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In an unprecedented move, the U.S. Department of Health and Human Services has released $50 million to fund 94 new research grants, contracts, and other projects to reduce medical errors and improve patient safety.
This initiative, the first phase of a multi-year effort, will be concentrated in the following areas:
• Supporting demonstration projects to report medical errors data. This will include 24 projects for $24.7 million to study methods of collecting and analyzing data on errors.
• Using computers and information tech-nology to prevent medical errors. Activities will include 22 projects for $5.3 million, to develop and test the use of computers and information technology to reduce medical errors, improve patient safety, and improve quality of care.
• Understanding the impact of working conditions on patient safety. Eight projects, to cost $5.3 million, will examine issues such as staffing, fatigue, stress, sleep deprivation, and other factors that can lead to errors. These issues have not been closely studied in health care settings.
• Developing innovative approaches to improving patient safety. These activities will include 23 projects for $8 million, and will involve health care facilities and organizations in geo-graphically diverse locations across the country.
• Disseminating research results. Seven projects, costing $2.4 million, will help educate clinicians and others about the results of patient safety research. This work will help develop, demonstrate, and evaluate new approaches to improving provider education in order to reduce errors.
•Additional patient safety research initiatives. The Agency for Healthcare Research and Quality (AHRQ) will use the remaining $6.4 million for 10 projects covering other safety research activities, including supporting meetings of state and local officials to advance local patient safety initiatives and assessing the feasibility of implementing a patient safety improvement corps.
"This funding is incredibly significant," says Gregg Meyer, MD, director of the AHRQ’s Center for Quality Improvement and Patient Safety. "One of the things that was made clear in the IOM [Institute of Medicine] report in 1999 was that, in order to make dramatic improvement, we have to answer a great many questions. This is a bold initiative in answering these questions." Meyer also points out that "with this [commitment], AHRQ becomes the world’s largest funder of patient safety research."
Meyer is quick to note that this agenda came not from researchers but from patients. "We took a very new and important approach in developing this agenda — we went to potential users. We went to patients, providers, professional associations, hospitals, health plans, and policy-makers. We asked: What are the important questions we could answer that will help you make it safer for patients?’ This approach, in the long run, will be very important and will pay off handsomely in terms of having a real impact on the safety of health care."
Meyer adds that this investment not only will fund research by the best in the field, but it will yield very relevant information. The AHRQ web site (www.ahrq.gov) or the site www.quick.gov will provide a look at current patient safety research.
His goals for the initiative include improving patient safety on two broad fronts. "First, it will help us translate what is already known about improving safety into practice. Evidence-based practice reports really show what can be put into practice now; we can immediately translate what we know into practice and get an immediate effect. I’m talking on the order of 12 to 24 months; some of the efforts we’ve funded should already be making health care safer," Meyers says.
His second goal is to truly understand the epidemiology of and solutions to the patient safety problem. "We hope to make a down payment in this area," he says. "One of our most controversial initiatives has to do with the role of reporting. We’re investing almost half of all the money into reporting — what works and what doesn’t. That’s very exciting."
Also exciting, says Meyer, is the fact that this is not a research initiative that will take five or 10 years to affect the lives of patients. "There are some more immediate benefits. We are pleased that Congress gave us the opportunity to do this research into what is such a huge challenge for the health care system."
[For more information, contact:
• Gregg Meyer, MD, Director, AHRQ Center for Quality Improvement and Patient Safety. E-mail: email@example.com.]