Linking characteristics of high-performing hospitals with patient safety

鉴于AHRQ的重点是改善卫生成果和改进卫生服务方法， 在包括成本效益分析的研究中，本申请具有三个目的： 具体目标1（主要目标）：制定内容有效的调查，可用于衡量高 绩效工作系统（HPWS）在医院环境中的实践。 具体目标2：将HPWS实践与医疗保健行业的患者安全和质量联系起来， 允许估计a）内部一致性，B）结构效度，以及 （三）标准效度。假设：HPWS实践在医院的使用程度将是积极的 关系到医院的病人安全和质量。 具体目标3：确定实施不同HPWS实践的成本效益， 在HPWS上花费的每一美元，哪些HPWS实践对患者安全和质量的影响最大 实践 本研究将采用混合方法，包括开发和管理 一项调查，收集有关美国各地医院HPWS的定性和定量信息 States.研究的第一部分将包括在 Pi的导师（Eric托马斯博士）和两位内容专家（Cynthia St. John博士和Michal Tamuz博士）。的 研究的第二部分将包括对一个随机样本进行关于HPWS实践的调查 的医院在美国25个州，并将调查的答复与三个标准-医院 质量联盟数据、临床卓越率和患者安全率，其中后两个比率为 使用Health Grades Inc.开发的方法计算。将AHRQ的病人安全 指标框架。研究的第三部分将研究HPWS做法的成本效益 对于每一个标准。 本研究旨在确定各组织所采用的与健康成果有关的工作做法。 为了实现这一目标，本研究将寻找高收入者在工作实践中的相似性和差异， 低绩效医院。

Given AHRQ's focus on improving health outcomes and advancing methodologies in health services research, including cost-effectiveness analysis, the present application has three aims: Specific Aim # 1 (Primary Aim): Develop a content valid survey that can be used to measure high- performance work systems (HPWS) practices in a hospital setting. Specific Aim # 2: Relate HPWS practices to patient safety and quality in the healthcare industry, which will allow for the estimation of a) internal consistency, b) construct validity, and c) criterion validity. Hypothesis: The extent that HPWS practices are used in hospitals will be positively related to the patient safety and quality in hospitals. Specific Aim # 3: Determine the cost effectiveness of implementing different HPWS practices to determine which HPWS practices provide the most impact on patient safety and quality per dollar spent on HPWS practices. A mixed methods approach will be used for this study, including the development and administration of a survey that collects qualitative and quantitative information about HPWS in hospitals throughout the United States. The first part of the study will consist of survey development and refinement with assistance from the Pi's mentor (Dr. Eric Thomas) and two content experts (Dr. Cynthia St. John and Dr. Michal Tamuz). The second part of the study will consist of administering the survey about HPWS practices to a random sample of hospitals in 25 of the states in the U.S. and linking the survey responses with three criteria - Hospital Quality Alliance data, clinical excellence rates, and patient safety rates, where the latter two rates are computed using methodology developed by Health Grades Inc. that incorporates AHRQ's patient safety indicator framework. The third part of the study will examine the cost effectiveness of the HPWS practices for each of the criteria. The present study seeks to identify work practices used by organizations that are related to health outcomes. To accomplish this, the present study will look for similarities and differences in work practices used by high- and low-performing hospitals.