This newly issued follow up to the seminal AHRQ Making Health Care Safer report (first published in 2001 and updated in 2013 critically examines the evidence supporting 47 separate patient safety practices chosen for the high-impact harms they address. It includes diagnostic errors, failure to rescue, sepsis, infections due to multi-drug resistant organisms, adverse drug events and nursing-sensitive conditions. The report discusses the evidence on cross-cutting safety practices, including safety culture, teamwork and team training, clinical decision support, patient and family engagement, cultural competency, staff education and training, and monitoring, audit and feedback. The report provides recommendations for clinicians and decision-makers on effective patient safety practices.

This report provides preliminary outcome data from a six-cohort collaborative that used the comprehensive unit-based safety program and associated tools to prevent catheter-associated urinary tract infections (CAUTI). The early data show a decrease in the overall rate of CAUTI, with a more striking decrease in non-intensive care unit settings than in ICU settings.

This Web site summarizes patient safety improvement efforts in Tennessee, shares information on their patient safety organization activities and a calendar of training opportunities.

This publication reports the impact hospital participation in CUSP had on patients. This AHRQ-funded program was designed to reduce central line infections using concepts tested in the successful Keystone program.

This Web site includes information on the Re-Engineered Discharge project (Project RED), which has developed strategies to enhance patient safety by improving the hospital discharge process to reduce readmissions.

This report analyzed the causes and rates of prescribing errors in the National Health Service and found that educational level had little impact on medication errors and that many were intercepted before reaching patients. The authors suggest that a standardized national prescription chart could help prevent errors.

Development of The Patient Safety Group was motivated by the death of a young girl named Josie King. The King family responded to their personal experience from medical errors by making a commitment to improve and advance safety and quality in health care. They created a program entitled eCUSP (electronic comprehensive unit-based safety program) as a mechanism for providers to manage and organize their patient safety efforts.