Farley D O, Haviland A, Champagne S, Jain A K, Battles J B, Munier W B, Loeb J M
RAND Corporation, Pittsburgh, PA 15213, USA.
Qual Saf Health Care. 2008 Dec;17(6):416-23. doi: 10.1136/qshc.2007.024638.
Little is known about hospitals' adverse-event-reporting systems, or how they use reported data to improve practices. This information is needed to assess effects of national patient-safety initiatives, including implementation of the Patient Safety and Quality Improvement Act of 2005 (PSQIA). This survey generated baseline information on the characteristics of hospital adverse-event-reporting systems and processes, for use in assessing progress in improvements to reporting.
The Adverse Event Reporting Survey, developed by Westat, was administered in September 2005 through January 2006, using a mixed-mode (mail/telephone) survey with a stratified random sample of 2050 non-federal US hospitals. Risk managers were the respondents. An 81% response rate was obtained, for a sample of 1652 completed surveys.
Virtually all hospitals reported they have centralised adverse-event-reporting systems, although characteristics varied. Scores on four performance indexes suggest that only 32% of hospitals have established environments that support reporting, only 13% have broad staff involvement in reporting adverse events, and 20-21% fully distribute and consider summary reports on identified events. Because survey responses are self-reported by risk managers, these may be optimistic assessments of hospital performance.
Survey findings document the current status of hospital adverse-event-reporting systems and point to needed improvements in reporting processes. PSQIA liability protections for hospitals reporting data to patient-safety organisations should also help stimulate improvements in hospitals' internal reporting processes. Other mechanisms that encourage hospitals to strengthen their reporting systems, for example, strong patient-safety programmes, also would be useful.
对于医院不良事件报告系统，以及它们如何利用报告数据改进医疗实践，人们了解甚少。评估包括2005年《患者安全与质量改进法案》（PSQIA）实施在内的国家患者安全倡议的效果，需要这些信息。本次调查得出了关于医院不良事件报告系统及流程特征的基线信息，用于评估报告改进方面的进展。
由韦斯塔特公司开发的不良事件报告调查于2005年9月至2006年1月实施，采用混合模式（邮件/电话）调查，对2050家美国非联邦医院进行分层随机抽样。受访者为风险管理人员。共获得81%的回复率，完成了1652份调查问卷。
几乎所有医院都报告称他们拥有集中式不良事件报告系统，尽管其特征各不相同。四项绩效指标的得分表明，只有32%的医院建立了支持报告的环境，只有13%的医院有广泛的工作人员参与不良事件报告，20% - 21%的医院充分分发并考虑已识别事件的总结报告。由于调查回复是由风险管理人员自行报告的，这些可能是对医院绩效的乐观评估。
调查结果记录了医院不良事件报告系统的现状，并指出了报告流程中需要改进的地方。PSQIA为向患者安全组织报告数据的医院提供的责任保护，也应有助于促进医院内部报告流程的改进。其他鼓励医院加强其报告系统的机制，例如强大的患者安全计划，也会很有用。
