Improving the Safety of Care Transitions for Cardiac Surgery Patients

提高心脏手术患者护理过渡的安全性

• 批准号: 8662775
• 负责人: AYSE PINAR GURSES
• 金额: $ 13.87万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-01 至 2015-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8662775
• 关键词: Improving; Safety; Care; Transitions; Cardiac

DESCRIPTION (provided by applicant): The purpose of this proposed career development award is to support Dr. Ayse P. Gurses, a human factors engineer, in establishing a research program that seeks to improve patient safety during transitions of care and handoffs. This award will facilitate Dr. Gurses's acquisition of additional skills and competencies in the areas of outcomes research, advanced research methods, and advanced statistical methods that are necessary for accomplishing her career goals. Moreover, the award will provide Dr. Gurses the opportunity to get mentoring from leading researchers who also have a strong track record of mentoring research scientists. The Johns Hopkins University offers an ideal environment for the proposed work, particularly because of the strong Schools of Medicine and Public Health and the strong focus on patient safety research. Increasing specialization in medicine, coupled with limited resources, has led to an increase in the number of care transitions. Unfortunately, care transitions can pose significant risks to patient safety and result in poor clinical and financial outcomes if not managed effectively. Dr. Gurses's long-term goal is to develop a care transitions improvement program that can be implemented nationally and internationally to improve patient safety. The overall objective of the proposed study is to identify the potential risks for post-operative cardiac surgery patients' safety in care transitions, and to develop methods and tools to reduce these risks. We will focus on cardiac surgery patients because of the complexity and severity of their illnesses and their needs for receiving medical care from various practitioners in multiple settings. We will focus on two processes of care: medication information management and the medical record interactions. To accomplish the overall study objective, we will first identify hazards (anything that has the potential to cause failure) that threaten post-operative cardiac surgery patients' safety in transitions of care (a) between different units in a hospital; (b) from hospital to home and to outpatient clinics. We will use both prospective and retrospective hazard identification methods. We will then conduct a prospective risk assessment of the identified hazards using the Health Care Failures Modes and Effects Analysis (HFMEA). We will conduct a separate HFMEA for each care process (e.g., medication information management); at each point of care transition (e.g., transfer from ICU to general floor). Finally, we will develop a novel; risk-analysis-informed intervention bundle and pilot test its impact on the safety of care transitions for post-operative cardiac surgery patients and on the care providers. Ineffective and poor transitions of care are a major threat to patient safety. This is especially true for patients who had cardiac surgery because of the complexity and severity of their illnesses and their needs for receiving medical care from various practitioners in multiple settings. In this study, we will identify the factors that lead to poor care transitions and unsafe care for post-operative cardiac surgery patients. We will then develop and pilot test tools and strategies to improve care transitions and the safety of post-operative cardiac surgery patients. These tools and strategies can potentially be used to improve the safety of care transitions for other patient populations in the future.

描述（由申请人提供）：这个拟议的职业发展奖项的目的是支持人为因素工程师Ayse P. Gurses博士建立一个研究项目，旨在提高患者在护理过渡和交接期间的安全性。该奖项将促进Gurses博士在成果研究、先进的研究方法和先进的统计方法领域获得额外的技能和能力，这些都是实现她的职业目标所必需的。此外，该奖项将为Gurses博士提供机会，从那些在指导研究科学家方面也有良好记录的领先研究人员那里获得指导。约翰霍普金斯大学为这项工作提供了一个理想的环境，特别是因为它强大的医学院和公共卫生学院，以及对患者安全研究的强烈关注。医学日益专业化，加上资源有限，导致护理转变的数量增加。不幸的是，如果不能有效管理，护理过渡可能对患者安全构成重大风险，并导致不良的临床和财务结果。Gurses博士的长期目标是制定一项可以在国内和国际上实施的护理过渡改进计划，以提高患者的安全性。本研究的总体目标是确定心脏手术后患者在护理过渡中安全的潜在风险，并开发降低这些风险的方法和工具。我们将重点关注心脏手术患者，因为他们的疾病的复杂性和严重性，以及他们在不同环境下接受不同医生医疗护理的需求。我们将重点关注两个护理过程：药物信息管理和病历交互。为了完成总体研究目标，我们将首先确定在医院不同单元之间的护理过渡中威胁心脏手术后患者安全的危险（任何可能导致失败的因素）；(b)从医院到家庭和门诊诊所。我们将使用前瞻性和回顾性危害识别方法。然后，我们将使用医疗失败模式和影响分析（HFMEA）对已确定的危害进行前瞻性风险评估。我们将对每个护理过程（例如，药物信息管理）执行单独的HFMEA；在每个护理过渡点（例如，从ICU转到普通楼层）。最后，我们将开发一部小说；风险分析知情干预包和试点测试其对心脏手术后患者护理过渡安全性和护理提供者的影响。无效和不良的护理过渡是对患者安全的主要威胁。对于接受心脏手术的患者来说尤其如此，因为他们的疾病复杂而严重，他们需要在不同的环境中接受不同的医生的医疗护理。在本研究中，我们将确定导致心脏手术后患者护理过渡不良和护理不安全的因素。然后，我们将开发和试点测试工具和策略，以改善护理过渡和心脏手术后患者的安全性。这些工具和策略可以潜在地用于改善未来其他患者群体护理过渡的安全性。

项目成果

Usability and perceived usefulness of Personal Health Records for preventive health care: a case study focusing on patients' and primary care providers' perspectives.

个人健康记录对于预防性医疗保健的可用性和感知有用性：重点关注患者和初级保健提供者观点的案例研究。

• DOI: 10.1016/j.apergo.2013.09.005
• 发表时间: 2014
• 期刊: Applied ergonomics
• 影响因子: 3.2
• 作者: AntOzok,A;Wu,Huijuan;Garrido,Melissa;Pronovost,PeterJ;Gurses,AyseP
• 通讯作者: Gurses,AyseP

Variation in local institutional review board evaluations of a multicenter patient safety study.

当地机构审查委员会对多中心患者安全研究的评估存在差异。

• DOI: 10.1111/j.1945-1474.2011.00150.x
• 发表时间: 2012
• 期刊: Journal for healthcare quality : official publication of the National Association for Healthcare Quality
• 作者: Thompson,DavidA;Kass,Nancy;Holzmueller,Christine;Marsteller,JillA;Martinez,ElizabethA;Gurses,AyseP;Kanchuger,Marc;Schwann,Nanette;Gibson,CharlesS;Bauer,Laura;Pronovost,PeterJ
• 通讯作者: Pronovost,PeterJ