Administrative Supplement to Improve Enrollment in The Family Input for Quality and Safety (FIQS) Study

提高家庭质量与安全投入 (FIQS) 研究入学率的行政补充

基本信息

批准号：
10704834
负责人：
Naomi Shula Bardach
金额：
$ 25.01万
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/10704834
关键词：
Address Administrative Supplement Admission activity Adult Adverse event Caring Categories Cellular Phone Characteristics Child Childhood Clinical Communication County Hospitals Data Development Diagnosis Enrollment 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 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 care delivery demographics detection method experience hospital readmission 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 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.

抽象的医院中的不良患者安全事件发生率仍然居高不下，对于儿童而言，不良事件发生率为 1.5-2。比成人住院患者的发生率高出 1 倍（40.0 次伤害/100 次入院 25.1 次伤害）。尚未开发的安全事件报告来源——住院儿科患者的患者和家属—— 解决 NICHD 确定的知识差距：儿科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；以及开发学习健康系统以解决住院儿科安全问题。电话应用技术提供了实时收集患者和家属安全报告的机会并匿名解决了我们基于手机的方法“家庭输入”的局限性。质量和安全 (FIQS) 是与家庭和教区居民合作开发的，并在儿科医疗外科单位，参与者和工作人员的热情参与。建议在其他医院测试该方法的同时，解决以下目标中先前工作的严格性目标 1：描述安全事件的变化。使用家庭和患者生成的安全报告跨护理环境和人群（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家庭的差异。按医院环境、医疗复杂性、语言、卫生技术素养和患者分类的患者安全报告目标 2：将 FIQS 报告与临床医生生成的安全报告进行比较。记录在事件报告和医疗记录中这将采用混合方法，量化事件。来自每个来源的重叠和独特事件的数量，并使用定性分析来描述独特的目标 3：评估专注于合并的改进协作。家属和患者将问题报告到安全工作中；该协作将包括所有参与单位；重点领域将是药物和沟通，将使用混合方法来评估。所提出的研究是使用理论驱动的 RE-AIM 实施科学框架进行协作。创新在于其范式转变的概念模型：1）患者参与的质量改进，2）其使用移动电话技术来收集实时数据，以及 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有力的实施策略。拟议研究的内容将是对多种类型的家庭和患者安全报告的描述两个不同卫生系统的住院环境；家庭和患者安全报告与其他报告的比较；检测不良事件的方法；以及跨环境实施工具和策略家庭和患者安全报告对护理的贡献将是重大的，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儿科住院患者的安全。