Inpatient Psychiatric Safety at the VA

描述（由申请人提供）： 影响：推进流行病学方法，以病人的安全住院精神卫生保健在VA是不可或缺的议程，使用经验证据，以确保严重精神疾病患者在一个安全和治疗的环境中接受护理。背景：在过去的二十年里，减少不良事件已经成为VA内外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：本申请旨在：1）评估VA医疗中心住院精神科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VHA不良事件报告系统报告的事件进行比较，以评估该系统当前可用信息的完整性; 3）使用定性的方法来理解患者、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，以改进精神病学中患者安全的概念模型。研究方法：该研究将从全国40个退伍军人管理局精神科单位的样本中抽取，并检查12，000例住院病例，目的是通过收集和理解代表性数据来解决研究的目标，以告知退伍军人管理局的做法和政策。

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.