Patient Safety Program

NH&MRC Patient Safety Program

Professor Braithwaite and his co-investigators have been awarded an NHMRC research grant totalling $8.4 million. The NHMRC Program Grant [Chief Investigators, Professor Jeffrey Braithwaite, Professor Johanna Westbrook, Professor Enrico Coiera, Professor William Runciman and Professor Ric Day will examine, across Australia, patient safety.

The program administered by the Institute of Health Innovation, University of NSW, commenced in January 2009 for five years providing exciting career and higher degree opportunities.

Internationally, patient safety is a growing concern. Patient harm occurs in 10% of hospital admissions. A million adverse events occur in general practice each year in Australia. International data shows that patients receive recommended care only 50% of the time. The NH&MRC Patient Safety Program will significantly advance this work by investigating how and why this occurs, with a focus on the roles of teamwork, safe medication use and the application of information technology to support improved decision-making.

Despite widespread recognition of the need for reliable measures of the state of healthcare, we still have a poor understanding of what goes wrong in healthcare, and, particularly, how and why things go wrong. There is an urgent need to develop genuinely safe health services based on sound theoretical foundations, grounded in accurate, relevant measurements of the health system, and an understanding of behavioural and practice change, using technology shaped by an understanding of clinical work.

Four cross-linked research programs will address these issues by elucidating: 1: Which plans are being used to treat Australian patients, and why are they chosen? 2: What system problems perpetuate flawed plans and failures of their execution? 3: Which information technology interventions are most likely to enhance the selection of the right plan, and its effective execution? 4: Can a theoretical synthesis of this knowledge build a safety model that predicts the dynamic and complex interactions of health service performance?

For further information about the program or degrees and employment opportunities contact Professor Jeffrey Braithwaite at clingov@unsw.edu.au or call 02 9385 3861.

Want to know more….

The Chief Investigators are internationally recognized for their leadership in the field of patient safety. They bring together various interrelated areas of expertise in health informatics, medicine, medication errors and the cultural determinants of health care problems. The scope of the project will include collaboration with national and international partners.

The NH&MRC Patient Safety Program is comprised of four sub-programs being completed over 5 years. It is expected that up to 15 staff approximately and 10 -12 higher degree students will be engaged in the entreprise. A brief description of the aims of each program is given below:

Program 1: Which plans are being used to treat patients, and why are they chosen? Aim 1: To extend our capabilities to measure the adoption of clinical best practice and to determine for the first time the extent to which Australians receive care consistent with the standards suggested by evidence- and consensus-based best clinical practice.

Aim 2: To determine the reasons that underlie provision of care that deviates from best-practice.
Stage 1: A random population survey of around 6,600 to ask about use of health services and consent to access medical records. Stage 2: Review of consenting patient records. Stage 3: Telephone interviews with around 2000 practitioners involved in the treatment of people identified in stage 1. Stage 4: A subset around 3000 participants from stage 1 being re-interviewed.

Program 2: What system problems perpetuate flawed plans and failures of their execution? Aims: To identify and measure the impact of clinicians’ work and communication patterns, social networks, and team and organisational factors, on safe plan execution.

Program 3: Which information technology interventions are most likely to enhance the selection of the right plan, and its effective execution? Aim 1: To study the determinants of safe and effective clinical decision-making mediated by decision support technologies. Aim 2: To determine the design parameters for safe and effective decision support system use in real world clinical settings.

Program 4: Can a theoretical synthesis of safety research build a safety model that predicts the dynamic and complex interactions of health service performance?
Aim 1: To use information from the literature and our research programs to develop and iteratively refine a computational model of each of the layers of healthcare and of the interactions between them. Aim 2: To use modelling and simulation to help identify practices and organisational components that fail tests of safety and quality, and to use the model as a predicative tool to guide research and policy about the safety and quality remedies most likely to succeed in given contexts.

For further information about the program or degree and employment opportunities contact Professor Jeffrey Braithwaite at clingov@unsw.edu.au or call 02 9385 3861.