Singh Ranjit
Department of Family Medicine, School of Medicine and Biomedical Sciences, University at Buffalo, NY, USA ; UB Patient Safety Research Center, University at Buffalo, NY, USA ; Department of Management Science and Systems, School of Management, University at Buffalo, NY, USA.
F1000Res. 2013 Dec 17;2:276. doi: 10.12688/f1000research.2-276.v1. eCollection 2013.
The author asks for the attention of leaders and all other stakeholders to calls of the World Health Organization (WHO), the Institute of Medicine (IOM), and the UK National Health Service (NHS) to promote continuous learning to reduce harm to patients. This paper presents a concept for structured bottom-up methodology that enables and empowers all stakeholders to identify, prioritize, and address safety challenges. This methodology takes advantage of the memory of the experiences of all persons involved in providing care. It respects and responds to the uniqueness of each setting by empowering and motivating all team members to commit to harm reduction. It is based on previously published work on "Best Practices Research (BPR)" and on "Systematic Appraisal of Risk and Its Management for Error Reduction (SARAIMER)". The latter approach, has been shown by the author (with Agency for Healthcare Research and Quality (AHRQ) support), to reduce adverse events and their severity through empowerment, ownership and work satisfaction. The author puts forward a strategy for leaders to implement, in response to national and international calls for Better health, Better care, and Better value (the 3B's of healthcare) in the US Patient Protection and Affordable Care Act. ( )This is designed to enable and implement " A promise to learn- a commitment to act". AHRQ has recently published "A Toolkit for Rapid-Cycle Patient Safety and Quality Improvement" that includes an adapted version of SARAIMER.
作者呼吁领导者和所有其他利益相关者关注世界卫生组织（WHO）、医学研究所（IOM）以及英国国家医疗服务体系（NHS）提出的促进持续学习以减少对患者伤害的呼吁。本文提出了一种结构化的自下而上方法的概念，该方法使所有利益相关者能够识别、确定安全挑战的优先级并加以应对。这种方法利用了所有参与护理人员的经验记忆。它通过赋予并激励所有团队成员致力于减少伤害，尊重并回应每个环境的独特性。它基于先前发表的关于“最佳实践研究（BPR）”以及“风险系统评估及其减少错误管理（SARAIMER）”的工作。作者（在美国医疗保健研究与质量局（AHRQ）的支持下）已证明，后一种方法通过赋予权力、主人翁意识和工作满意度来减少不良事件及其严重程度。作者针对美国《患者保护与平价医疗法案》中关于更好的健康、更好的护理和更好的价值（医疗保健的3B）的国内和国际呼吁，提出了一项供领导者实施的战略。（ ）这旨在促成并实施“学习的承诺——行动的承诺”。美国医疗保健研究与质量局最近发布了《快速循环患者安全与质量改进工具包》，其中包括SARAIMER的改编版本。
