Inpatient Psychiatric Safety at the VA

描述(由申请人提供)： 影响：在退伍军人管理局推进住院精神卫生护理患者安全的流行病学方法是使用经验证据确保严重精神疾病患者在安全和治疗环境中得到护理的议程中不可或缺的一部分。背景：在过去的二十年里，无论是退伍军人事务部内部还是外部，减少不良事件已经成为卫生保健系统的中心焦点。然而，精神障碍患者一直被排除在这一领域的主要研究之外。目的：当前的应用寻求1)评估在退伍军人医学中心住院精神病室内发生的不良事件的发生率和性质，并确定与这些事件相关的患者特征；2)将通过流行病学记录审查检测到的事件与向VHA不良事件报告系统报告的事件进行比较，以评估该系统现有信息的完整性；以及3)使用定性方法来了解患者、提供者和组织因素在VHA系统中改善或阻碍患者安全的机制，以完善精神病学患者安全的概念模型。方法：这项研究将从40个退伍军人管理局精神病院的全国样本中抽取，并检查12,000个住院病例，目的是通过收集和了解具有代表性的数据，为退伍军人管理局的实践和政策提供信息，从而达到研究的目标。

DESCRIPTION (provided by applicant): Impact: Advancing an epidemiological approach to patient safety for inpatient mental health care at the VA is integral to an agenda that uses empirical evidence to ensure that patients with serious mental illness receive care in a safe and therapeutic environment. Background: Reducing adverse events has become a central focus of the health care system over the last two decades both within and outside of the VA. However, patients with mental disorders have been excluded from the major research in this field. Objectives: The current application seeks to 1) Assess the incidence and nature of adverse events that occur within VA medical center inpatient psychiatric units and identify patient characteristics associated with these events; 2) Compare events detected through an epidemiologic record review with those reported to the VHA's adverse event reporting system, to assess the completeness of the information currently available through this system; and 3) Use qualitative methods to understand the mechanisms by which patient, provider, and organizational factors improve or impede patient safety in the VHA system, in order to refine a conceptual model of patient safety in psychiatry. Methods: The study will draw from a national sample of 40 VA psychiatric units and examine 12,000 hospitalizations, with the goal of addressing the objectives of the study by gathering and understanding representative data to inform VA practice and policy.