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AHRQ awards six grants in systems-related best practices to improve patient safety

The Agency for Healthcare Research and Quality recently funded six new research projects designed to improve patient safety by identifying and preventing avoidable system errors. Funding for these FY 2000 projects totals $2 million and builds on AHRQ's earlier investments in patient safety research. The Agency expects to award additional funding in FY 2001 for research on patient safety. The first two in a series of RFAs (requests for applications) on medical errors research have just been announced by AHRQ; select for more information. The newly funded grants are:

Characterizing Medical Error: A Primary Care Study. Principal investigator: Steven H. Woolf, M.D., Virginia Commonwealth University, Richmond. Total projected funding: $350,362. Project period: 9/15/00 - 8/31/02.

The researchers will interview primary care patients and providers from Virginia and Ohio to compare and contrast their experiences with medical errors. They will ask patients and providers what they think constitutes a medical error and what types of errors they think are most common and most serious.

TIPI Systems to Reduce Errors in Emergency Cardiac Care. Principal investigator: Harry P. Selker, M.D., New England Medical Center, Boston, MA. Total projected funding: $1,585,335. Project period: 9/15/00 - 8/31/03.

This project focuses on the prevention of medical errors in emergency department triage and treatment of acute cardiac ischemia (ACI) by more accurately predicting the likelihood that a patient has ACI. The researchers will gauge the benefits of thrombolytic therapy using a time-insensitive predictive instrument that provides real-time decision support to prevent inappropriate discharges.

Brief Risky High-Benefit Procedures: Best Practice Model. Principal investigator: Colin F. MacKenzie, M.D., R. Adams Cowley Shock Trauma Center, University of Maryland, Baltimore. Total projected funding: $537,843. Project period: 9/30/00 - 8/31/03.

This project focuses on the procedures used in thoracostomy for chest tube insertion at the Maryland Shock Trauma Center. The researchers will use video and audio recordings to demonstrate how medical errors can occur through deviations in processes and to prompt discussion among the clinical team about using practice guidelines to encourage appropriate clinical actions.

Developing Best Practices for Patient Safety. Principal investigator: Mark B. McClellan, M.D., Ph.D., Stanford University, Stanford, CA. Total projected funding: $1,259,823. Project period: 9/30/00 - 8/31/03.

The researchers will develop a public-private patient safety consortium between leading national organizations and 14 northern California hospitals serving diverse populations. The goals are to build a national evidence base for measuring and predicting patient safety performance and develop cost-effective strategies for improving safety practices in hospitals.

Improving Safety by Computerizing Outpatient Prescribing. Principal investigator: David W. Bates, M.D., M.Sc., Brigham and Women's Hospital, Boston, MA. Total projected funding: $1,700,187. Project period: 9/30/00 - 8/31/03.

The researchers will study the impact of electronic medical records and computerized medication prescribing on adverse drug events (ADEs) in outpatient clinics associated with Partners HealthCare System and the Regenstrief Institute at Indiana University.

Teamwork and Error in Neonatal Intensive Care. Principal investigator: Eric J. Thomas, M.D., University of Texas Medical School, Houston. Total projected funding: $677,795. Project period: 9/30/00 - 8/31/02.

The researchers will assess team-related, error-management behavior in the hospital neonatal intensive care unit. They will design an intervention to improve these behaviors and address elements of the organizational and professional culture that influence the frequency of errors.

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