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混合方法评价住院患者及其照护者实时安全报告:MySafeCare 应用程序。

Mixed-Methods Evaluation of Real-Time Safety Reporting by Hospitalized Patients and Their Care Partners: The MySafeCare Application.

机构信息

Departments of Medicine.

Partners Healthcare System, Boston, Massachusetts.

出版信息

J Patient Saf. 2020 Jun;16(2):e75-e81. doi: 10.1097/PTS.0000000000000493.

Abstract

OBJECTIVE

The aims of the study were to evaluate the amount and content of data patients and care partners reported using a real-time electronic safety tool compared with other reporting mechanisms and to understand their perspectives on safety concerns and reporting in the hospital.

METHODS

This study used mixed methods including 20-month preimplementation and postimplementation trial evaluating MySafeCare, a web-based application, which allows hospitalized patients/care partners to report safety concerns in real time. The study compared MySafeCare submission rates for three hospital units (oncology acute care, vascular intermediate care, medical intensive care) with submissions rates of Patient Family Relations (PFR) Department, a hospital service to address patient/family concerns. The study used triangulation of quantitative data with thematic analysis of safety concern submissions and patient/care partner interviews to understand submission content and perspectives on safety reporting.

RESULTS

Thirty-two MySafeCare submissions were received with an average rate of 1.7 submissions per 1000 patient-days and a range of 0.3 to 4.8 submissions per 1000 patient-days across all units, indicating notable variation between units. MySafeCare submission rates were significantly higher than PFR submission rates during the postintervention period on the vascular unit (4.3 [95% confidence interval = 2.8-6.5] versus 1.5 [95% confidence interval = 0.7-3.1], Poisson) (P = 0.01). Overall trends indicated a decrease in PFR submissions after MySafeCare implementation. Triangulated data indicated patients preferred to report anonymously and did not want concerns submitted directly to their care team.

CONCLUSIONS

MySafeCare evaluation confirmed the potential value of providing an electronic, anonymous reporting tool in the hospital to capture safety concerns in real time. Such applications should be tested further as part of patient safety programs.

摘要

目的

本研究旨在评估患者和护理伙伴使用实时电子安全工具报告数据的数量和内容,与其他报告机制进行比较,并了解他们对医院安全问题和报告的看法。

方法

本研究采用混合方法,包括 20 个月的实施前和实施后试验,评估了 MySafeCare,这是一种基于网络的应用程序,允许住院患者/护理伙伴实时报告安全问题。该研究比较了 MySafeCare 在三个医院病房(肿瘤急症护理、血管中级护理、内科重症监护)的提交率与 Patient Family Relations(PFR)部门的提交率,后者是一个处理患者/家庭问题的医院服务。该研究使用定量数据的三角测量和安全问题提交的主题分析以及患者/护理伙伴访谈,以了解提交内容和安全报告的观点。

结果

共收到 32 份 MySafeCare 提交,平均每 1000 个患者日提交 1.7 份,所有病房的范围为每 1000 个患者日 0.3 至 4.8 份,表明各病房之间存在显著差异。血管病房干预后,MySafeCare 的提交率明显高于 PFR 的提交率(4.3 [95%置信区间=2.8-6.5]比 1.5 [95%置信区间=0.7-3.1],泊松)(P=0.01)。总体趋势表明,MySafeCare 实施后,PFR 的提交量减少。三角数据表明,患者更喜欢匿名报告,不希望将问题直接提交给他们的护理团队。

结论

MySafeCare 的评估证实了在医院提供实时电子匿名报告工具以捕获安全问题的潜在价值。此类应用程序应作为患者安全计划的一部分进一步测试。

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