Spigelman Allan D, Swan Judith
Clinical Governance, Hunter Area Health Service, and Surgical Science, University of Newcastle, Newcastle, New South Wales, Australia.
ANZ J Surg. 2005 Aug;75(8):657-61. doi: 10.1111/j.1445-2197.2005.03482.x.
A survey was conducted to assess the benefits and limitations of the Australian Incident Monitoring System (AIMS) as a programme to improve patient safety.
A 12-point questionnaire was sent to 12 current users of AIMS in November 2002.
The AIMS provides a consistent system of coding, trending and monitoring of incident data. It promotes a patient safety culture and an awareness of system error. Other benefits include the building of teamwork and the implementation of strategies to reduce the prevalence and severity of incidents. The majority of respondents (83%) reported that AIMS investigations resulted in significant changes to equipment usage, medication prescribing or administration, clinical protocols, training programmes and falls risk assessment tools. Although 75% of users reported improvements in patient outcomes, these were difficult to measure. A major limitation of AIMS was the low rate of incident reporting by medical staff. Voluntary reporting systems did not capture all incident data and the information was often too generic for root cause analysis. There were difficulties benchmarking data and concerns were raised regarding the ownership of information. The programme requires ongoing resources to implement change strategies and to maintain incident reporting levels. On a scale of 1 (poor rating) to 10 (excellent rating) the mean benefit rating was 7.6.
The Australian Incident Monitoring System is beneficial as a component of a clinical risk management strategy. Usefulness could be improved by increased participation by medical staff. The level of resources required should not be underestimated if the programme is to demonstrate improvements to patient outcomes. More recent versions of AIMS promise improved capabilities and will require similar evaluation.
开展了一项调查，以评估澳大利亚事件监测系统（AIMS）作为一项旨在提高患者安全的计划的益处和局限性。
2002年11月，向12位AIMS的现有用户发送了一份包含12个问题的调查问卷。
AIMS提供了一个对事件数据进行编码、趋势分析和监测的统一系统。它促进了患者安全文化以及对系统错误的认识。其他益处包括团队协作的建立以及实施减少事件发生率和严重程度的策略。大多数受访者（83%）报告称，AIMS调查导致设备使用、药物处方或给药、临床方案、培训计划以及跌倒风险评估工具发生了重大变化。尽管75%的用户报告患者结局有所改善，但这些改善难以衡量。AIMS的一个主要局限性是医务人员的事件报告率较低。自愿报告系统未能收集到所有事件数据，且信息通常过于笼统，无法进行根本原因分析。在对数据进行基准比较方面存在困难，并且有人对信息的所有权提出了担忧。该计划需要持续的资源来实施变革策略并维持事件报告水平。在从1（差）到10（优）的评分标准中，平均益处评分为7.6。
澳大利亚事件监测系统作为临床风险管理策略的一个组成部分是有益的。通过提高医务人员的参与度，其效用可能会得到提升。如果该计划要证明能改善患者结局，所需资源水平不应被低估。AIMS的最新版本有望具备更好的功能，并且需要进行类似的评估。
