The Family Input for Quality and Safety (FIQS) Study

家庭质量与安全投入 (FIQS) 研究

基本信息

批准号：
10349550
负责人：
Naomi Shula Bardach
金额：
$ 66.45万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-03-01 至 2025-02-28
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10349550
关键词：
Address Admission activity Adult Adverse event Car Phone Caring Categories Characteristics Child Childhood Clinical Communication County Hospitals Data Development Diagnosis Epidemiology Evaluation Event Family Family member Health Technology Health system Hematology Hospital Units Hospital safety Hospitalization Hospitalized Adolescent Hospitals Inpatients Intensive Care Interview Knowledge Language Learning Medical Medical Records Medication Errors Methods Modeling National Institute of Child Health and Human Development Newborn Infant Nurseries Oncology Operative Surgical Procedures Outcome Outcomes Research Participant Patients Pediatric epidemiology Pediatrics Persons Pharmaceutical Preparations Physicians Population Prevention Public Health Publications Reach Effectiveness Adoption Implementation and Maintenance Report (document)Reporting Research Safety San Francisco Social Desirability Source System Technology Testing Text Messaging Time Variant Work attributable mortality base care delivery demographics experience implementation evaluation implementation framework implementation strategy implementation tool improved infection rate innovation interest literacy mortality new technology novel strategies patient engagement patient population patient safety pediatric patients pilot test point of care prevent readmission rates safety net safety study systematic review theories tool trauma centers

项目摘要

Abstract Adverse patient safety event rates remain stubbornly high in hospitals. For children, adverse events are 1.5-2 times more common than in adult inpatients (40.0 vs. 25.1 harms/100 admissions). This proposal uses an untapped source of safety event reporting—patients and family members of hospitalized pediatric patients—to address knowledge gaps identified by the NICHD: the epidemiology of pediatric safety events; strengths and limitations of current methods of error reporting systems; methods to prevent pediatric medication errors; and the development of learning health systems to address inpatient pediatric safety. Text messaging and mobile phone applications technologies offer the opportunity to gather patients' and families' safety reports in real-time and anonymously, addressing limitations of prior work. Our mobile phone-based approach, Family Input for Quality and Safety (FIQS), was developed in partnership with families and clinicians, and was pilot-tested on a pediatric medical-surgical unit, with enthusiastic engagement from participants and staff. The objectives of this proposal are to address the rigor of prior work in the following aims, while testing the approach in other hospital units (e.g., ICU, hematology-oncology) and in a safety net hospital. Aim 1: Describe variations in safety events across care settings and populations using family- and patient-generated safety reports (N~6,500 participants; N~3000 FIQS Reports). This will use the real-time mobile phone tool to determine differences in family and patient safety reports by hospital setting, medical complexity, language, health technology literacy, and patient and family-member demographics. Aim 2: Compare FIQS reports to clinician-generated safety reports documented in incident reports and in the medical record. This will employ mixed-methods, quantifying the number of overlapping and unique events from each source, and using qualitative analysis to describe unique domains covered in each source. Aim 3: Evaluate an improvement collaborative focused on incorporating family and patient reports issues into safety efforts. The collaborative will include all participating units; domains of focus will be medication and communication. Mixed-methods will be used to evaluate the collaborative using the theory-driven RE-AIM implementation science framework. The proposed research is innovative in its paradigm-shifting conceptual model of 1) patient-engaged quality improvement, 2) its use of mobile phone technologies to gather real time data, and 3) its use of an improvement collaborative to develop robust implementation strategies for incorporating family and patient reports into safety efforts. The contribution of the proposed research will be a description of family and patient safety reports across multiple types of inpatient settings in two diverse health systems; a comparison of family and patient safety reports to other methods of detecting adverse events; and cross-setting implementation tools and strategies to incorporate family and patient safety reports into care. These contributions will be significant because they are key steps in implementing and evaluating a potential new approach to improving pediatric inpatient safety.

抽象的不良患者的安全事件发生率在医院中仍然固执。对于儿童，不良事件为1.5-2 比成人住院患者（40.0 vs. 25.1 Harms/100入院）更常见的倍。该建议使用尚未开发的安全事件报告（住院儿科患者的患者和家人）解决NICHD确定的知识差距：小儿安全事件的流行病学；优势和当前错误报告系统方法的局限性；预防小儿药物错误的方法；和学习卫生系统的开发以解决住院儿科安全。文本消息传递和手机电话应用技术提供了实时收集患者和家庭安全报告的机会并匿名解决了先前工作的局限性。我们基于手机的方法，家庭输入质量和安全（FIQ）是与家庭和临床医生合作开发的，并经过了试点测试儿科医学手术单位，参与者和员工的热情参与。目标的目标提案是在以下目的中解决先前工作的严格性，同时测试其他医院的方法单位（例如ICU，血液肿瘤学）和安全网医院。目标1：描述安全事件中的变化使用家庭和患者生成的安全报告（n〜6,500名参与者； N〜3000 FIQS报告）。这将使用实时手机工具来确定家庭和患者安全报告按医院设置，医疗复杂性，语言，卫生技术素养和患者报告和家庭成员人口统计。 AIM 2：将FIQS报告与临床生成的安全报告进行比较记录在事件报告和病历中。这将采用混合方法，量化来自每个来源的重叠和独特事件的数量，并使用定性分析描述独特每个源覆盖的域。目标3：评估专注于编码的改进协作家庭和患者将问题报告为安全工作。该协作将包括所有参与单位；重点领域将是药物和沟通。混合方法将用于评估使用理论驱动的RE-AIM实施科学框架进行协作。拟议的研究是创新的范式转移概念模型1）患者参与质量的改进，2）手机技术收集实时数据，3）使用改进协作来开发将家庭和患者报告纳入安全工作的强大实施策略。贡献拟议的研究中将描述多种类型的家庭和患者安全报告在两个不同的卫生系统中的住院环境；家庭和患者安全报告与其他人的比较检测不良事件的方法；以及交叉设定的实施工具和策略以合并家庭和患者安全报告要照顾。这些贡献将是重要的，因为它们是关键步骤实施和评估一种潜在的新方法来改善小儿住院安全。