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Research program on patient safety and complex care (PSCC)

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Title Research program on patient safety and complex care (PSCC)
Period 01 / 2007 - unknown
Status Completed
Research number OND1326546
Data Supplier Website ZonMw

Abstract

The objective of the research program is to gain further knowledge and insight in: 1) prevention of unintended events and avoidable harm for vulnerable groups of patients, e.g. older patients with hip fractures; 2) moments of sub-optimal information transfer and communication between care providers in hospitals, between hospitals and adjoining care sectors and between care providers and patient/informal carers, 3) the effectiveness of a patient safety intervention program. The study consists of a main study covering the three phases of the earlier described Risk Governance framework, and three intervention studies combined in an integral intervention program as part of the main study. The main study focuses on the chain of care for vulnerable elderly hip fracture patients, starting from (nursing/elderly) home and the ambulance through the emergency department and several other hospital departments back home to the (nursing/elderly) home. The intervention studies focus on: · improving the effectiveness of communication among care givers within the hospital and within the care chain by implementing SBAR tools (situation, background, assessment, recommendation); · strengthening the role of patients and their family in preventing errors and harm.· improving the transition between hospital and (nursing) home, and the care process after discharge. Safety management in organizations should be based on awareness, insights into the nature and scale of harm to patients and an understanding of the causes of harm. This knowledge can be used for developing and testing methods of prevention, and developing and running ongoing safety improvement programmes. The intended research program on Patient Safety and Complex Care (PSCC) intends to provide insights in possibilities for improvement, by generating, disseminating and implementing knowledge and improvement activities. During currently ongoing studies several care providers have indicated elderly people with hip fractures to be the patients that suffer from inadequate care, unintended events and avoidable harm during the care process.Therefore, elderly patients with hip fractures are the focus of the research program PSCC, in which the complete care chain - from the moment the patient arrives with a hip fracture at the care provider to the moment that the patient returns to his own environment - is part of the study. Elderly patients with hip fractures are a vulnerable group (multi-morbidity) in a complex care chain (emergency situation and several different care providers). Below, we will explain the motivation for choosing this target group of the study in more detail. Aim of the research programThe objective of the research program is to gain further knowledge and insight in: 1) prevention of unintended events and avoidable harm for vulnerable groups of patients, e.g. older patients with hip fractures; 2) moments of sub-optimal information transfer and communication between care providers in hospitals, between hospitals and adjoining care sectors and between care providers and patient/informal carers, 3) the effectiveness of a patient safety intervention program.The study consists of a main study and several intervention studies as part of the main study. The main study focuses on the chain of care for vulnerable elderly hip fracture patients, starting from (nursing/elderly) home and the ambulance through the emergency department and several other hospital departments back home to the (nursing/elderly) home. The intervention studies focus on: 1) improving the effectiveness of information transfer/communication among care givers within the hospital and within the care chain by implementing SBAR tools (situation, background, assessment, recommendation); 2) strengthening the role of patients and their family in preventing errors and harm by implementing a patient safety card;3) improving the care process after discharge by implementing bundles of evidence based recommendations for common complications. MethodsTo answer the research questions we will us several methods, e.g. meetings with stakeholders, patient record review, surveys, incident reporting, and an intervention program with three integrated intervention studies. Expected resultsThe research program will deliver usable results for research, practice and policy. Professionals can use the observation forms for self-evaluation, the incident registration form to build a registration system or the forms for patient record screening to get, periodically, insight into events with regard to miscommunication between professionals and the nature and scale of avoidable harm to patients in their own practice. Insight into weak and strong barriers in the care chain makes it possible to adapt organization policies. The tools of the intervention studies, e.g. SBAR communication tools, the patient safety pocket card with guidelines for patients, and the bundles with recommendations can be used for the development of a patient safety management system.

Related organisations

Related people

Project leader Prof.dr. C. Wagner

Classification

A73200 Second-line health care
A76000 Patients care
D23363 Geriatrics

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