Ambulatory Patient Safety of Clients in Treatment for Substance Abuse

描述(由应用程序提供)：许多安全问题围绕成瘾者的门诊药物滥用治疗。接受化学依赖治疗的人通常有共同发生的心理和身体健康问题。针对这些疾病的多种药物可能会由不同的提供者开出。当多个提供者开出处方时，很容易发生用药错误，这些提供者的数据有限或没有共同之处。这些考虑很重要，因为在美国有100多万人获得了 每年的药物滥用治疗主要是在门诊项目中。大多数药物滥用治疗 服务是在公共部门项目中提供的，这些项目通常缺乏复杂的信息技术。 此外，少数群体成员和低收入个人等优先人群 代表人数过多。然而，主动的风险评估方法很少被应用于 为药物滥用治疗客户提供服务的系统。拟议的项目将为在大型公共部门学术卫生保健系统内的成瘾项目、心理健康诊所和初级保健提供者之间过渡的客户进行风险评估。首先，将制定一份流程图，跟踪患者从进入成瘾治疗计划到在精神卫生机构和初级保健诊所进行随访的过渡。其次，流程图将通过与利益相关者的访谈和焦点小组进行验证，以确保准确表示客户信息交换和识别对患者安全构成威胁的节点。利益相关者将包括客户、提供者(成瘾、心理健康和初级保健)、接待员、办事员、计费人员和管理员。第三，关键的线人访谈和记录审查将产生不良事件的例子，重点是用药错误。第四，工作人员将进行“走查”，以验证流程图并查明对患者安全的潜在威胁。第五，将使用根本原因分析来检查改进的流程图和不良事件的实例，以了解错误的来源。第六，将修改调查工具，以解决实质性问题 滥用治疗并被用来衡量为有化学依赖的客户提供的服务周围的安全氛围。拟议的规划项目将为干预措施以及确定干预措施是否成功的方法奠定基础。

DESCRIPTION (provided by the application): Numerous safety concerns surround outpatient substance abuse treatment for people with addictions. People in treatment for chemical dependency often have co-occurring mental and physical health problems. Multiple medications aimed at these disorders may be prescribed by assorted providers. Medication errors can easily occur when prescriptions are written by multiple providers acting with limited or no data in common. These considerations are important because more than a million people in the United States obtain substance abuse treatment each year chiefly in outpatient programs. Most substance abuse treatment services are delivered in public sector programs that typically lack sophisticated information technology. Moreover, priority populations such as minority group members and low-income individuals are greatly over-represented. However, proactive risk assessment methods have rarely if ever been applied to the systems serving substance abuse treatment clients. The proposed project will address risk assessment for clients who make transitions among addiction programs, mental health clinics, and primary care providers within a large public-sector academic health care system. First, a process map will be developed tracking patient transitions from entry into the addiction treatment program through follow-up at mental health facilities and primary care clinics. Second, the process map will be authenticated via interviews and focus groups with stakeholders in order to secure accurate representation of client information exchange and identification of nodes that represent threats to patient safety. Stakeholders will include clients, providers (addiction, mental health, and primary care), receptionists, clerical staff, billing personnel, and administrators. Third, key informant interviews and record reviews will generate examples of adverse events with emphasis on medication errors. Fourth, staff will conduct "walk-throughs" to validate the process map and pinpoint potential threats to patient safety. Fifth, the refined process map and the examples of adverse events will be examined using root cause analysis in order to understand sources of errors. Sixth, survey instruments will be modified to address substance abuse treatment and employed to measure the safety climate surrounding services for clients with chemical dependency. The proposed planning project will set the stage for interventions as well as methodology to determine whether they are successful.