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DESCRIPTION (provided by the applicant): Southwestern Vermont Health Care (SVHC) and five private physician practices serving a rural area propose to reduce medical errors and adverse events through the implementation of an integrated electronic health record. The comprehensive record will be accessible at all participating care delivery sites and to the patient/resident from home. This will include implementation of an electronic patient medical record, electronic medication administration record, computerized physician order entry, and clinical decision support software in physician practices, the medical center, a home health agency and a long-term care facility. SVHC will institute a new Safety Division under the leadership of the project director, who will serve as Chief Medical Safety Officer. By project end it is expected that all partners will use common access to an EHR to ensure high quality care. Key barriers are the cultural changes required for a proactive rather than reactive safety culture, and alignment of goals across and within providers regarding technology implementation. The project goals are: 1) SVHC will demonstrate an increased culture of safety that encourages and supports the reporting of errors and adverse events, near misses and good catches, and feed information back to improve systems safety; 2) Physicians and other health care providers will use a secure, confidential, integrated electronic health record that is accessible from any location and includes all episodes of care from all locations of care among grant partners; and 3) Improve patient safety and quality of care for patients served by partners. A summative evaluation will report on attainment of each of the outcomes listed in the goals and objectives. A formative evaluation will record changes in the safety climate, effectiveness of the e-MAR system; and the framing of key issues among the partners over time. The proposed safety and EHR project is part of a much larger strategic plan at SVHC to implement a wide range of IT tools throughout the health care system.
描述(由申请人提供):西南佛蒙特州医疗保健(SVHC)和五个服务于农村地区的私人医生建议通过实施综合电子健康记录来减少医疗差错和不良事件。综合记录将在所有参与的护理交付站点和患者/住院医师家中访问。这将包括在医生实践、医疗中心、家庭健康机构和长期护理机构中实施电子患者医疗记录、电子药物管理记录、计算机化医嘱输入和临床决策支持软件。高级医疗卫生中心将设立一个新的安全司,由项目主任领导,他将担任首席医疗安全干事。到项目结束时,预计所有合作伙伴将共同使用电子病历,以确保高质量的护理。关键的障碍是主动而非被动的安全文化所需的文化变革,以及供应商之间和内部在技术实施方面的目标一致性。该项目的目标是:1)SVHC将展示一种增强的安全文化,鼓励和支持报告错误和不良事件、未遂事件和良好捕获事件,并反馈信息以提高系统安全性;2)医生和其他医疗保健提供者将使用安全、保密、集成的电子健康记录,该记录可从任何地点访问,并包括资助合作伙伴在所有地点的所有护理事件;3)提高合作伙伴所服务患者的患者安全和护理质量。总结性评价将报告目标和目的中列出的每项成果的实现情况。形成性评估将记录安全环境的变化,e-MAR系统的有效性;以及合作伙伴之间关键问题的框架。拟议的安全和电子病历项目是SVHC在整个医疗保健系统中实施广泛IT工具的更大战略计划的一部分。

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