The Family Input for Quality and Safety (FIQS) Study

家庭质量与安全投入 (FIQS) 研究

• 批准号: 10264650
• 负责人: Naomi Shula Bardach
• 金额: $ 9万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-01-01 至 2021-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10264650
• 关键词: Address; Administrative Supplement; Admission activity; Adult; Adverse event; Car Phone; Caring; Child; Childhood; Data; Development; Epidemiology; Evaluation; Event; Family; Family member; Future; Health Technology; Health system; Hematology; Hospital Units; Hospitals; Inpatients; Language; Latinx; Lead; Learning; Medical; Medical Records; Medication Errors; Methods; Modeling; National Institute of Child Health and Human Development; Oncology; Operative Surgical Procedures; Parents; Participant; Patients; Pediatric epidemiology; Physicians; Pilot Projects; Population; Public Health; Report (document); Reporting; Research; Research Personnel; Safety; Source; System; Technology; Testing; Time; Variant; Work; base; career; career development; demographics; high school; implementation strategy; implementation tool; improved; innovation; interest; literacy; novel strategies; patient engagement; patient safety; pediatric patients; prevent; safety net; safety study; tool

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). The parent R01 proposal uses an untapped source of safety event reporting—patients and family members of hospitalized pediatric patients—to assess 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. 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. The proposed administrative supplement will support the career development for a future Latinx physician-researcher, Ms. Maite Garcia, to improve care for Latinx patients and families through rigorous and innovative research. The candidate is a US citizen whose parents did not receive post-secondary high school degrees. Ms. Garcia will lead a qualitative study to better elicit safety events in Latinx patients and families, who were found to report events infrequently in the pilot study. Aim 2: Compare FIQS reports to clinician-generated 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 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。家长R01提案 使用尚未开发的安全事件报告的来源 - 住院儿科的患者和家人 患者 - 评估小儿安全事件的流行病学；当前方法的优势和局限 错误报告系统；预防小儿药物错误的方法；以及学习的发展 卫生系统以解决住院儿科安全。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。拟议的行政补品将支持职业 未来拉丁裔物理研究者Maite Garcia女士的开发，以改善拉丁裔患者的护理 通过严格而创新的研究来家庭。候选人是美国公民，父母没有收到 博士后高中学位。加西亚女士将领导一项定性研究，以更好地引起安全活动 在试点研究中发现事件很少报告的Latinx患者和家庭。目标2：比较 FIQS向事件报告和病历中记录的临床生成报告报告。这会 员工混合方法，量化每个来源的重叠和唯一事件的数量，并使用 定性分析描述每个来源涵盖的独特域。目标3：评估改进 协作专注于将家庭和患者报告问题纳入安全工作。提议 研究在其范式转移概念模型的1）改进质量上是创新的，2） 它使用手机技术来收集实时数据，以及3）使用改进协作 制定强大的实施策略，将家庭和患者报告纳入安全工作中。 拟议研究的贡献将是对多个家庭和患者安全报告的描述 两个潜水员卫生系统中的住院环境类型；家庭和患者安全报告与 检测不良事件的其他方法；以及交叉设定的实施工具和策略 将家庭和患者安全报告纳入护理。这些贡献将是重要的，因为它们是 实施和评估潜在的新方法来改善儿科住院安全的方法。