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).
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. 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: Leapfrog Group The Leapfrog Group, a healthcare arm of many of America’s largest employers, was created in part to promote patient safety activities. In 2001, the Leapfrog Group recommended three safe practices: computerized prescriber order entry, intensive care unit physician staffing, and evidence-based hospital referral (Leapfrog Group, 2010). The organization Updated dental safety issues A 2011 article by Perea-Perez, Santiago-Saez, Garcia-Marin, Labajo-Gonzalez, and Villa-Vigil suggests seven steps for improving patient safety, by ensuring that risk management is applied to clinical dentistry. These are summarized in Table 5. The steps are similar to those suggested by Shekelle and colleagues in the Annals of Internal Medicine in 2013; this paper describes the patient safety strategies that are ready for adoption based on best available evidence and also recommends priority areas of research to be pursued in order
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). maintains that adopting these three practices in all urban hospitals in the United States would save more than 57,000 lives, prevent 3 million serious medication errors, and save $12 billion each year. There is some evidence that the Leapfrog Group’s activities have led to more widespread adoption of the endorsed practices (Wachter, 2012). to answer outstanding questions on how to improve safety, including assessment of the impact of interventions designed to improve safety. They are also similar to the steps advised by the National Patient Safety Agency in the UK. These include the following: promote incident reporting, involve patients in the development of interventions, and implement solutions known to prevent harm (NPSA, 2009).
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