Patient Safety through Implementation Science: Clinical Work Culture & IT Design

通过实施科学实现患者安全：临床工作文化

基本信息

批准号：
8132270
负责人：
Laurie L Novak
金额：
$ 23.9万
依托单位：
VANDERBILT UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-09-30 至 2013-09-29
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8132270
关键词：
Accounting Acute Adoption Affect Ambulatory Care Facilities Attention Award Behavioral Sciences Caring Clinic Clinical Clinical Informatics Clinical Management Clinical Sciences Cognitive Complex Computerized Medical Record Computers Data Collection Development Diabetes Mellitus Discipline Discipline of Nursing Doctor of Philosophy Elements Engineering Environment Ethnography Evaluation Failure Goals Health Healthcare Hospitals Human Human Engineering Informatics Inpatients Institution Intervention Interview Knowledge Life Manuscripts Medical Medical Informatics Mentors Methodology Methods Modeling Organizational Change Outcome Patient Care Patients Pharmaceutical Preparations Pharmacy facility Phase Process Professional Role Provider Psyche structure Public Health Informatics Qualitative Evaluations Qualitative Research Reporting Research Research Design Research Methodology Research Personnel Research Project Grants Resources Role Safety Scheme Science Scientist Solutions Structure System Technology Thinking Time Training Translational Research Translations United States National Institutes of Health Work base career career development clinical practice cognitive system design engineering design expectation experience health care quality high risk implementation science improved innovation meetings new technology organizational structure patient safety programs research in practice routine practice satisfaction social social science research symposium theories tool virtual

项目摘要

DESCRIPTION (provided by applicant): The long-term objective of this K99/R00 career development proposal is to improve the interaction between informatics tools and everyday clinical practice. A core premise of this proposal is that medication safety can be improved with informatics technologies that better support the safety-producing routines used by clinicians and patients. The PI is a medical and organizational anthropologist seeking to develop her capacity as an independent researcher through structured, innovative career development activities and two related research projects. Career development activities focus on human factors engineering and human centered design. The proposed projects each employ a cycle of work practice research, design, implementation and evaluation in two settings: hospital inpatient, and outpatient clinic. The work practice research methodology is Cultural Process Modeling, in which orienting frames (or mental models) and routine activities are identified through observation and interviewing and described for a specific group (e.g., a nursing unit). The data collection will focus on the use of informatics and other technologies in medication planning and administration. Special attention will be paid to transitions or handovers in care. A matrix will be used to describe the relationships between safe medication routines and attributes of technology that support or create barriers to safe practice. The PI will collaborate with clinical, management and informatics stakeholders to design and implement a work practice or informatics-based intervention to improve medication safety. Evaluation will focus on stakeholder experiences and value assessment using a Responsive/Illuminative approach. With projects that engage the complete cycle of 1) understanding context, 2) designing improved processes and tools, 3) implementation and 4) evaluation, this proposal views the implementation of informatics tools as organizational change. This research advances the emerging field of Implementation Science in informatics, which seeks to apply knowledge, theory and methods from social and organizational science, safety science, engineering and other fields to improve informatics implementation processes and outcomes. Implementation Science, applied to health informatics, can result in improved patient safety, efficiency, and technology adoption and user satisfaction.

描述（由申请人提供）：这项K99/R00职业发展建议的长期目标是改善信息学工具与日常临床实践之间的相互作用。该提案的核心前提是，可以通过信息技术来改善药物安全性，以更好地支持临床医生和患者使用的安全制作程序。 PI是一名医学和组织人类学家，试图通过结构化的创新职业发展活动和两个相关研究项目来发展自己作为独立研究人员的能力。职业发展活动的重点是人力因素工程和以人为中心的设计。拟议的项目每个项目都在两种情况下采用工作实践研究，设计，实施和评估周期：住院治疗和门诊诊所。工作实践研究方法是文化过程建模，其中通过观察和访谈来确定定向框架（或心理模型）和常规活动（例如，护理单位）。数据收集将集中于在药物计划和管理中使用信息学和其他技术。将要特别注意过渡或切换。矩阵将用于描述支持或创造安全实践障碍的技术属性和技术属性之间的关系。 PI将与临床，管理和信息学利益相关者合作设计和实施基于工作的干预措施，以提高药物安全。评估将使用响应/照明方法来关注利益相关者的经验和价值评估。通过参与1）理解环境的完整周期的项目，2）设计改进的流程和工具，3）实施和4）评估，该建议将实施信息学工具视为组织变革。这项研究推动了信息学实施科学的新兴领域，该领域试图应用社会和组织科学，安全科学，工程和其他领域的知识，理论和方法来改善信息学实施过程和结果。应用于健康信息学的实施科学可以改善患者的安全性，效率和技术的采用和用户满意度。