Building evidence based patient safety monitoringindicators for heathcare institutions

• Main Authors: Ying-Chuan Hsu, 許英娟
• Other Authors: Che-Minf Yang
• Format: Others
• Language: zh-TW
• Published: 2007
• Online Access: http://ndltd.ncl.edu.tw/handle/2reqsr

碩士 === 臺北醫學大學 === 醫務管理學研究所 === 95 === Patient safety has become a very important global issue recently. The Department of Health (DOH) of Taiwan is also dedicated to improve the healthcare quality; hence, effective evaluation of healthcare quality must begin with establishment of legitimate indicators and practical evaluation process. Currently, Taiwan has not established an objective patient safety monitoring system with complete data. This research intends to develop an objective system of patient safety indicators. The research of its feasibility is conducted through clinical applications in hospitals with goals to provide a model for policy making and to improve patient safety in Taiwan. This study includes two stages: firstly to select patient safety monitoring indicators and secondly to test the indicators. The first stage includes three phases. First of all, We chose 48 indicators from the Hospital Patient Safety Indicator project funded by the DOH in 2004, and also selected other items from Taiwan Healthcare Indicator Series (THIS), American Hospital Association, Agency for Healthcare Quality and Research, and the Taiwan Quality Indicator Project (TQIP). Altogether 75 items were included in our study. Secondly, according to the opinions of a panel of experts, these indicators were further divided into 7 categories according to the 2006 patient safety goals of the DOH of Taiwan, including 10 indicators of medication safety, 11 indicators of infection control, 1 indicator of accuracy in surgery, 4 indicators of patient identification, 1 indicator of prevention of patient falls, 5 indicators of incident reporting, and 16 indicators of healthcare monitoring. 48 from the original 75 indicators were selected in the phase. Thirdly, We then applied the modified Delphi Technique to build up consensus among experts in terms of validity and reliability so as to come up with the most suitable indicators for Taiwan. Twenty two indicators were further deleted after the modified Delphi round, and twenty six indicators remained. The second stage includes two phases. First of all, through the discussions of many patient safety related staffs from various hospitals in Taiwan, 47 indicators were recommended for further trials. Secondly, the patient safety indicators definition handbook was written up. THIS participating hospitals were then invited to join the following trial. The selected indicators were collected clinically for there months. The trial results indicated that participating hospitals have reached the agreement that these indicators have positive impacts on the establishment of a safer medical environment and a patient centered culture. On the other hand, negative impacts were also noted including the increase of workload and expenses. Over all, all the participating hospitals fully support the feasibility of this patient safety monitoring system and believe that it will improve the reliability of future healthcare quality evaluation.