Patient Safety in Inpatient Psychiatry

住院精神病学中的患者安全

• 批准号: 7993264
• 负责人: STEVEN C MARCUS
• 金额: $ 56.16万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-20 至 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7993264
• 关键词: Acute; Address; Adverse event; Award; Caring; Characteristics; Clinical; Colorado; Data; Development; Epidemiology; Event; Eye; Foundations; General Hospitals; Goals; Grant; Health Care Costs; Healthcare; Healthcare Systems; Hospital Records; Hospital Units; Hospitals; Incidence; Inpatients; Intervention; Interview; K-Series Research Career Programs; Knowledge; Leadership; Learning; Medicaid; Medical; Medical Errors; Medicine; Mental Health; Mental Health Services; Mental disorders; Methods; Morbidity - disease rate; National Institute of Mental Health; Nature; Operative Surgical Procedures; Outcome; Patient Care; Patient Discharge; Patients; Peer Review; Pennsylvania; Persons; Policies; Prevention strategy; Principal Investigator; Provider; Psychiatry; Public Health; Qualitative Methods; Quality of Care; Research; Review Literature; Safety; Sampling; Seminal; Surveys; Taxonomy; Testing; Time; Utah; Vulnerable Populations; base; clinical care; data collection methodology; evidence base; improved; informant; instrument; mortality; patient population; patient safety; policy implication; prevent; public health relevance; therapy development

DESCRIPTION (provided by applicant): Reducing errors and adverse events have become a central focus of the health care system over the last two decades. However, patients with mental disorders have been systematically excluded from this research. As a result, the epidemiology of patient safety events (adverse events and errors) in hospital based mental health services remains unknown. The current application seeks to assess the incidence, nature and preventability of patient safety events via a record review of 11,000 Medicaid patient medical charts in a random sample of 38 inpatient psychiatric units of general hospitals in Pennsylvania. We will supplement this information with detailed surveys of unit leadership to define the patient, provider, and psychiatric unit/hospital factors that influence, contribute to, and/or protect against the commission of adverse events and/or errors. In-depth qualitative interviews with key informants from ten hospitals will be used to help interpret these quantitative findings and more deeply understand the mechanisms by which patient, provider and unit factors interact and contribute to cause harm and error with an eye towards intervention development. PUBLIC HEALTH RELEVANCE: Advancing an epidemiological approach to patient safety for inpatient mental health care is integral to a public health agenda that uses empirical evidence for improving hospital- based care. Our findings will have significant policy and practice implications with regard to targeting opportunities and strategies to prevent medical errors and adverse events. Such interventions have the potential to impact over a million patients discharged from inpatient psychiatric units each year and enhance the overall safety and quality of care for this vulnerable population.

描述（由申请人提供）：过去二十年来，减少错误和不良事件已成为医疗保健系统的中心焦点。然而，精神障碍患者已被系统地排除在这项研究之外。因此，医院心理健康服务中患者安全事件（不良事件和错误）的流行病学仍然未知。当前的应用程序旨在通过对宾夕法尼亚州综合医院 38 个住院精神科病房的随机样本中的 11,000 份医疗补助患者病历进行记录审查，评估患者安全事件的发生率、性质和可预防性。我们将通过对单位领导层的详细调查来补充此信息，以确定影响、促成和/或防止不良事件和/或错误发生的患者、提供者和精神科单位/医院因素。对来自十家医院的关键信息提供者进行深入的定性访谈将有助于解释这些定量结果，并更深入地了解患者、提供者和单位因素相互作用并导致伤害和错误的机制，着眼于干预措施的发展。 公共卫生相关性：推进住院精神卫生保健患者安全的流行病学方法是公共卫生议程的组成部分，该议程利用经验证据来改善医院护理。我们的研究结果将对预防医疗差错和不良事件的机会和策略产生重大的政策和实践影响。此类干预措施每年有可能影响超过 100 万从精神病院出院的患者，并提高该弱势群体的整体安全性和护理质量。