Ambulatory Patient Safety of Clients in Treatment for Substance Abuse

药物滥用治疗中客户的门诊患者安全

• 批准号: 7363485
• 负责人: BENTSON H MCFARLAND
• 金额: $ 19.77万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 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/7363485
• 关键词: Ambulatory; Patient; Safety; Clients; Treatment

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.

描述（由应用程序提供）：许多安全问题围绕着成瘾者的门诊药物滥用治疗。 接受化学药物依赖治疗的人通常会同时出现精神和身体健康问题。 针对这些疾病的多种药物可能由各种供应商开出。当处方由多个提供者撰写时，很容易发生用药错误，这些提供者的共同数据有限或没有共同数据。这些考虑很重要，因为美国有100多万人获得 药物滥用治疗，每年主要是在门诊计划。大多数药物滥用治疗 服务是在公共部门的方案中提供的，这些方案通常缺乏先进的信息技术。 此外，少数群体成员和低收入个人等优先群体受到很大影响。 过度代表。然而，积极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。拟议的项目将解决在大型公共部门学术医疗保健系统内在成瘾计划，心理健康诊所和初级保健提供者之间过渡的客户的风险评估。首先，将制定一个过程图，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认证，以确保准确表示客户信息交换和识别代表患者安全威胁的节点。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，计费人员和管理人员。第三，关键知情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“步行检查”，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检查改进的流程图和不良事件示例，以了解错误来源。第六，将修改调查文书，以处理实质问题 滥用治疗，并用于衡量为有化学品依赖的客户提供服务的安全环境。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。