Blumenthal David, Ferris Timothy G
Institute for Health Policy, Massachusetts General Hospital and Partners Health System, 55 Fruit Street, Boston, MA 02114, USA.
Acad Med. 2006 Sep;81(9):817-22. doi: 10.1097/00001888-200609000-00010.
Patient safety has emerged as an important challenge to the leadership of academic medical centers (i.e., teaching hospitals with significant research activity). This article describes the evidence regarding patient safety at academic medical centers (AMCs) and the special circumstances of AMCs that create challenges and opportunities for making improvements. While the research on the relative safety of patients in AMCs compared to other types of hospitals is sparse, it seems clear that AMCs in general do not stand out as models of patient safety. AMCs are unique as health care providers because of the multiple consequences of their three missions: patient care, research, and teaching. Aspects of these missions can serve to both enhance an AMC's ability to address safety issues and at the same time create unique and challenging barriers. For example, the research enterprise may distract managers' focus on safety issues but at the same time provide a wealth of highly trained talent for investigating and reducing safety problems. By addressing these challenges, AMCs have the opportunity, even the obligation, to be both the source of new knowledge on health care safety as well as the transmitter of new skills in safe patient care for the health care providers of the future.
患者安全已成为学术医疗中心（即开展大量研究活动的教学医院）领导层面临的一项重大挑战。本文阐述了有关学术医疗中心患者安全的证据，以及学术医疗中心所面临的特殊情况，这些情况为改进工作带来了挑战与机遇。尽管相较于其他类型的医院，关于学术医疗中心患者相对安全性的研究较为匮乏，但总体而言，学术医疗中心显然并非患者安全的典范。作为医疗服务提供者，学术医疗中心具有独特性，因为其三项使命（患者护理、研究和教学）会产生多重影响。这些使命的各个方面既有助于提升学术医疗中心解决安全问题的能力，同时也会形成独特且具有挑战性的障碍。例如，研究工作可能会分散管理人员对安全问题的关注，但与此同时，也能为调查和减少安全问题提供大量训练有素的人才。通过应对这些挑战，学术医疗中心有机会，甚至有义务成为医疗保健安全新知识的来源，以及未来医疗服务提供者安全患者护理新技能的传播者。
