Advancing Safety Process Innovation in Rheumatology (ASPIRE)

推进风湿病学安全流程创新 (ASPIRE)

• 批准号: 10656161
• 负责人: Jinoos Yazdany
• 金额: $ 39.47万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-01 至 2027-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10656161
• 关键词: Advancing; Safety; Process; Innovation; Rheumatology

Project Summary Despite widespread recognition of pervasive patient safety problems in the U.S. health care system, research to develop feasible, scalable solutions has lagged, particularly in the ambulatory setting. The need for new approaches to improve safety is especially pressing in the care of ambulatory patients using high-risk immunosuppressive medications, as use of this category of medications has grown precipitously and reports of preventable adverse events have increased. In the last AHRQ funding period, our research team generated new epidemiological evidence of patient safety risks and adverse events and used this information to develop electronic health record-based quality measures (eMeasures) for the Centers for Medicare and Medicaid Services Quality Payment Program. In addition, we implemented these eMeasures nationally in the American College of Rheumatology's RISE registry, which includes electronic health record data from over one-third of U.S. practicing rheumatologists. In this proposal, we aim to build on this work to improve ambulatory patient safety for individuals using high-risk immunosuppressive drugs. In Aim 1, we will use data from the RISE registry linked to Medicare claims to identify emerging patient safety errors for newly approved immunosuppressive drugs and analyze these errors across race/ethnicity, socioeconomic status, medical complexity, access to care and practice characteristics. In Aim 2, we will perform a comprehensive evaluation of current national patient safety eMeasures related to immunosuppressive drugs, assessing feasibility, reliability, and validity across diverse practice settings, electronic health record systems, and visit types (telemedicine versus face-to-face). In Aim 3, we will use mixed-methods grounded in implementation science theory to determine key drivers of performance on ambulatory patient safety eMeasures. Data from this research will be used to develop and disseminate the first implementation toolkit designed to improve patient safety for high-risk immunosuppressive drugs. The proposed research will contribute significantly to the national infrastructure to improve ambulatory patient safety for the millions of Americans with immune- mediated diseases.

项目摘要 尽管广泛认识到美国医疗保健系统中普遍存在的患者安全问题，但研究 为了开发可行的可扩展解决方案，尤其是在门诊环境中。需要新的 提高安全性的方法尤其是使用高风险的门诊患者的护理 免疫抑制药物，随着这种类型的药物的使用已急剧增长，报道了 可预防的不良事件增加了。在最后一个AHRQ资金期间，我们的研究团队产生了 患者安全风险和不良事件的新流行病学证据，并使用此信息来发展 Medicare和Medicaid中心的基于电子健康记录的质量测量 服务质量付款计划。此外，我们在美国在全国范围内实施了这些唤起量 风湿病学院的崛起注册表，其中包括来自三分之一以上的电子健康记录数据 美国执业风湿病学家。在此提案中，我们旨在以这项工作为基础，以改善卧床患者 使用高风险免疫抑制药物的人的安全。在AIM 1中，我们将使用RISE的数据 注册表与Medicare索赔有关，以确定新批准的新兴患者安全错误 免疫抑制药物并在种族/种族，社会经济地位，医学上分析这些错误 复杂性，获得护理和练习特征。在AIM 2中，我们将进行全面的评估 目前与免疫抑制药物有关的国家患者安全估计，评估可行性， 可靠性和有效性，各种练习环境，电子健康记录系统和访问类型 （远程医疗与面对面）。在AIM 3中，我们将使用以实施科学为基础的混合方法 理论确定卧床患者安全透度效果的关键驱动因素。来自此的数据 研究将用于开发和传播旨在改善患者的第一个实施工具包 高风险免疫抑制药物的安全性。拟议的研究将对 国家基础设施，以改善数百万免疫的美国人的门诊患者安全 介导的疾病。