Patient Safety through Implementation Science: Clinical Work Culture & IT Design

通过实施科学实现患者安全：临床工作文化

• 批准号: 7786786
• 负责人: Laurie L Novak
• 金额: $ 12.78万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2010-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7786786
• 关键词: Accounting; Acute; Adoption; Affect; Ambulatory Care Facilities; Attention; Award; Behavioral Sciences; Caring; Classification; Clinic; Clinical; Clinical Informatics; Clinical Management; Cognitive; Complex; Computerized Medical Record; Computers; Data Collection; Development; Diabetes Mellitus; Discipline; Doctor of Philosophy; Elements; Engineering; Environment; Ethnography; Evaluation; Failure; Goals; Health; Healthcare; Hospitals; Human; Human Engineering; Informatics; Inpatients; Institution; Intervention; Interview; Knowledge; Life; Manuscripts; Medical; Medical Informatics; Mentors; Methodology; Methods; Modeling; Nurses; Organizational Change; Outcome; Patient Care; Patients; Pharmaceutical Preparations; Pharmacy facility; Phase; Process; Professional Role; Provider; Psyche structure; Public Health Informatics; Qualitative Evaluations; Qualitative Research; Reporting; Research; Research Design; Research Methodology; Research Personnel; Research Project Grants; Resources; Role; Safety; Scheme; Science; Scientist; Solutions; Structure; System; Technology; Thinking; Time; Training; Translational Research; Translations; United States National Institutes of Health; Work; base; career; career development; clinical practice; cognitive system; design; engineering design; expectation; experience; health care quality; high risk; implementation science; improved; innovation; meetings; new technology; organizational structure; patient safety; programs; research in practice; routine practice; satisfaction; social; social science research; symposium; theories; tool; virtual

DESCRIPTION (provided by applicant): The long-term objective of this K99/R00 career development proposal is to improve the interaction between informatics tools and everyday clinical practice. A core premise of this proposal is that medication safety can be improved with informatics technologies that better support the safety-producing routines used by clinicians and patients. The PI is a medical and organizational anthropologist seeking to develop her capacity as an independent researcher through structured, innovative career development activities and two related research projects. Career development activities focus on human factors engineering and human centered design. The proposed projects each employ a cycle of work practice research, design, implementation and evaluation in two settings: hospital inpatient, and outpatient clinic. The work practice research methodology is Cultural Process Modeling, in which orienting frames (or mental models) and routine activities are identified through observation and interviewing and described for a specific group (e.g., a nursing unit). The data collection will focus on the use of informatics and other technologies in medication planning and administration. Special attention will be paid to transitions or handovers in care. A matrix will be used to describe the relationships between safe medication routines and attributes of technology that support or create barriers to safe practice. The PI will collaborate with clinical, management and informatics stakeholders to design and implement a work practice or informatics-based intervention to improve medication safety. Evaluation will focus on stakeholder experiences and value assessment using a Responsive/Illuminative approach. With projects that engage the complete cycle of 1) understanding context, 2) designing improved processes and tools, 3) implementation and 4) evaluation, this proposal views the implementation of informatics tools as organizational change. This research advances the emerging field of Implementation Science in informatics, which seeks to apply knowledge, theory and methods from social and organizational science, safety science, engineering and other fields to improve informatics implementation processes and outcomes. Implementation Science, applied to health informatics, can result in improved patient safety, efficiency, and technology adoption and user satisfaction.

描述（由申请人提供）： 这个K99/R 00职业发展计划的长期目标是改善信息学工具和日常临床实践之间的互动。该提案的核心前提是，可以通过信息技术来改善药物安全性，这些技术可以更好地支持临床医生和患者使用的安全生产程序。PI是一名医学和组织人类学家，她希望通过结构化的创新职业发展活动和两个相关的研究项目来发展自己作为独立研究人员的能力。职业发展活动侧重于人因工程和以人为本的设计。每个拟议的项目采用一个周期的工作实践研究，设计，实施和评估两个设置：医院住院和门诊诊所。工作实践研究方法是文化过程建模，其中定向框架（或心理模型）和日常活动通过观察和访谈确定，并为特定群体（例如，护理单元）。数据收集将侧重于在药物规划和管理中使用信息学和其他技术。将特别注意护理中的过渡或过渡。将使用一个矩阵来描述安全用药程序与支持或创建安全实践障碍的技术属性之间的关系。PI将与临床、管理和信息学利益相关者合作，设计和实施工作实践或基于信息学的干预措施，以提高用药安全性。评价将采用反应/启发性方法，侧重于利益攸关方的经验和价值评估。对于涉及1）理解背景，2）设计改进的过程和工具，3）实施和4）评估的完整周期的项目，本提案将信息学工具的实施视为组织变革。这项研究推进了信息学中新兴的实施科学领域，该领域旨在应用社会和组织科学，安全科学，工程和其他领域的知识，理论和方法来改善信息学实施过程和结果。应用于健康信息学的实施科学可以提高患者的安全性、效率、技术采用率和用户满意度。