Ranji Sumant R, Shojania Kaveh G
Division of Hospital Medicine, Department of Medicine, University of California, San Francisco 94143, USA.
Med Clin North Am. 2008 Mar;92(2):275-93, vii-viii. doi: 10.1016/j.mcna.2007.10.007.
Hospitalists play an important role in improving patient safety through clinical expertise and leadership in hospital quality improvement activities. The evidence base in patient safety remains incomplete, despite an increasing body of published research in recent years. Thus, physicians must consider other factors in addition to the strength of evidence supporting a practice when deciding which patient safety interventions to implement. These factors include the prevalence of the safety problem targeted, the potential for unintended consequences of the intervention, the costs and complexity of implementing the intervention, and the potential of the intervention to generate momentum for further safety initiatives. In this article, the authors define a framework for evaluating patient safety interventions and discuss specific interventions hospitalists should consider.
住院医师通过临床专业知识以及在医院质量改进活动中的领导作用，在提高患者安全方面发挥着重要作用。尽管近年来发表的研究越来越多，但患者安全方面的证据基础仍不完整。因此，医生在决定实施哪些患者安全干预措施时，除了支持某种做法的证据强度外，还必须考虑其他因素。这些因素包括所针对的安全问题的普遍性、干预措施产生意外后果的可能性、实施干预措施的成本和复杂性，以及干预措施为进一步的安全举措创造动力的潜力。在本文中，作者定义了一个评估患者安全干预措施的框架，并讨论了住院医师应考虑的具体干预措施。
