Brown C, Hofer T, Johal A, Thomson R, Nicholl J, Franklin B D, Lilford R J
Department of Public Health and Epidemiology, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
Qual Saf Health Care. 2008 Jun;17(3):158-62. doi: 10.1136/qshc.2007.023630.
This is the first of a four-part series of articles examining the epistemology of patient safety research. Parts 2 and 3 will describe different study designs and methods of measuring outcomes in the evaluation of patient safety interventions, before Part 4 suggests that "one size does not fit all". Part 1 sets the scene by defining patient safety research as a challenging form of service delivery and organisational research that has to deal (although not exclusively) with some very rare events. It then considers two inter-related ideas: a causal chain that can be used to identify where in an organisation's structure and/or processes an intervention may impact; and the need for preimplementation evaluation of proposed interventions. Finally, the paper outlines the authors' pragmatist ontological stance to patient safety research, which sets the philosophical basis for the remaining three articles.
这是关于探讨患者安全研究认识论的系列文章的第一篇，共四部分。第二和第三部分将描述不同的研究设计以及在评估患者安全干预措施时测量结果的方法，第四部分则提出“一刀切并不适用于所有情况”。第一部分通过将患者安全研究定义为一种具有挑战性的服务提供和组织研究形式来展开论述，这种研究必须（尽管并非仅仅）应对一些非常罕见的事件。接着它考量了两个相互关联的观点：一个可用于确定干预措施可能在组织结构和/或流程中的何处产生影响的因果链；以及对拟议干预措施进行实施前评估的必要性。最后，本文概述了作者对患者安全研究的实用主义本体论立场，这为其余三篇文章奠定了哲学基础。
