From Here to There: Lessons from an Integrative Patient Safety Project in Rural Health Care Settings

摘要

To date, few studies have focused on patient safety issues that occur in rural health care settings. This article presents and discusses the methodology and the key findings obtained from a multi-method research study of patient safety in rural health care settings, funded by the Agency for Healthcare Research and Quality. Interdisciplinary teams of health care providers from 30 rural hospitals and Indian Health Service settings in a 9- state area of the West participated in this initiative. Study instruments included surveys, interviews, and textual analysis of responses to case studies. Data indicate that health care providers strongly affirm the importance of patient safety and want access to guides and resources that help achieve that goal. However, the lack of shared agreement regarding the definition, recognition, responsibility, reporting, and disclosing of errors compromises the development of a patient safety agenda. Using e-mail and a secure Web site, the authors developed a model for retrieving data, increasing discussion, providing resources, and disseminating findings. Following descriptions of the study participants and protocol is a summary of the findings. Overall, the findings highlight the complexity and the interdisciplinary scope of the patient safety problem, including factors related to the cognitive aspects of error-related processes (i.e., the differential recognition of error across disciplines); behavioral aspects (i.e., perception versus action); and organizational structures (e.g., reporting mechanisms, barriers, and outcome measures).