Minimizing Error, Maximizing Outcome (MEMO): The Physic*

描述（应用摘要）：MEMO研究的长期目标 （最小化错误，最大化结果）是为了确定 医疗工作环境对医疗质量和医生角色的影响 作为这种效应的媒介。具体目标包括：1）确定效果 工作场所特征对患者结果的影响，例如满意度，疾病 控制和医疗错误; 2）确定最低错误率和最佳 结果发生在低医生压力和倦怠的环境中， 确定这种环境的要素; 3）定义预测因素如何 的质量和错误之间的男女医生，少数民族和 非少数民族医生和城乡医生。MEMO研究是一项 对500名医生和3,000名 5个临床研究中心的患者：纽约、芝加哥、密尔沃基、麦迪逊和农村 威斯康星州。患者将患有以下三种情况中的一种或多种：高血压， 糖尿病和慢性肺病。最初的6个月阶段将包括 医生、其他医护人员和患者的焦点小组， 个人可以“讲述他们的故事”， 他们的日常医疗保健经验。这些信息将用于 为第二阶段进行调查，为期两年， 医生、患者和他们的结果。治疗中的医疗错误， 在第二阶段结束时，将通过图表审查来评估诊断。 第三阶段将包括数据分析和传播活动， 包括编写非技术专著，以及使用“知识 CAF 在区域和国家初级保健会议上采用的方法。一项研究结果 将是一个“最佳实践指数”，列出工作场所的特点， 在低错误率和高质量的护理。该索引将提供一个菜单， 实践管理者和医疗保健组织使用，以确定如何 最好修改他们的做法，以提高质量。由于我们多样化的临床 网站，我们预计能够回答有关医生的问题， 农村和市中心的患者。我们还希望能够 回答有关妇女和少数民族医生的问题， 在以医生为中心的研究中通常代表性不足。

DESCRIPTION (APPLICATION ABSTRACT): The long-term objective of the MEMO Study (Minimizing Error, Maximizing Outcome) is to determine the effect of the healthcare work environment on the quality of care and the role of physicians as mediators of this effect. Specific aims include: 1) to determine the effect of workplace characteristics on patient outcomes such as satisfaction, disease control and medical errors; 2) to determine if the lowest error rates and best outcomes occur in an environment with low physician stress and burnout, and to identify the elements of such an environment; and 3) to define how predictors of quality and errors differ between women and men physicians, minority and non-minority physicians, and urban and rural physicians. The MEMO Study is a longitudinal, observational study of 500 physicians and 3,000 of their patients in 5 clinical sites: New York, Chicago, Milwaukee, Madison and rural Wisconsin. Patients will have one or more of three conditions: hypertension, diabetes and chronic lung disease. The initial 6 month phase will include focus groups with physicians, other healthcare personnel, and patients where individuals can "tell their stories" about the successes and challenges of their day-to-day healthcare experiences. This information will be utilized to develop surveys for the second phase, a two year prospective evaluation of physicians, patients and their outcomes. Medical errors in treatment and diagnosis will be assessed via chart review at the conclusion of phase two. Phase three will consist of data analysis and dissemination activities, including preparation of non-technical monographs, and use of the "Knowledge Caf method at regional and national primary care meetings. One study outcome will be a "best practice index" listing workplace characteristics that result in low error rates and high quality care. This index will provide a menu for practice managers and healthcare organizations to use in determining how to best modify their practices to improve quality. Due to our diverse clinical sites, we anticipate being able to answer questions concerning physicians and patients in rural and inner-city settings. We also anticipate being able to answer questions about women and minority physicians, groups that are typically underrepresented in physician-centered research.