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Search results for "General Internal Medicine"
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- General Internal Medicine
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- United States Federal Government
Web Resource > Multi-use Website
Massachusetts Department of Public Health.
The majority of early patient safety interventions focused on the hospital setting, but there is a growing determination to improve safety practices across the ambulatory sphere as well. This AHRQ-funded project, Proactive Reduction of Outpatient Malpractice: Improving Safety, Efficiency, and Satisfaction (PROMISES), created a collaborative learning network of Massachusetts primary care practices and patient safety leaders. Program coaches visited 16 pilot primary care offices and worked directly with improvement teams to implement safe practices. The project also includes a report from physicians, malpractice insurers, and policy experts translating the hospital-based consensus statement, "When Things Go Wrong," into clear recommendations for ambulatory adverse events. The Web site provides various materials, including recorded lectures, case study videos, and tools to assist individuals and teams with enhancing outpatient safety. A past AHRQ WebM&M perspective explored patient safety in the office setting.
Web Resource > Government Resource
Atlanta, GA: Centers for Disease Control and Prevention.
This Web site provides information about government initiatives to research and prevent health care–associated infections.
Journal Article > Study
Indication-based prescribing prevents wrong-patient medication errors in computerized provider order entry (CPOE).
Galanter W, Falck S, Burns M, Laragh M, Lambert BL. J Am Med Inform Assoc. 2013;20:477-481.
Wrong-patient errors have long been a risk in hospitals. In one seminal case, a patient underwent an invasive procedure intended for another patient with a similar name. In the era of electronic medical records, errors such as entering notes or ordering medications for the wrong patient may occur as a consequence of multitasking. This AHRQ-funded study evaluated the effectiveness of an alert system, which required entry of an appropriate clinical diagnosis, at preventing wrong-patient medication errors in a computerized provider order entry system. Although the system did correctly identify and prevent incorrect prescriptions, 4000 alerts were required to prevent a single error. Other studies have successfully used forcing functions, or simply placing the patient's photograph on the order screen, to prevent wrong-patient errors.
Sorra J, Famolaro T, Dyer N, Smith S, Liu H, Ragan M. Rockville, MD: Agency for Healthcare Research and Quality; May 2012. AHRQ Publication No. 12-0052.
The Agency for Healthcare Research and Quality's (AHRQ) Medical Office Survey on Patient Safety Culture is designed to assess safety culture in outpatient clinics. This inaugural database describes survey results from more than 23,000 respondents (including both clinical and administrative staff) from 934 participating offices. Notable results include generally positive perceptions of teamwork and patient tracking, but the majority of respondents felt that production pressures adversely affected safety. The database is freely available from AHRQ for benchmarking and comparison purposes, as is the Hospital Survey on Patient Safety Culture database.
Journal Article > Study
Singh H, Giardina TD, Forjuoh SN, et al. BMJ Qual Saf. 2012;22:93-100.
Diagnostic errors are one of the most common types of preventable errors in ambulatory care, according to data from closed malpractice claims. Difficulty in identifying missed and delayed diagnoses has hampered progress in addressing diagnostic errors. In this case-control study, investigators assessed two triggers for identifying possible cases of diagnostic error within an electronic health record. These triggers were refined from a prior study by the same investigators. The trigger methodology was reasonably accurate in identifying likely diagnostic errors, although the study was limited by poor interrater reliability between physician reviewers on whether an error occurred. Nevertheless, this study demonstrates the potential of screening approaches within electronic medical records for identifying and categorizing possible diagnostic errors.
Journal Article > Commentary
Singh H, Graber M. JAMA. 2010;304:463-464.
This commentary discusses how the patient-centered medical home could improve safety and reduce diagnostic errors.
Rockville, MD: Agency for Healthcare Research and Quality. June 3, 2009.
This podcast discusses an AHRQ project to design information technology systems that support safe care transitions for elderly patients.
Tools/Toolkit > Government Resource
Rockville, MD: Agency for Healthcare Research and Quality; March 2018.
This survey collects information from outpatient providers and staff about the culture of patient safety in their medical offices. The survey is intended for offices with at least three providers, but it also can be used as a tool for smaller offices to stimulate discussion about quality and patient safety issues. The survey is accompanied by a set of resources to support its use. Medical offices that have administered the survey can submit data to AHRQ from September 3, 2019 to October 21, 2019.