Patient Safety and Quality

Hospital patient safety systems show moderate progress in meeting Institute of Medicine recommendations

Development and implementation of hospital patient safety systems that meet Institute of Medicine recommendations is at best modest, concludes a study supported in part by the Agency for Healthcare Research and Quality (HS11885). Researchers surveyed all acute care hospitals in Missouri and Utah in 2002 and 2004, using a 91-item questionnaire; 107 hospitals responded to both surveys.

While 74 percent of the surveyed hospitals reported full implementation of a written safety plan, nearly 9 percent reported no plan. The area of surgery appeared to have the greatest level of patient safety systems. For example, nearly all hospital surgical units had systems for preanesthesia patient assessment (98.4 percent), inclusion of all prediagnostic studies in the patient's chart prior to surgery (97.6 percent), and a policy requiring the primary surgeon to verbally confirm the side for operation and mark the limb and/or site with a witness present (95.1 percent).

During the 2-year period, more hospitals had fully implemented policies providing for voluntary reporting of errors and near misses (from 60.9 to 69.9 percent), error reporting without fear of reprisal (63.9 to 77.6 percent), no demerits/points for making a medical error (73 to 86.8 percent), and thanks/praise for error detection/reports (23.1 to 33.6 percent). By the 2004 survey, 34 percent of hospitals had fully implemented computerized physician order entry systems for medications.

See "The long road to patient safety: A status report on patient safety systems," by Daniel R. Longo, Obl.S.B., Sc.D., John E. Hewett, Ph.D., Bine Ge, M.D., M.A., and Shari Schubert, B.A., in the December 14, 2005, Journal of the American Medical Association 294(22), pp. 2858-2865.

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