DEVELOPING BEST PRACTICES FOR PATIENT SAFETY

我们建议进行一项公私合作研究，以改善医院实施有效的病人安全措施。我们的患者安全联盟将由不同的北加州医院、医疗组织认证联合委员会(JCAHO)、安全用药实践研究所(ISMP)、加州医疗协会(CHA)和退伍军人事务部患者安全调查中心(PSCI)组成。我们合作研究和试点实施项目的目标是改善衡量和预测潜在患者安全问题的国家证据基础，并制定成本效益高的战略，以改善个别医院的患者安全实践。该项目将以所有参与组织正在开展的与护理质量和医疗差错有关的活动为基础。我们的具体目标包括：1.对于绝大多数美国医院，构建一系列潜在的患者安全指标(PSI)，这些指标可能会被常规使用，为可能存在的患者安全问题提供经验证据。PSI包括对不良事件、医疗差错和诉讼事件的衡量。2.描述大多数美国医院在重要患者安全实践方面的最新趋势，并使用补充调查详细描述Consortium医院的患者安全实践和“安全文化”。3.使用认识到可用措施的局限性和潜在报告偏差的统计方法，检查患者安全实践、PSI和医院资源使用之间的经验关系。4.开展一项持续的倡议，帮助联盟医院分享、评估和改进其患者安全实践，包括介绍我们针对个别医院量身定做的经验分析。5.通过将PSI中反映的患者安全实践和患者安全表现的趋势与非参与医院的匹配控制集进行比较，评估我们的倡议对联盟医院的影响。6.编写手稿并提出关于改善医院患者安全的有效干预措施的主要结论，并将我们的结论纳入参与组织在其成员医院促进患者安全的持续战略。

We propose a public-private collaborative study to improve the implementation of effective patient safety practices in hospitals. Our Patient Safety Consortium will consist of a partnership between diverse Northern California hospitals, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the Institute for Safe Medication Practices (ISMP), the California Healthcare Association (CHA), and the Patient Safety Center of Inquiry (PSCI) at the Department of Veterans' Affairs. The goals of our collaborative research and pilot implementation project are to improve the national evidence base for measuring and predicting potential patient safety problems, and to develop cost-effective strategies for improving patient safety practices at individual hospitals. The project will build on activities related to quality of care and medical errors underway in all of the participating organizations. Our specific aims include: 1. For the vast majority of U.S. hospitals, construct a broad range of potential patient safety indicators (PSIs) that can potentially be used on a routine basis to provide empirical evidence on possible patient safety problems. The PSIs include measures of adverse events, medical errors, and litigation events. 2. Describe recent trends in important patient safety practices at most U.S. hospitals, and use supplemental surveys to describe patient safety practices and "safety cultures" in detail at Consortium hospitals. 3. Examine the empirical relationship between patient safety practices, PSIs, and hospital resource use with statistical methods that recognize the limitations of available measures and potential reporting biases. 4. Conduct an ongoing initiative to help Consortium hospitals share, assess, and improve their patient safety practices, including presentations of our empirical analysis tailored to the individual hospitals. 5. Evaluate the impact of our initiative on Consortium hospitals, by comparing trends in patient safety practices and patient safety performance, as reflected in the PSIs, to a matched control set of nonparticipating hospitals. 6. Prepare manuscripts and present major findings on effective interventions for improving hospital patient safety, and incorporate our findings into the ongoing strategies of the participating organizations to promote patient safety in their member hospitals.