Summaries of Independent Scientist (K) Awards

Elder, Nancy

Institution: University of Cincinnati
Grant Title: Patient Safety and the Primary Care Testing Process
Grant Number:  K08 HS013914
Duration: 5 years (2005-2010)
Total Award: $671,100

Project Description: This research project has four specific goals:

1. Identify critical points in a proposed Human Factors-Testing Process (HF-TP) Model that are most likely to lead to gaps in patient safety.
2. Describe the flow of functions and tasks in the testing process through in-depth study of four family practice offices using human factors engineering (HFE) techniques.  This will be done through direction observation of testing process elements, semi-structured interviews, written questionnaires and surveys, and reviewing existing documents (forms, protocols, manuals).
3. Revise and validate the Human Factors-Testing Process Model and identify the tasks and functions critical to patient safety.  This will be accomplished by applying data from Aim 2 to the Model.  Also, a limited study will be conducted focusing on critical tasks, functions, and decisions in the Model using HFE techniques.
4. Identify barriers and promoters of future quality improvement intervention to prevent critical task errors in the primary care testing process.  This will be accomplished through focus groups with primary care physicians, office staff, and patients.

Career Goals: Dr. Elder is a family practice physician and has a Master's degree in Public Health.  She is committed to expanding her research in medical errors and patient safety in the outpatient primary care setting and wants to build on her earlier work and collaborations.  She would like to acquire the following new competencies:  learn human factors engineering theory, methods, and application; up-date knowledge and skills in the responsible conduct of research; and strengthen qualitative research skills.  Additionally, she would like to acquire a strong foundation in organizational change theory.  Dr. Elder's ultimate goal is to become an independent health services researcher and develop future quality improvement innovations.

Progress to Date: Dr. Elder's has recruited four practices and has completed data collection at two.  She has also completed the audit of a human decision-making graduate-level course and maintains a small commitment of clinical and teaching efforts.

Future Plans: The grantee will apply data from Aim 2 to the HF-TP model and perform a limited study of additional practices focused on critical tasks, function, and decisions in the HF-TP model using HRE techniques.  She will prepare and submit several manuscripts for publication.  Further, Dr. Elder will develop new data collection instruments and begin soliciting practices to participate in the next phase of the study.

Highlights and Specific Accomplishments:

• Associate Professor, Department of Family Medicine, University of Cincinnati.

K-Generated Publications:

Elder N, Brungs SM, Nagy M, et al. Intensive care unit nurses' perceptions of safety after a highly specific safety intervention. Quality and Safety in Health Care 2008. 17:25-30.

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