The Resource Patient safety in ambulatory settings, prepared for, Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by, RAND Southern California Evidence-based Practice Center, University of California, San Francisco, Stanford University and University of Toronto ; investigators, Paul G. Shekelle, Urmimala Sarkar, Kaveh Shojania, Robert M. Wachter, Kathryn McDonald, Aneesa Motala, Patty Smith, Lorri Zipperer, Roberta Shanman

Patient safety in ambulatory settings, prepared for, Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by, RAND Southern California Evidence-based Practice Center, University of California, San Francisco, Stanford University and University of Toronto ; investigators, Paul G. Shekelle, Urmimala Sarkar, Kaveh Shojania, Robert M. Wachter, Kathryn McDonald, Aneesa Motala, Patty Smith, Lorri Zipperer, Roberta Shanman

Label
Patient safety in ambulatory settings
Title
Patient safety in ambulatory settings
Statement of responsibility
prepared for, Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by, RAND Southern California Evidence-based Practice Center, University of California, San Francisco, Stanford University and University of Toronto ; investigators, Paul G. Shekelle, Urmimala Sarkar, Kaveh Shojania, Robert M. Wachter, Kathryn McDonald, Aneesa Motala, Patty Smith, Lorri Zipperer, Roberta Shanman
Creator
Contributor
Author
Issuing body
Sponsoring body
Subject
Genre
Language
eng
Summary
BACKGROUND: Even though most medical care occurs in ambulatory settings, the patient safety movement originated in, and has been mainly focused on, adverse events in hospitalized patients. However, it is increasingly clear that the ambulatory setting is critically important. Ambulatory care differs substantially from inpatient care in ways that affect patient safety hazards and interventions. To better understand the scope of ambulatory care safety issues and the types of evaluations that have been reported for ambulatory patient safety practice (PSP), we have been tasked by AHRQ to provide an overview of key issues relating to the interventions. PURPOSE: This Technical Brief had the following guiding questions: What are the evidence-based hospital patient safety practices that may be applicable to the ambulatory care setting? What are the ambulatory care patient safety practices that have been studied in the literature? Which ones have not been broadly implemented or studied beyond a single ambulatory care center? What tools, settings, and other factors (such as implementation of Patient-Centered Medical Home and team-based care) may influence the implementation and spread of ambulatory care patient safety practices? METHODS: We integrated insights from discussions with eight Key Informants (KIs) with a literature scan of 28 safety topics/strategies. FINDINGS: KIs identified medication safety, diagnosis, transitions, referrals, and testing as important ambulatory care safety topics, and strategies that addressed communications, health IT, teams, patient engagement, organizational approaches, and safety culture as the most important strategies. The literature search found a moderate number of published intervention evaluations for e-prescribing, medication errors and adverse events, pharmacist-based interventions, and transitions from hospital to ambulatory care. There were few published evaluations of interventions for other targets/strategies. These results will assist AHRQ in developing a research agenda in ambulatory patient safety. SUMMARY AND IMPLICATIONS: Both key informant interviews and the literature scan reveal important differences between inpatient and ambulatory safety. There are significant gaps in ambulatory safety research, including a notable lack of studies on patient engagement and timely and accurate diagnosis. Key informants recommend prospective, large-scale studies in diverse ambulatory settings to develop and test ambulatory safety interventions
Member of
Cataloging source
NLM
http://library.link/vocab/creatorName
Shekelle, Paul G
Government publication
federal national government publication
Index
no index present
Literary form
non fiction
Nature of contents
  • dictionaries
  • surveys of literature
NLM call number
WX 205
http://library.link/vocab/relatedWorkOrContributorName
  • United States
  • Southern California Evidence-Based Practice Center/RAND
  • University of California, San Francisco
  • Stanford University
  • University of Toronto
  • Effective Health Care Program (U.S.)
Series statement
  • Technical brief
  • AHRQ publication
Series volume
  • number 27
  • no. 16 (17)-EHC033-EF
http://library.link/vocab/subjectName
  • Patient Safety
  • Ambulatory Care Facilities
  • Ambulatory Care
  • Ambulatory Care
  • Safety Management
  • United States
  • United States
Label
Patient safety in ambulatory settings, prepared for, Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by, RAND Southern California Evidence-based Practice Center, University of California, San Francisco, Stanford University and University of Toronto ; investigators, Paul G. Shekelle, Urmimala Sarkar, Kaveh Shojania, Robert M. Wachter, Kathryn McDonald, Aneesa Motala, Patty Smith, Lorri Zipperer, Roberta Shanman
Instantiates
Publication
Note
  • "Effective Health Care Program"--PDF cover
  • "October 2016."
Bibliography note
Includes bibliographical references
Carrier category
online resource
Carrier category code
cr
Carrier MARC source
rdacarrier
Content category
text
Content type code
txt
Content type MARC source
rdacontent
Control code
971614012
Extent
1 online resource (various pagings).
Form of item
online
Media category
computer
Media MARC source
rdamedia
Media type code
c
Specific material designation
remote
System control number
(OCoLC)971614012
Label
Patient safety in ambulatory settings, prepared for, Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by, RAND Southern California Evidence-based Practice Center, University of California, San Francisco, Stanford University and University of Toronto ; investigators, Paul G. Shekelle, Urmimala Sarkar, Kaveh Shojania, Robert M. Wachter, Kathryn McDonald, Aneesa Motala, Patty Smith, Lorri Zipperer, Roberta Shanman
Publication
Note
  • "Effective Health Care Program"--PDF cover
  • "October 2016."
Bibliography note
Includes bibliographical references
Carrier category
online resource
Carrier category code
cr
Carrier MARC source
rdacarrier
Content category
text
Content type code
txt
Content type MARC source
rdacontent
Control code
971614012
Extent
1 online resource (various pagings).
Form of item
online
Media category
computer
Media MARC source
rdamedia
Media type code
c
Specific material designation
remote
System control number
(OCoLC)971614012

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