Pham Julius Cuong, Alblaihed Leen, Cheung Dickson Sui, Levy Frederick, Hill Peter Michael, Kelen Gabor D, Pronovost Peter J, Kirsch Thomas D
1Johns Hopkins University School of Medicine, Baltimore, MD.
Am J Med Qual. 2014 Mar-Apr;29(2):99-104. doi: 10.1177/1062860613489846. Epub 2013 May 31.
As a safety net for the health care system, quality and safety performance in emergency medicine (EM) is important for policy makers, insurers, researchers, health care providers, and patients. Developing performance indicators that are relevant, valid, feasible, and easy to measure has proven difficult. To monitor progress, patient safety should be measured objectively. Although conceptual frameworks and error taxonomies have been proposed, a practical scorecard for measuring patient safety over time in EM has been lacking. This article proposes a framework that measures safety through 4 major domains: (1) how often patients are harmed, (2) how often appropriate interventions are delivered, (3) how well errors in the system are identified and corrected, and (4) emergency department (ED) safety culture. Examples of specific measures for each of these domains are provided, but the EM community should reach consensus on what measures are important for the ED environment and patients.
作为医疗保健系统的安全网，急诊医学（EM）中的质量和安全绩效对政策制定者、保险公司、研究人员、医疗保健提供者和患者而言都很重要。事实证明，制定相关、有效、可行且易于衡量的绩效指标颇具难度。为监测进展情况，应客观衡量患者安全。尽管已提出概念框架和错误分类法，但一直缺乏一个用于长期衡量急诊医学中患者安全的实用记分卡。本文提出了一个通过4个主要领域衡量安全性的框架：（1）患者受到伤害的频率；（2）提供适当干预措施的频率；（3）系统中的错误被识别和纠正的程度；（4）急诊科（ED）的安全文化。文中给出了这些领域各自具体措施的示例，但急诊医学领域应就哪些措施对急诊科环境和患者至关重要达成共识。
