Legal and Policy Interventions to Improve Patient Safety

Kachalia, Allen; Nallamothu, Brahmajee K.; Studdert, David M.

doi:10.1161/circulationaha.115.015880

Cited by 26 publications

(38 citation statements)

References 102 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Research purposes on the basis of inadequate reliability 1 and clinical relevance, 2 our results suggest that the current set of indicators may represent a more consistent measure of patient safety than previously argued.…”

Section: Openmentioning

confidence: 62%

“…Although administrative data including the Agency for Healthcare Research and Quality's patient safety indicators have been used to measure quality improvement and patient safety, their suitability for these purposes has been debated. 1,2 In the field of patient safety, many studies have evaluated the impact of health care system improvements on medical liability, with much of this work focusing on obstetrics. [3][4][5][6][7][8][9][10][11][12] Other research has attempted to study the link between the patient experience and various measures of quality and safety, with overall findings of a positive association between patient satisfaction, clinical effectiveness and patient safety.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Improved hospital safety performance and reduced medicolegal risk: an ecological study using 2 Canadian databases

Yang

Zhang

Hines

et al. 2018

cmajo

View full text Add to dashboard Cite

Background: Few empirical studies have validated the relation between medicolegal risk and hospital patient safety performance. We sought to determine whether there was a relation between in-hospital patient safety events and medicolegal cases involving Canadian physicians. Methods: In this ecological study, we used Poisson regression to compare data from the Canadian Institute for Health Information's Discharge Abstract Database and the database of the Canadian Medical Protective Association (CMPA) of medicolegal cases over 10 years (2005/06 to 2014/15). We identified incidents and cases based on 15 Agency for Healthcare Research and Quality patient safety indicators within the Canadian Institute for Health Information and CMPA data sets. We performed subgroup analyses for obstetrical and surgical cases. Results: We found a statistically significant positive association between volume changes in patient safety indicator events (n = 339 741) and medicolegal cases (n = 15 180) (parameter estimate 1.15, 95% confidence interval [CI] 0.4 to 1.9). This association suggests that, on average, a 10% decrease in events would correspond to a decrease of 11% in medicolegal cases. The degree of positive association varied by practice type, with obstetrics (97 982 patient safety indicator events, 865 cases) showing a 25% decrease in medicolegal cases for every 10% decrease in events (parameter estimate 2.9, 95% CI 0.5 to 5.3) and surgery (168 886 patient safety indicator events, 4568 cases) showing a decrease of 9% for every 10% decrease in events (parameter estimate 0.9, 95% CI 0.2 to 1.7). Interpretation: The statistically significant positive association between patient safety indicator events and medicolegal cases quantifies a relation between patient safety and physician medicolegal risk in Canadian hospitals. This suggests new, practical uses for both medicolegal and patient safety indicator data in system-level quality-improvement efforts.

show abstract

Section: Openmentioning

confidence: 62%

mentioning

confidence: 99%

Improved hospital safety performance and reduced medicolegal risk: an ecological study using 2 Canadian databases

Yang

Zhang

Hines

et al. 2018

cmajo

View full text Add to dashboard Cite

show abstract

“…This legislation prompted the creation of patient safety organizations (PSOs) charged with identifying error patterns by analyzing large numbers of error reports from diverse sources so that threats to patient safety could be identified and interventions could be developed to reduce risks to patients (Kachalia, Mello, Nallamothu,& Studdert, 2016;Clancy, 2008). Licensed nurses (registered nurses [RNs], licensed practical nurses [LPNs]) and unlicensed nursing assistants (UNAs) comprise 54% of the healthcare workers in the United States (Page, 2004).…”

mentioning

confidence: 99%

Nurses' experiences with errors in nursing

2016

View full text Add to dashboard Cite

“…The importance of patient safety continues to be recognised yet progress on improvement has been modest and patients everywhere continue to experience avoidable harm and substandard care [1].…”

Section: Introductionmentioning

confidence: 99%

Development of the Prototype Concise Safe Systems Checklist Tool for General Practice

Litchfield

Spencer

Bell

et al. 2020

Preprint

View full text Add to dashboard Cite

Background In the course of producing a patient safety toolkit for primary care, we identified the need for a concise safe-systems checklist designed to address areas of patient safety which are under-represented in mandatory requirements and existing tools. This paper describes the development of a prototype checklist designed to be used in busy general practice environments to provide an overview of key patient safety related processes and prompt practice wide-discussion. Methods An extensive narrative review and a survey of world-wide general practice organisations were used to identify existing primary care patient safety issues and tools. A RAND panel of international experts rated the results, summarising the findings for importance and relevance. The checklist was created to include areas that are not part of established patient safety tools or mandatory and legal requirements. Four main themes were identified: information flow, practice safety information, prescribing, and use of IT systems from which a 13 item checklist was trialled in 16 practices resulting in a nine item prototype checklist, which was tested in eight practices. Qualitative data on the utility and usability of the prototype was collected through a series of semi-structured interviews.Results In testing the prototype four of nine items on the checklist were achieved by all eight practices. Three items were achieved by seven of eight practices and two items by six of eight practices. Participants welcomed the brevity and ease of use of the prototype, that it might be used within time scales at their discretion and its ability to engage a range of practice staff in relevant discussions on the safety of existing processes. The items relating to prescribing safety were considered particularly useful. Conclusions As a result of this work the concise patient safety checklist tool, specifically designed for general practice, has now been made available as part of an online Patient Safety Toolkit hosted by the Royal College of General Practitioners. Senior practice staff such as practice managers and GP partners should find it a useful tool to understand the safety of less explored yet important safety processes within the practice.

show abstract

Legal and Policy Interventions to Improve Patient Safety

Cited by 26 publications

References 102 publications

Improved hospital safety performance and reduced medicolegal risk: an ecological study using 2 Canadian databases

Improved hospital safety performance and reduced medicolegal risk: an ecological study using 2 Canadian databases

Nurses' experiences with errors in nursing

Development of the Prototype Concise Safe Systems Checklist Tool for General Practice

Contact Info

Product

Resources

About