● Encouraging teamwork: TeamSTEPPS ™ is an evidence- based system to improve teamwork and communication among healthcare professionals, using a comprehensive set of training curricula (AHRQ, 2010b). As of 2009, TeamSTEPPS ™ had been distributed to 14,000 healthcare organizations. ● Reducing healthcare-associated infections: AHRQ supported the development of a patient safety checklist proven to prevent common, costly, and sometimes deadly central-line-associated bloodstream infections by up to 66% (AHRQ, 2009a; Pronovost et al., 2006). ● Preventing medication errors: Blood Thinner Pills: Your Guide to Using Them Safely is designed to enhance care coordination around anticoagulant therapy. Warfarin is the second most common drug, after insulin, implicated in emergency room visits for adverse drug events (AHRQ, 2009b). ● Reducing hospital readmissions: AHRQ supported the development of a toolkit to prevent unnecessary hospital readmissions. By focusing on the discharge process, the traditional weak link in hospital care, the toolkit helped reduce hospital readmission rates by nearly 30% at a Boston teaching hospital (Jack et al., 2009). U.S. Food and Drug Administration The FDA is an agency within the Department of Health and Human Services. The FDA is responsible for protecting the public health by assuring the safety, efficacy, and security of human and veterinary drugs, biological products, medical devices, our nation’s food supply, cosmetics, products that emit radiation, and tobacco products (FDA, 2014b). National Patient Safety Foundation Another national initiative, the Ask Me 3 program ( http://www. npsf.org/?page=askme3 ) developed by the National Patient Safety Foundation (NPSF), is designed to promote effective communication between healthcare providers and patients to improve healthcare outcomes. The program encourages patients to ask their physicians, dentists, nurses, pharmacists, and therapists three questions: National Quality Forum The National Quality Forum (NQF) is a nonprofit organization that aims to improve the quality of health care for all Americans through fulfillment of its three-part mission: ● Setting national priorities and goals for performance improvement ● Endorsing national consensus standards for measuring and publicly reporting on performance ● Promoting the attainment of national goals through education and outreach programs. (NQF, 2014) The NQF’s membership encompasses a variety of healthcare stakeholders, including consumer organizations, public and private purchasers, physicians, nurses, hospitals, accrediting and certifying bodies, supporting industries, and healthcare research and quality improvement organizations. To help fulfill its mission, the NQF publishes the Safe Practices for Better Healthcare Consensus Report. The report was first published in 2003 and last updated in 2010 (with an update to Safe Practice 22: Surgical-site infection, in 2011). The report outlines 34 safe practices that are organized into seven functional categories for improving patient safety:
● Advances in event reporting: Event reporting and standardized data collection yield critical data. Patient Safety Organizations (PSOs), authorized under the Patient Safety and Quality Improvement Act, are organizations that share the goal of improving the quality and safety of healthcare delivery. Organizations that are eligible to become PSOs include public and private entities, profit and not-for-profit entities, and provider entities such as hospital chains. These organizations receive patient safety data while working with providers to improve care without fear of legal repercussions (AHRQ, n.d.b). ● Supporting patient safety training: To better prepare physicians and surgeons for high-risk events, AHRQ has supported several projects that assess the use of simulation technology in improving teamwork, communication, diagnostic and technical skills, safety culture, and other hallmarks of safe care. ● Understanding resident fatigue: AHRQ-supported research into medical resident fatigue and its connection to medical/dental errors prompted limits in 2003 on the hours per week that medical residents could work at U.S. hospitals (HMD, 2008) (Clancy, 2009). The VA has been a leader in the development of the electronic health record. A recent study singles out the VA for its successful implementation of a comprehensive system of electronic health records (Jha et al., 2009). Patient records are now available 100% of the time to VA healthcare workers, compared to 60% of the time when the VA relied on paper records (VA, 2009). The FDA is also responsible for advancing public health by helping speed innovations that make medicines more effective and food, medicine, and medical devices safer and more affordable, and by helping the public get accurate, science- based information they need for the proper use of medicines, medical devices, and foods.
U.S. Department of Veterans Affairs (VA) – National Center for Patient Safety The National Center for Patient Safety (NCPS) was established in 1999 to develop and nurture a culture of safety throughout the Veterans Health Administration (VA, 2014a). The goal of the NCPS is the nationwide reduction and prevention of inadvertent harm to patients as a result of their care. Patient safety managers at 150 VA hospitals and patient safety officers at 21 regional headquarters participate in the program (VA, 2014a).
1. What is my main problem? 2. What do I need to do? 3. Why is it important for me to do this?
This intervention is based on studies showing that people who understand their health instructions make fewer mistakes when they take their medicine or prepare for a medical procedure (NPSF, 2014). ● Creating and sustaining a culture of safety. ● Informed consent, life-sustaining treatment, disclosure, and care of the caregiver. ● Matching healthcare needs with service delivery capability. ● Facilitating information transfer and clear communication. ● Medication management. ● Prevention of healthcare-associated infections. ● Condition- and site-specific practices. This report does not capture all activities that might reduce adverse healthcare events. Also, the safe practices are not prioritized or weighted across or within categories. Rather, the report focuses on practices that are evidence-based, applicable across multiple clinical settings, likely to benefit patient safety, and about which useful knowledge is available to consumers, purchasers, providers, and researchers (NQF, 2014). The organization also works in conjunction with other patient safety advocates, such as the AHRQ, to develop guidelines to prevent adverse events such as catheter-associated urinary tract infections (NQF, 2014).
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