Reporting trends in a regional medication error data-sharing system
Department of Sociology, Purdue University, West Lafayette, IN 47907-2059, USA.Health Care Management Science (Impact Factor: 1.05). 03/2010; 13(1):74-83. DOI: 10.1007/s10729-009-9111-1
Inter-organizational systems for sharing data about medication errors have emerged as an important strategy for improving patient safety and are expected to encourage not only voluntary error reporting but also learning from errors. Yet, few studies have examined the hypothesized benefits of inter-organizational data sharing. The current study examined the developmental trends in information reported by hospitals participating in a regional reporting system for medication errors. A coalition of hospitals in southwestern Pennsylvania, under the auspices of the Pittsburgh Regional Healthcare Initiative (PRHI), implemented a voluntary system for quarterly sharing of information about medication errors. Over a 12-month period, 25 hospitals shared information about 17,000 medication errors. Using latent growth curve analysis, we examined longitudinal trends in the quarterly number of errors and associated corrective actions reported by each hospital. Controlling for size, teaching status, and JCAHO accreditation score, for the hospitals as a group, error reporting increased at a statistically significant rate over the four quarters. Moreover, despite significant baseline differences among hospitals, error reporting increased at similar rates across hospitals over subsequent quarters. In contrast, the reporting of corrective actions remained unchanged. However, the baseline levels of corrective actions reporting were significantly different across hospitals. Although data sharing systems promote error reporting, it is unclear whether they encourage corrective actions. If data sharing is intended to promote not just error reporting but also root-cause-analysis and process improvement, then the design of the reporting system should emphasize data about these processes as well as errors.
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ABSTRACT: Two major challenges to current voluntary medical incident reporting system (VMIR) are underreporting and low quality reports, which make it difficult for health providers to effective use and learn from mistakes for patient safety improvement. According to prior researches on a variety of voluntary system design and usage in different domains such as aviation, system usability and utility were considered as significant contributing factors that influence the system acceptance. However, the published studies of dealing with these factors to maximize system acceptance and effectiveness in medical incident reporting domain are few and fragmented. In this study, we elaborated the background and problems in target domain of medical incident reporting firstly, and then synthesized practical and academic instance by unobtrusive data analysis and literature review to propose a design framework to the future applications. Finally, a developing computer-based prototype as a partial solution of proposed design was paraphrased to illustrate our initial progress on user-centered design of VMIR. It is expected to increase reporting efficiency and data quality that will promote a learning culture and help remove shame-blame barriers in collecting patient safety events.
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ABSTRACT: Voluntary medical incident reporting systems (VMIR) are an application of information technology to support medical errors reporting for health professionals and thus ultimately improve healthcare quality and patient safety. The overall goal of this paper was to investigate the usage and effective design of VMIR by literature review. We expected to uncover design potentials from prior studies by examining on both incident reports analysis and system design, by which to establish a user-centered design framework that integrates identified factors for advancing VMIR effectiveness and efficiency. All papers regarding voluntary reporting system were identified through systematic electronic database searches. Three eligibility criteria were applied: 1) voluntary programs; 2) information system; 3) medical incident/error reporting. Of 8 eligible articles identified, the main themes are about current systems’ shortcomings on underreporting, report quality, standardized nomenclature/ taxonomy, communication, usability as well as reporting culture and environment. Eventually, all of identified concerns in the study will be addressed in a VMIR system prototyping process to attack the shortcomings aforementioned.
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ABSTRACT: Background: This systematic review seeks to define the general advantages and disadvan-tages of accreditation programs to assist in choosing the most appropriate approach. Method: Systematic search of SID, Ovid Medline & PubMed databases was conducted by the keywords of accreditation, hospital, medical practice, clinic, accreditation models, health care and Persian meanings. From 2379 initial articles, 83 articles met the full inclusion criteria. From initial analysis, 23 attributes were identified which appeared to define advantages and disadvantages of different accreditation approaches and the available systems were compared on these. Results: Six systems were identified in the international literature including the JCAHO from USA, the Canadian program of CCHSA, and the accreditation programs of UK, Australia, New Zealand and France. The main distinguishing attributes among them were: quality improve-ment, patient and staff safety, improving health services integration, public's confi-dence, effectiveness and efficiency of health services, innovation, influence global standards, information management, breadth of activity, history, effective relationship with stakeholders, agreement with AGIL attributes and independence from government. Conclusion: Based on 23 attributes of comprehensive accreditation systems we have defined from a systematic review, the JCAHO accreditation program of USA and then CCHSA of Can-ada offered the most comprehensive systems with the least disadvantages. Other programs such as the ACHS of Australia, ANAES of France, QHNZ of New Zealand and UK accredita-tion programs were fairly comparable according to these criteria. However the decision for any country or health system should be based on an assessment weighing up their specific objec-tives and needs.
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