Medication Safety in Primary Care Practice - Translating Research into Practice (

初级保健实践中的用药差错是发病率的重要原因，但 这些错误在很大程度上是未知的，需要采取有效的干预措施来减少这些错误 开发和测试。实践伙伴研究网络(PPRNet)，以实践为基础的 在38个州开展业务的初级卫生保健提供者中的研究网络 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结合了基于证据的质量哲学的优先顺序，涉及所有员工 (团队合作)、交付系统重新设计、患者激活和EMR工具，以实现个性化和 以人口为基础的医学。PPRNet-Trip在实践环境中通过 实践绩效报告、实践现场访问、网络会议和基于Web的组合 工具。申请中建议的活动的目的是进行 20个PPRNet实践中的示范项目。该项目旨在开发一套 与初级保健相关的用药安全措施，将这些措施纳入实践 每季度向参与实践发送绩效报告，并评估PPRNet的影响- 绊倒这些错误的发生率。该项目将持续3年。在前9年 几个月后，研究小组开发的一套初步药物安全指标将是 改进，在参与实践中采用协商一致的发展过程。节目 将被开发为将这些药物安全措施添加到PPRNet季度实践中 报告。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，以帮助实践系统化其使用 他们的电子病历系统中的用药安全临床决策支持功能。这些功能 包括药物过敏、药物-药物相互作用、药物-疾病相互作用警告，不正确 剂量和药物无效；以及提示进行治疗监测以防止不良反应 毒品事件。干预两年后对用药差错发生率的影响 将会被评估。还将进行混合方法的过程评估，以评估项目。 然后，调查结果将传播到PPRNet的其他实践中，并更广泛地通过 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.