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In 2000, the U.S. Congress mandated the Agency for Healthcare Research and Quality (AHRQ) to take a leadership role in helping health care providers reduce medical errors and improve patient safety. AHRQ has been fulfilling that mandate through a patient safety research and development initiative which began shortly thereafter. In September 2002, AHRQ contracted with RAND to serve as the patient safety evaluation center for this initiative. The evaluation center has been responsible for performing a four-year formative evaluation of the full scope of AHRQ's patient safety activities, and providing regular feedback to support the continuing improvement of the initiative over the evaluation period. The contract also includes a two-year option for analysis of the diffusion of safe practices in the health care system, which RAND performed in October 2006 through September 2008.

This working paper presents the results for a component of the community studies that RAND performed under the two-year contract option, which examines in detail how hospitals implemented some of the specific safe practices endorsed by the National Quality Forum. The full results from the community studies, as well as from other analyses related to practice adoption and trends in patient safety outcomes are presented in a separate document, entitled Assessing Patient Safety Practices and Outcomes in the U.S. Health Care System (Farley et al., 2009).

Table of Contents

  • Chapter One

    Introduction and Background

  • Chapter Two

    Summary of Findings: Implementation of NQF Safe Practices by Hospitals

  • Chapter Three

    Patient Safety Culture Practices

  • Chapter Four

    Other Groups of Safe Practices

  • Appendix A

    National Quality Forum Safe Practices, by Group

The research in this report was supported by the Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services, and conducted by RAND Health.

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