Medication Safety in Primary Care Practice - Translating Research into Practice

初级保健实践中的用药错误是发病的重要原因，但 这些错误在很大程度上是未知的，减少这些错误的有效干预措施需要 开发和测试。实践伙伴研究网络（PPRNet），一个基于实践的 在38个州的初级卫生保健提供者中开展的研究网络， 通用电子病历（EMR）开发了一种质量改进模型， 成功地将研究转化为初级保健实践，称为PPRNet-TRIP。PPRNet- TRIP包含所有工作人员参与的基于证据的质量哲学的优先次序 （团队合作），输送系统重新设计，患者激活和EMR工具， 基于人口的医学PPRNet-TRIP在实践环境中通过 结合实践绩效报告、实践现场访问、网络会议和基于网络的 工具.申请书中提议的活动的目的是进行一项 在20个PPRNet做法中开展示范项目。该项目旨在开发一套 与初级保健相关的药物安全措施，将这些措施纳入实践 * 每季度向参与的业务单位发送业绩报告，并评估PPRNet的影响， TRIP对这些错误的发生率。该项目将持续3年。在第一个9 月，研究小组开发的一套初步的药物安全指标将在 在参与实践中使用共识发展过程进行改进。程序 将制定这些药物安全措施添加到季度PPRNet实践中 报道然后将进行为期两年的干预，包括业绩报告， 网络会议和实践现场访问，以帮助实践系统化他们对 药物安全临床决策支持功能在他们的电子病历系统。这些特征 包括药物过敏、药物间相互作用、药物与疾病相互作用、不正确的 剂量和药物无效;并提示治疗监测，以防止不良反应 药物事件。两年后干预对用药错误发生率的影响 将被评估。还将进行混合方法过程评价，以评估项目。 调查结果将随后传播到其他项目伙伴关系网络做法，并通过 演讲和出版物。

Medication errors in primary care practice are an important cause of morbidity but the extent of these errors is largely unknown and effective interventions for reducing these errors need to be developed and tested. The Practice Partner Research Network (PPRNet), a practice-based research network among primary health care providers practicing in 38 States who use a common electronic medical record (EMR), has developed a quality improvement model for successfully translating research into primary care practice termed PPRNet-TRIP. PPRNet- TRIP incorporates prioritization of evidence-based quality philosophies, involving all staff (teamwork), delivery system redesign, patient activation, and EMR tools for individualized and population-based medicine. PPRNet-TRIP is implemented in practice settings through a combination of practice performance reports, practice site visits, network meetings, and webbased tools. The purpose of the activities proposed in the application is to conduct a demonstration project among 20 PPRNet practices. The project is intended to develop a set of medication safety measures relevant for primary care, incorporate these measures in practice performance reports sent quarterly to participating practices, and assess the impact of PPRNet- TRIP on the incidence of these errors. The project will be 3 years in duration. During the first 9 months, a preliminary set of medication safety indicators developed by the research team will be refined, using a consensus development process among the participating practices. Programs will be developed to add these medication safety measures to the quarterly PPRNet practice reports. A two year intervention will then be conducted, including the performance reports, network meetings, and practice site visits, to help practices systematize their use of the medication safety clinical decision support features in their EMR system. These features include warnings for drug allergies, drug-drug interactions, drug-disease interactions, incorrect dosages, and drug ineffectiveness; and prompts for therapeutic monitoring to prevent adverse drug events. After two years the impact of the intervention on the incidence of medication errors will be assessed. A mixed-method process evaluation will also be conducted to assess project. The findings will then be disseminated to other PPRNet practices and more broadly through presentations and publications.