Increasing nurse staffing levels in acute-care hospitals and nursing homes and enhancing systems for communicating between hospitals and other health care settings are among the strategies that are likely to lead to improved patient safety, according to a new evidence report from the Agency for Healthcare Research and Quality.
The report, which was developed for AHRQ by the Oregon Health & Science University Evidence-based Practice Center (EPC), details the effects of health care working conditions on patient safety. Based on a review of 115 existing studies conducted in health care and non-health care settings, the EPC researchers concluded that there is enough evidence in the scientific literature to make specific recommendations about these strategies for improving patient safety. They also found that when complex procedures are performed by physicians who do them frequently, preventable complications are less likely. In addition, they found that fewer interruptions and distractions to staff can reduce errors, and systems to improve information exchange and "handing off" care between hospital and nonhospital settings can decrease medication errors.
However, the researchers also found that there is insufficient evidence to draw clear conclusions for several other specific working conditions, including workplace stress, lighting conditions, and various organizational factors.
In 2001, AHRQ began funding a large portfolio of patient safety research projects to address key unanswered questions about how errors occur and provide science-based information on what patients, clinicians, hospital leaders, policymakers, and others can do to make the health care system safer. The results of this research will identify strategies to improve the quality of care in hospitals, doctors' offices, nursing homes, and other health care settings across the nation, including home care.
Prominent among these projects are a number focusing specifically on working conditions that will address some of the issues this new report cites as needing further research. For example, some projects are examining the impact of nurses' stress and fatigue on patient safety and potential interventions that could enhance patient safety.
Select to access the fact sheet, Impact of Working Conditions on Patient Safety.
A summary of the new report, The Effect of Health Care Working Conditions on Patient Safety, Evidence Report/Technology Assessment No. 74 (AHRQ Publication No. 03-E024) and the full report (AHRQ Publication No. 03-E031) are available from the AHRQ Publications Clearinghouse.
The report summary is also available from the National Guideline Clearinghouse™.
Other evidence reports and summaries published recently by AHRQ are also available from AHRQ. Topics include the following:
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