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The Agency for Healthcare Research and Quality (AHRQ) has been carrying out its congressional mandate to establish a patient-safety research and development initiative to help health care providers reduce medical errors and improve patient safety. In September 2003, AHRQ entered into a four-year contract with the RAND Corporation to serve as the patient safety evaluation center for its patient safety initiative. The evaluation center is responsible for performing a longitudinal evaluation of the full scope of AHRQ’s patient safety activities and for providing regular feedback to support the continuing improvement of this initiative over the four-year project period.

This report covers the period October 2004 through September 2005. It is the third of what will be four annual reports prepared by RAND during the formative evaluation. It builds on two preceding evaluation reports, which covers the periods October 2003 through September 2004 and October 2004 through September 2005. This report updates the policy context framing the AHRQ patient safety initiative, documents the evolution and current status of priorities and activities undertaken in the initiative, assesses contributions of newly awarded health information technology projects to the broader initiative, and tracks dissemination actions AHRQ has taken to support adoption of evidence-based safe practices. Implications of the evaluation findings are discussed with respect to future AHRQ policy, programming, and research, and suggestions are presented for strengthening AHRQ’s future activities in the initiative. The annual evaluation reports are designed to provide a stable structure for the longitudinal evaluation, with the results of each year’s assessment contributing to a cumulative record of the initiative’s progress.

The contents of this report will be of interest to national and state policymakers, health care organizations and clinical practitioners, patient-advocacy organizations, health researchers, and others with responsibilities for ensuring that patients are not harmed by the health care they receive.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    Context and Input Evaluations

  • Chapter Three

    Process: Monitoring Progress and Maintaining Vigilance

  • Chapter Four

    Process Evaluation: Knowledge of Epidemiology and Development of Effective Practices

  • Chapter Five

    Process: Building Infrastructure for Effective Practices

  • Chapter Six

    Process: Achieving Broader Adoption of Effective Practices

  • Chapter Seven

    Patient Safety Outcomes

  • Chapter Eight

    Conclusion

  • Appendix

    Suggestions for AHRQ Action: Evaluation Reports I and II

This work was prepared for the Agency for Healthcare Research and Quality. The research 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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