Networks’ Experiences. Connecticut Center for Primary Care : ProHealth Physicians Practice Based Research Network (PI: John Lynch, MPH) The Oregon Rural Practice-based Research Network ( ORPRN ) ( PI: LJ Fagnan, MD) CenTexNet (PI: Samuel N. Forjuoh, M.D., M.P.H., Dr.P.H)
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The Connecticut Center for Primary Care (CCPC) is an independent 501c3 non-profit research and education foundation.
On incorporation in 2002, CCPC assumed management of the ProHealth Physicians Practice Based Research Network, a PBRN affiliated with the AAFP Federation of Practice Based Research Networks.
Reminders & Feedback
Weekly “Chalk Talk” reports
Access to online error report page
Occasional “fun” reminders
MEADERS Desktop Icon
Active engagement of lead clinician & staff
Did you ask about patient medications?
1) Rural Family Practice Clinicians and office staff will report to MEADERS as evidenced during a 10 week reporting trial
“It was painless.”
“It went well. All participated and seemed to enjoy it. It did not take an excessive amount of time.”
“People in the practice picked up on the type of events to report quite quickly and required little direction. Melinda helped a lot too.”
2) Barriers to reporting included: making the time to report, breadth of reporting options, and confusion regarding what to report.
“It was more difficult for the staff it seemed because it was one more thing that they had to do.”
“I am assuming that some errors did not get reported because the criteria were too broad and clinicians didn’t think that they were important.”
3) Some practices used MEADERS data for internal Quality Improvement
“Overall, I think that the MEADERS reporting system was helpful to staff and providers to remind us that errors occur and we should be mindful of them and work to prevent them in the future…my MA and I worked especially hard with one patient who kept taking the wrong dose of her Coumadin… Her care improved because of MEADERS.”
“The biggest thing it changed was making us more attentive to documentation and keeping med lists up to date ‑ especially between institutions like LTC and hospitals and hospices.”
4) Some clinics report a desire to continue using MEADERS while others do not.
“It was easy to use, we would like to continue using it in our practice.”
“I doubt the practice would be excited about reporting events on a regular basis…This will be a significant obstacle to over come if this or a similar system becomes required in clinical practice.”
“The overall thing is that the direct access made the process much easier - most of our staff had never made any reports regarding adverse drug reactions so in my eyes - if the goal is to improve the process by which reports are made - this is a huge improvement.”
Family Physician, Clinic 2
28 Scott & White Regional Clinics in 22 Locations + Brazos Family Medicine Residency Clinic, Bryan + Family Practice Residency Clinic, Waco
Quality & Safety Officers
Clinic staff & MD champions
Adequacy of training
Part of network mission
Staff familiarity with IT
Workflow conflictFacilitators & Barriers
Reducing Health Care Disparities in Southern California
Through Participatory Research Partnerships With the Health Care Community
Clinica Msr. Oscar A. Romero Alvarado St.
Clinica Msr. Oscar A. Romero Marengo St.
QueensCare, Echo Park
Cleaver Family Wellness Center
East Valley Community Health Center West Covina
East Valley Community Health Center Pomona
Note: QueensCare dropped out week 5 and Cleaver joined at week 6
A survey was sent to the 220 clinicians and staff members who agreed to participate in the project
Purpose: to learn about participants experience with MEADERS
164 completed the survey, a 75% response rate
The MEADERS tool was used by practices and felt to be of value
FDA MedWatch is rarely used by clinicians
Reporting on medication errors is was not considered “safe” by many participants. They expressed concerns about repercussions of reporting and a few people were uncomfortable reporting on the mistakes of others
Comments of participants note that MEADERS improved the quality of their care; they learned from mistakes and changed how they did their job
Time is money: the sustainability of using a reporting tool such as MEADERS is unclear. Health systems might consider implementing MEADERS across their organization.