源和改善护理的干预措施方面，医疗保健系统的住院部分受到了最多的关注。尽管如此，在任何一个月，大约四分之一的美国公众在门诊护理机构就诊，而大约1%的人在住院治疗。此外，门诊护理中的错误也有很好的记录。因此，对更安全的流动系统的需求是明确的。制定干预措施，以减少错误和伤害，需要当地的信息，不仅涉及系统故障，但也当地的护理过程，实践水平的变化准备，并承诺在各级机构提供安全的护理。该项目的具体目标是：1）使用下列工具从12所科罗拉多大学医院（UCH）门诊诊所收集实践层面的数据，以帮助进行主动风险分析：a）AHRQ医疗办公室医疗质量和患者安全调查; B）AHRQ支持的办公室生命体征工具; c）医疗集团管理协会的办公室风险评估工具; 2）分析来自UCH特定的两个流动错误数据库的数据，以证实目标1中确定的特定流动高风险领域;和3）为三个领域之一制定数据驱动的风险降低计划（实验室管理，影像管理，药物管理）使用UCH门诊系统内的参与式方法，使用优势，劣势，机会，威胁（SWOT）分析。