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：
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
项目类别：
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

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). 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。比成人住院患者常见的倍数（每 100 次入院 40.0 次伤害与 25.1 次伤害）。家长 R01 建议。使用未开发的安全事件报告来源——住院儿科的患者和家属患者——评估儿科安全事件的流行病学；当前方法的优点和局限性错误报告系统；防止儿科用药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问题。我们基于手机的方法“家庭输入”。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拟议的行政补充将支持职业生涯。培养未来的拉丁裔医生兼研究员 Maite Garcia 女士，以改善对拉丁裔患者的护理和候选人是美国公民，其父母没有接受过严格和创新的研究。加西亚女士将领导一项定性研究，以更好地引发安全事件。试点研究中发现很少报告事件的拉丁裔患者和家属：目标 2：比较。 FIQS 向临床医生生成的报告记录在事件报告和医疗记录中。采用混合方法，量化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每个来源中涵盖的独特领域目标 3：评估改进。拟议的合作重点是将家庭和患者报告问题纳入安全工作中。研究的创新之处在于其范式转变的概念模型：1）患者参与的质量改进，2）它使用移动电话技术来收集实时数据，以及3）它使用改进的协作来制定强有力的实施策略，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不同卫生系统中住院环境的类型；家庭和患者安全报告的比较检测不良事件的其他方法；以及跨环境实施工具和策略将家庭和患者安全报告纳入护理中，这些贡献将意义重大，因为它们是实施和评估改善儿科住院患者安全的潜在新方法的关键步骤。