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医院医师作为患者安全领域的新兴领导者:经验教训和未来方向。

Hospitalists as emerging leaders in patient safety: lessons learned and future directions.

机构信息

Hospitalist Program, University of Michigan Division of General Medicine, Ann Arbor VA Health Services Research & Development Center of Excellence, Ann Arbor, Michigan, USA.

出版信息

J Patient Saf. 2009 Mar;5(1):3-8. doi: 10.1097/PTS.0b013e31819751f2.

Abstract

OBJECTIVE

To examine the results of a multi-institution, hospitalist-centered consortium designed to disseminate knowledge of best practices relevant to patient safety and to facilitate institutional innovation around such practices.

METHODS

The Hospitalists as Emerging Leaders in Patient Safety (HELPS) consortium consisted of a hospitalist lead and a patient safety representative from each of 9 health care systems in southeastern Michigan. The consortium's aim was to provide rapid dissemination of best practices in patient safety through regular group meetings and to facilitate implementation and analysis of hospitalist-led patient safety initiatives. Key safety targets included prevention of device-related infections, creating a culture of safety, care transitions, medication safety, fall prevention, perioperative care, intensive care unit safety, and end-of-life care. Participating institutions were free to implement any of the best practices and had access to the expertise of the HELPS coordinating site. Surveys were used to assess knowledge dissemination among participants.

RESULTS

Participating institutions described their patient safety initiative and identified several key barriers and facilitators encountered during implementation. Common themes emerged among both barriers and facilitators. In postmeeting surveys to measure dissemination, consortium participants answered a mean of 84.2% (SD = 19.2) of the questions correctly.

CONCLUSIONS

The HELPS consortium successfully disseminated knowledge regarding best practices and identified common barriers and facilitators faced by hospitalists and institutions attempting to improve safety. The next step is to transform the consortium into a robust quality collaborative that leverages key facilitators and prospectively addresses barriers to implementing high-impact interventions in a multihospital setting.

摘要

目的

考察一个多机构、以内科住院医师为中心的联盟的成果,该联盟旨在传播与患者安全相关的最佳实践知识,并促进围绕这些实践的机构创新。

方法

医院医师作为患者安全领域的新兴领导者(HELPS)联盟由密歇根州东南部 9 个医疗系统的一名内科住院医师领导和一名患者安全代表组成。该联盟的目标是通过定期小组会议快速传播患者安全方面的最佳实践,并促进内科住院医师主导的患者安全举措的实施和分析。主要安全目标包括预防器械相关感染、营造安全文化、护理交接、用药安全、预防跌倒、围手术期护理、重症监护病房安全和临终关怀。参与机构可自由实施任何最佳实践,并可获得 HELPS 协调地点的专业知识。调查用于评估参与者之间的知识传播。

结果

参与机构描述了他们的患者安全举措,并确定了在实施过程中遇到的几个关键障碍和促进因素。障碍和促进因素都出现了共同的主题。在衡量传播效果的会后调查中,联盟参与者平均正确回答了 84.2%(SD=19.2)的问题。

结论

HELPS 联盟成功传播了最佳实践知识,并确定了内科住院医师和试图提高安全性的机构所面临的共同障碍和促进因素。下一步是将联盟转变为一个强大的质量协作组织,利用关键的促进因素,并前瞻性地解决在多医院环境中实施高影响力干预措施的障碍。

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