Interventions gaining ground as next phase for patient safety research

Recent research has focused on guidelines for preventing pneumonia and on computerized physician order entry.

By Andis Robeznieks, AMNews staff. Sept. 20, 2004.

Nancy C. Elder, MD, associate professor at the University of Cincinnati's Dept. of Family Medicine, said she turned down an invitation to speak on evidence-based patient-safety interventions last year because there wasn't enough to discuss.

Now, however, her prediction that interventions would be the next phase of patient safety research appears to be coming true. One sign: A report on evidence-based guidelines for preventing ventilator-associated pneumonia published in the Aug. 17 Annals of Internal Medicine. Another example experts cite is research at Boston's Brigham and Women's Hospital on computerized physician order entry systems designed to protect patients and reduce redundant tests.

The interventions are not limited to hospitals. The Kentucky Medical Assn. Patient Safety Task Force has developed a test-tracking system for primary care doctors.

"I think there are other areas in patient safety where we still don't know enough to say, 'This intervention works,' " Dr. Elder said. "But the lab test process -- getting the right test done and getting the results handled properly -- that's an up-and-coming area that holds a lot of potential for improving patient health."

The KMA unveiled its test-tracking tips Aug. 14, and while they may not fit a classic definition for "evidence-based" development, Task Force Chair Greg Cooper, MD, said he believes the end result is a system that will improve quality and safety.

"We've taken the foundation from evidence-based systems that have shown to be functional and information from practical applications has been added," said Dr. Cooper, a family physician in a three-physician practice based in Cynthiana, Ky. "We didn't have to reinvent the wheel, and it was interesting to sit at the table and get input about what's worked in individual practice and what hasn't."