10 strategies to improve patient safety

Hospitals should immediately adopt 10 strategies to improve patient safety, according to a research group headed by RAND Corp.

The findings, published Monday in the Annals of Internal Medicine, followed four years of study in which researchers identified safety hazards, determined how to measure them and identified solutions to reduce patient harm. The work was supported by the Agency for Healthcare Research and Quality.

The top 10 strategies hospitals are "strongly encouraged" to adopt are:

  • Preoperative checklists and anesthesia checklists to prevent operative and postoperative events

  • Bundles that include checklists to prevent central line-associated bloodstream infections

  • Interventions to reduce urinary catheter use, including catheter reminders, stop orders and nurse-initiated removal protocols

  • Bundles to prevent ventilator-associated pneumonia including head-of-bed elevation, sedation vacations, oral care and subglottic suctioning endotracheal tubes

  • Hand hygiene

  • A do-not-use list for hazardous abbreviations

  • Multicomponent interventions to reduce pressure ulcers

  • Barrier precautions to prevent healthcare-associated infections

  • Use of real-time ultrasonography for placing central lines

  • Interventions to improve prophylaxis for venous thromboembolisms

Additionally, the study group identified another 12 strategies that hospitals are "encouraged" to implement. They include multicomponent fall-reduction interventions, use of clinical pharmacists to reduce adverse drug events and computerized provider order entry.

They also developed recommendations for evaluating the effectiveness of patient safety strategies.The contexts to consider in reporting patient safety research include teamwork, leadership and patient safety culture, which combined can produce transformational change, previous studies have found.

In addition to RAND, the research team included representatives from Stanford University, the University of California, San Francisco, Johns Hopkins University and ECRI Institute, as well as an international panel of stakeholders and experts.

To learn more:
- read the findings