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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.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    Context Evaluation

  • Chapter Three

    Input Evaluation

  • Chapter Four

    Process Evaluation: Monitoring Progress and Maintaining Vigilance

  • Chapter Five

    Process Evaluation: Knowledge of Epidemiology of Patient Safety Risks

  • Chapter Six

    Process Evaluation: Establishing Effective Patient Safety Practices

  • Chapter Seven

    Process Evaluation: Building Infrastructure for Effective Practices

  • Chapter Eight

    Process Evaluation: Achieving Broader Adoption of Effective Practices

  • Chapter Nine

    Conclusion

  • Appendix A

    Organizations and Project Groups Involved in the Patient Safety Initiative

  • Appendix B

    Patient Safety Projects With Potential to Generate Patient Safety Epidemiology Information

  • Appendix C

    Analysis of AHRQ Patient Safety Projects in the Context of the Evidence Report and NQF Safe Practices

This work was sponsored by the Agency for Healthcare Research and Quality and was conducted in RAND Health, a division of the RAND Corporation.

This report is part of the RAND Corporation technical report series. RAND technical reports may include research findings on a specific topic that is limited in scope or intended for a narrow audience; present discussions of the methodology employed in research; provide literature reviews, survey instruments, modeling exercises, guidelines for practitioners and research professionals, and supporting documentation; or deliver preliminary findings. All RAND reports undergo rigorous peer review to ensure that they meet high standards for research quality and objectivity.

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