Title Omitted

描述(由申请人提供)：佛蒙特州西南部医疗保健(SVHC)和为农村地区服务的五家私人医生诊所建议通过实施综合电子健康记录来减少医疗差错和不良事件。全面的记录将在所有参与的护理提供地点和患者/居民在家中查阅。这将包括在医生执业、医疗中心、家庭保健机构和长期护理设施中实施电子病人病历、电子用药管理记录、计算机化医嘱输入和临床决策支持软件。SVHC将成立一个新的安全司，由项目主任领导，项目主任将担任首席医疗安全官。到项目结束时，预计所有合作伙伴将使用电子健康记录的共同通道，以确保高质量的护理。关键障碍是主动而不是被动的安全文化所需的文化变革，以及供应商之间和供应商内部关于技术实施的目标一致。该项目的目标是：1)SVHC将展示一种加强的安全文化，鼓励和支持报告错误和不良事件、险些失手和良好捕获，并反馈信息以提高系统安全性；2)医生和其他医疗保健提供者将使用安全、保密的综合电子健康记录，可从任何地点访问，包括赠款合作伙伴所有护理地点的所有护理事件；以及3)提高患者的安全性和由合作伙伴服务的患者的护理质量。总结性评价将报告目标和目的所列每项成果的实现情况。形成性评价将记录安全氛围的变化、e-MAR系统的有效性；以及随着时间的推移，合作伙伴之间关键问题的框架。拟议的安全和电子健康记录项目是SVHC一个更大的战略计划的一部分，该战略计划在整个医疗保健系统中实施广泛的IT工具。

DESCRIPTION (provided by the applicant): Southwestern Vermont Health Care (SVHC) and five private physician practices serving a rural area propose to reduce medical errors and adverse events through the implementation of an integrated electronic health record. The comprehensive record will be accessible at all participating care delivery sites and to the patient/resident from home. This will include implementation of an electronic patient medical record, electronic medication administration record, computerized physician order entry, and clinical decision support software in physician practices, the medical center, a home health agency and a long-term care facility. SVHC will institute a new Safety Division under the leadership of the project director, who will serve as Chief Medical Safety Officer. By project end it is expected that all partners will use common access to an EHR to ensure high quality care. Key barriers are the cultural changes required for a proactive rather than reactive safety culture, and alignment of goals across and within providers regarding technology implementation. The project goals are: 1) SVHC will demonstrate an increased culture of safety that encourages and supports the reporting of errors and adverse events, near misses and good catches, and feed information back to improve systems safety; 2) Physicians and other health care providers will use a secure, confidential, integrated electronic health record that is accessible from any location and includes all episodes of care from all locations of care among grant partners; and 3) Improve patient safety and quality of care for patients served by partners. A summative evaluation will report on attainment of each of the outcomes listed in the goals and objectives. A formative evaluation will record changes in the safety climate, effectiveness of the e-MAR system; and the framing of key issues among the partners over time. The proposed safety and EHR project is part of a much larger strategic plan at SVHC to implement a wide range of IT tools throughout the health care system.