PDF(Pubmed)
Abstract：
BACKGROUND: At least 10% of hospital admissions in high-income countries, including Australia, are associated with patient safety incidents, which contribute to patient harm (\'adverse events\'). When a patient is seriously harmed, an investigation or review is undertaken to reduce the risk of further incidents occurring. Despite 20 years of investigations into adverse events in healthcare, few evaluations provide evidence of their quality and effectiveness in reducing preventable harm.This study aims to develop consistent, informed and robust best practice guidance, at state and national levels, that will improve the response, learning and health system improvements arising from adverse events.
METHODS: The setting will be healthcare organisations in Australian public health systems in the states of New South Wales, Queensland, Victoria and the Australian Capital Territory. We will apply a multistage mixed-methods research design with evaluation and in-situ feasibility testing. This will include literature reviews (stage 1), an assessment of the quality of 300 adverse event investigation reports from participating hospitals (stage 2), and a policy/procedure document review from participating hospitals (stage 3) as well as focus groups and interviews on perspectives and experiences of investigations with healthcare staff and consumers (stage 4). After triangulating results from stages 1-4, we will then codesign tools and guidance for the conduct of investigations with staff and consumers (stage 5) and conduct feasibility testing on the guidance (stage 6). Participants will include healthcare safety systems policymakers and staff (n=120-255) who commission, undertake or review investigations and consumers (n=20-32) who have been impacted by adverse events.
BACKGROUND: Ethics approval has been granted by the Northern Sydney Local Health District Human Research Ethics Committee (2023/ETH02007 and 2023/ETH02341).The research findings will be incorporated into best practice guidance, published in international and national journals and disseminated through conferences.
METHODS: The setting will be healthcare organisations in Australian public health systems in the states of New South Wales, Queensland, Victoria and the Australian Capital Territory. We will apply a multistage mixed-methods research design with evaluation and in-situ feasibility testing. This will include literature reviews (stage 1), an assessment of the quality of 300 adverse event investigation reports from participating hospitals (stage 2), and a policy/procedure document review from participating hospitals (stage 3) as well as focus groups and interviews on perspectives and experiences of investigations with healthcare staff and consumers (stage 4). After triangulating results from stages 1-4, we will then codesign tools and guidance for the conduct of investigations with staff and consumers (stage 5) and conduct feasibility testing on the guidance (stage 6). Participants will include healthcare safety systems policymakers and staff (n=120-255) who commission, undertake or review investigations and consumers (n=20-32) who have been impacted by adverse events.
BACKGROUND: Ethics approval has been granted by the Northern Sydney Local Health District Human Research Ethics Committee (2023/ETH02007 and 2023/ETH02341).The research findings will be incorporated into best practice guidance, published in international and national journals and disseminated through conferences.
摘要：
背景：高收入国家至少有10％的住院人数，包括澳大利亚,与患者安全事件有关，导致患者伤害(“不良事件”)。当病人受到严重伤害时，进行调查或审查，以减少发生进一步事件的风险。尽管对医疗保健中的不良事件进行了20年的调查，很少有评估提供证据证明其在减少可预防伤害方面的质量和有效性。这项研究旨在制定一致的，知情和强大的最佳实践指导，在州和国家层面，这将改善反应，不良事件引起的学习和卫生系统改善。
方法：设置将是新南威尔士州澳大利亚公共卫生系统中的医疗机构，昆士兰，维多利亚和澳大利亚首都领地。我们将采用多级混合方法研究设计，并进行评估和现场可行性测试。这将包括文献综述(阶段1)，评估来自参与医院的300份不良事件调查报告的质量（第二阶段），以及参与医院的政策/程序文件审查（第三阶段），以及焦点小组和访谈，内容涉及与医护人员和消费者进行调查的观点和经验（第四阶段）。在对第1-4阶段的结果进行三角测量之后，我们将与员工和消费者共同设计进行调查的工具和指南（第5阶段），并对指南进行可行性测试（第6阶段）。参与者将包括医疗安全系统政策制定者和工作人员（n=120-255），进行或审查已受到不良事件影响的调查和消费者（n=20-32）。
背景：伦理学已获得北悉尼地方卫生区人类研究伦理学委员会的批准（2023/ETH02007和2023/ETH02341）。研究结果将纳入最佳实践指南，在国际和国家期刊上发表，并通过会议传播。
方法：设置将是新南威尔士州澳大利亚公共卫生系统中的医疗机构，昆士兰，维多利亚和澳大利亚首都领地。我们将采用多级混合方法研究设计，并进行评估和现场可行性测试。这将包括文献综述(阶段1)，评估来自参与医院的300份不良事件调查报告的质量（第二阶段），以及参与医院的政策/程序文件审查（第三阶段），以及焦点小组和访谈，内容涉及与医护人员和消费者进行调查的观点和经验（第四阶段）。在对第1-4阶段的结果进行三角测量之后，我们将与员工和消费者共同设计进行调查的工具和指南（第5阶段），并对指南进行可行性测试（第6阶段）。参与者将包括医疗安全系统政策制定者和工作人员（n=120-255），进行或审查已受到不良事件影响的调查和消费者（n=20-32）。
背景：伦理学已获得北悉尼地方卫生区人类研究伦理学委员会的批准（2023/ETH02007和2023/ETH02341）。研究结果将纳入最佳实践指南，在国际和国家期刊上发表，并通过会议传播。
