Plint Amy C, Stang Antonia S, Calder Lisa A
Department of Pediatrics, University of Ottawa, 401 Smyth Road, Ottawa, Ontario K1Y 4E9 Canada ; Department of Emergency Medicine, University of Ottawa, The Ottawa Hospital - Civic Campus, 1053 Carling Ave, Ottawa, Ontario K1Y 4E9 Canada ; The Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, Ontario K1H 8 L1 Canada.
Department of Pediatrics, University of Calgary, 2888 Shaganappi Trail NW, Calgary, Alberta T3B 4Z6 Canada ; Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6 Canada ; The Alberta Children's Hospital, 2888 Shaganappi Trail NW, Calgary, Alberta T3B 6A8 Canada.
Int J Emerg Med. 2015 Jan 23;8:1. doi: 10.1186/s12245-014-0049-9. eCollection 2015.
Patient safety in the context of emergency medicine is a relatively new field of study. To date, no broad research agenda for patient safety in emergency medicine has been established. The objective of this study was to establish patient safety-related research priorities for emergency medicine. These priorities would provide a foundation for high-quality research, important direction to both researchers and health-care funders, and an essential step in improving health-care safety and patient outcomes in the high-risk emergency department (ED) setting.
A four-phase consensus procedure with a multidisciplinary expert panel was organized to identify, assess, and agree on research priorities for patient safety in emergency medicine. The 19-member panel consisted of clinicians, administrators, and researchers from adult and pediatric emergency medicine, patient safety, pharmacy, and mental health; as well as representatives from patient safety organizations. In phase 1, we developed an initial list of potential research priorities by electronically surveying a purposeful and convenience sample of patient safety experts, ED clinicians, administrators, and researchers from across North America using contact lists from multiple organizations. We used simple content analysis to remove duplication and categorize the research priorities identified by survey respondents. Our expert panel reached consensus on a final list of research priorities through an in-person meeting (phase 3) and two rounds of a modified Delphi process (phases 2 and 4).
After phases 1 and 2, 66 unique research priorities were identified for expert panel review. At the end of phase 4, consensus was reached for 15 research priorities. These priorities represent four themes: (1) methods to identify patient safety issues (five priorities), (2) understanding human and environmental factors related to patient safety (four priorities), (3) the patient perspective (one priority), and (4) interventions for improving patient safety (five priorities).
This study established expert, consensus-based research priorities for patient safety in emergency medicine. This framework could be used by researchers and health-care funders and represents an essential guiding step towards enhancing quality of care and patient safety in the ED.
急诊医学背景下的患者安全是一个相对较新的研究领域。迄今为止，尚未建立急诊医学患者安全的广泛研究议程。本研究的目的是确定急诊医学中与患者安全相关的研究重点。这些重点将为高质量研究提供基础，为研究人员和医疗保健资助者提供重要方向，并成为在高风险急诊科环境中改善医疗保健安全和患者结局的关键一步。
组织了一个多学科专家小组参与的四阶段共识程序，以确定、评估并就急诊医学患者安全的研究重点达成一致。这个由19名成员组成的小组包括来自成人和儿科急诊医学、患者安全、药学和心理健康领域的临床医生、管理人员和研究人员；以及患者安全组织的代表。在第一阶段，我们通过电子方式对来自北美各地的患者安全专家、急诊科临床医生、管理人员和研究人员进行了有目的的便利抽样调查，利用多个组织的联系人名单，制定了一份潜在研究重点的初始清单。我们使用简单的内容分析来消除重复，并对调查受访者确定的研究重点进行分类。我们的专家小组通过面对面会议（第三阶段）和两轮改进的德尔菲法（第二阶段和第四阶段）就最终的研究重点清单达成了共识。
在第一阶段和第二阶段之后，确定了66个独特的研究重点供专家小组审查。在第四阶段结束时，就15个研究重点达成了共识。这些重点代表四个主题：（1）识别患者安全问题的方法（五个重点），（2）理解与患者安全相关的人为和环境因素（四个重点），（3）患者视角（一个重点），以及（4）改善患者安全的干预措施（五个重点）。
本研究为急诊医学患者安全建立了基于专家共识的研究重点。该框架可供研究人员和医疗保健资助者使用，是朝着提高急诊科护理质量和患者安全迈出的重要指导步骤。
