Assessment of the National Patient Safety Initiative

In September 2002, RAND contracted with the U.S. Agency for Healthcare Research and Quality (AHRQ) to serve as the evaluation center for its national patient safety initiative. The evaluation center is responsible for performing a longitudinal evaluation of AHRQ’s patient safety activities and for providing regular feedback to support the continuing improvement of this initiative over a four-year project period. This report presents findings on the history leading to the AHRQ patient safety initiative, the start-up of the initiative, and early activities through September 2003. It focuses on assessing the context and goals that were the foundation for the initiative and documents the baseline status of the activities being undertaken. The evaluation found the agency has done an impressive job in starting the patient safety initiative, despite unreasonable high expectations and insufficient funding. The evaluators identify four priorities for AHRQ that they believe will have the strongest positive impact on the future of the patient safety initiative: designing interim objectives to pull the health care system toward the long-term goal of reducing errors by 50 percent; developing a national patient safety data repository; participating in active public-private partnerships and supporting health care organizations in their implementation activities; and balancing research and adoption activities.