Making health care safer II an updated critical analysis of the evidence for patient safety practices

OBJECTIVES: To review important patient safety practices for evidence of effectiveness, implementation, and adoption. DATA SOURCES: Searches of multiple computerized databases, gray literature, and the judgments of a 20-member panel of patient safety stakeholders. REVIEW METHODS: The judgments of th...

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Bibliographic Details
Main Authors: Shekelle, Paul G., Wachter, Robert M. (Author), Pronovost, Peter J. (Author)
Corporate Author: United States Agency for Healthcare Research and Quality
Format: eBook
Language:English
Published: Rockville, Md. Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services [2013], 2013
Series:Evidence report/technology assessment
Subjects:
Online Access:
Collection: National Center for Biotechnology Information - Collection details see MPG.ReNa
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100 1 |a Shekelle, Paul G. 
245 0 0 |a Making health care safer II  |h Elektronische Ressource  |b an updated critical analysis of the evidence for patient safety practices  |c prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by RAND Corporation, University of California, San Francisco/Stanford, Johns Hopkins University, ECRI Institute ; co-principal investigators, Paul G. Shekelle, Robert M. Wachter, Peter J. Pronovost 
260 |a Rockville, Md.  |b Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services  |c [2013], 2013 
300 |a 1 volume (various pagings  |b illustrations) 
505 0 |a Includes bibliographical references 
653 |a United States 
653 |a Evidence-Based Practice 
653 |a Patient Safety / standards 
653 |a Medical Errors / prevention & control 
653 |a Quality Assurance, Health Care / standards 
700 1 |a Wachter, Robert M.  |e [author] 
700 1 |a Pronovost, Peter J.  |e [author] 
710 2 |a United States  |b Agency for Healthcare Research and Quality 
041 0 7 |a eng  |2 ISO 639-2 
989 |b NCBI  |a National Center for Biotechnology Information 
490 0 |a Evidence report/technology assessment 
500 |a "Contract no. 290-2007-10062-I.". - "March 2013.". - Title from PDF t.p 
856 4 0 |u https://www.ncbi.nlm.nih.gov/books/NBK133363  |3 Volltext  |n NLM Bookshelf Books  |3 Volltext 
082 0 |a 610 
520 |a OBJECTIVES: To review important patient safety practices for evidence of effectiveness, implementation, and adoption. DATA SOURCES: Searches of multiple computerized databases, gray literature, and the judgments of a 20-member panel of patient safety stakeholders. REVIEW METHODS: The judgments of the stakeholders were used to prioritize patient safety practices for review, and to select which practices received in-depth reviews and which received brief reviews. In-depth reviews consisted of a formal literature search, usually of multiple databases, and included gray literature, where applicable. In-depth reviews assessed practices on the following domains: 1. How important is the problem?2. What is the patient safety practice?3. Why should this practice work?4. What are the beneficial effects of the practice?5. What are the harms of the practice?6. How has the practice been implemented, and in what contexts?7. Are there any data about costs?8.  
520 |a Are there data about the effect of context on effectiveness?We assessed individual studies for risk of bias using tools appropriate to specific study designs. We assessed the strength of evidence of effectiveness using a system developed for this project. Brief reviews had focused literature searches for focused questions. All practices were then summarized on the following domains: scope of the problem, strength of evidence for effectiveness, evidence on potential for harmful unintended consequences, estimate of costs, how much is known about implementation and how difficult the practice is to implement. Stakeholder judgment was then used to identify practices that were "strongly encouraged" for adoption, and those practices that were "encouraged" for adoption. RESULTS: From an initial list of over 100 patient safety practices, the stakeholders identified 41 practices as a priority for this review: 18 in-depth reviews and 23 brief reviews.  
520 |a Of these, 20 practices had their strength of evidence of effectiveness rated as at least "moderate," and 25 practices had at least "moderate" evidence of how to implement them. Ten practices were classified by the stakeholders as having sufficient evidence of effectiveness and implementation and should be "strongly encouraged" for adoption, and an additional 12 practices were classified as those that should be "encouraged" for adoption. CONCLUSIONS: The evidence supporting the effectiveness of many patient safety practices has improved substantially over the past decade. Evidence about implementation and context has also improved, but continues to lag behind evidence of effectiveness. Twenty-two patient safety practices are sufficiently well understood, and health care providers can consider adopting them now