Holden Richard J, Karsh Ben-Tzion
Department of Industrial and Systems Engineering, University of Wisconsin-Madison, 1513 University Ave., Room 387, Madison, WI 53706, USA.
Hum Factors. 2007 Apr;49(2):257-76. doi: 10.1518/001872007X312487.
To review the literature on medical error reporting systems, identify gaps in the literature, and present an integrative cross-level systems model of reporting to address the gaps and to serve as a framework for understanding and guiding reporting system design and research.
Medical errors are thought to be a leading cause of death among adults in the United States. However, no review exists summarizing what is known about the barriers and facilitators for successful reporting systems, and no integrated model exists to guide further research into and development of medical error reporting systems.
Relevant literature was identified using online databases; references in relevant articles were searched for additional relevant articles.
The literature review identified components of medical error reporting systems, error reporting system design choices, barriers and incentives for reporting, and suggestions for successful reporting system design. Little theory was found to guide the published research. An integrative cross-level model of medical error reporting system design was developed and is proposed as a framework for understanding the medical error reporting literature, addressing existing limitations, and guiding future design and research.
The medical error reporting research provides some guidance for designing and implementing successful reporting systems. The proposed cross-level systems model provides a way to understand this existing research. However, additional research is needed on reporting and related safety actions. The proposed model provides a framework for such future research.
This work can be used to guide the design, implementation, and study of medical error reporting systems.
回顾有关医疗差错报告系统的文献，找出文献中的差距，并提出一个综合的跨层次报告系统模型，以弥补这些差距，并作为理解和指导报告系统设计与研究的框架。
医疗差错被认为是美国成年人死亡的主要原因之一。然而，尚无综述总结关于成功报告系统的障碍和促进因素的已知情况，也没有综合模型来指导对医疗差错报告系统的进一步研究和开发。
使用在线数据库识别相关文献；在相关文章的参考文献中搜索其他相关文章。
文献综述确定了医疗差错报告系统的组成部分、差错报告系统的设计选择、报告的障碍和激励因素以及成功报告系统设计的建议。发现很少有理论来指导已发表的研究。开发了一个医疗差错报告系统设计的综合跨层次模型，并将其作为理解医疗差错报告文献、解决现有局限性以及指导未来设计和研究的框架提出。
医疗差错报告研究为设计和实施成功的报告系统提供了一些指导。所提出的跨层次系统模型提供了一种理解现有研究的方法。然而，需要对报告及相关安全行动进行更多研究。所提出的模型为未来此类研究提供了一个框架。
这项工作可用于指导医疗差错报告系统的设计、实施和研究。
