Table 2.

Evaluation Questions and Assessments for Monitoring and Vigilance, 2006

Evaluation Question	Summary Assessment
What progress has been made in establishing and using generally accepted sets of measures for patient safety events or outcomes in a range of health care service settings?	A modified Delphi consensus process was run by the evaluation center in 2006, which identified important outcome measures and assessed validity and measurement issues for them. The panelists concluded that work remains to validate most of these measures and to address definitions, measurement issues, and specifications
What progress has been made in establishing a consistent set of standards for patient safety reporting systems, public or private, for use by both government agencies and health care providers?	AHRQ began work on this with funding to IOM for preparation of its Data Standards report (IOM 2004). With passage of the PSQIA, AHRQ started work in 2006 to identify candidate standards for the data content of a national data network and reach consensus on which standards to use. These standards should complement the information technology standards being developed by Department of Health and Human Services
What actions have been taken to establish a national-level patient safety data repository?	With passage of the PSQIA, AHRQ has been able to move forward with design of a data capability, under the data network provisions of the Act. Plans are to begin full implementation of the Act in 2007, including progress on the national network of databases
To what extent are national-level data available regarding the performance of our health care system on patient safety measures, and how has this changed?	Data availability continues to be extremely limited, with heavy reliance on the HCUP data. State reporting systems have grown in number but vary widely in the measures and data they collect. No national-level data are available for ambulatory care, except Medicare data, which has not yet been used for patient safety measurement
What is the status of the use of generally accepted patient safety measures for assessing performance as part of accreditation or other credentialing processes?	The primary organization using patient safety measures is Joint Commission, which has had relevant policies in place for several years, specifically its Sentinel Events reporting policy. The National Quality Forum consensus process has established measure sets, but none of them has been used consistently across the country
What steps need to be taken to enhance the capability for effective monitoring of patient safety performance?	Priority issues to be addressed include standardization of measures and standards, increasing data availability at the national level, and measurement issues such as use of rates versus counts

PSQIA, Patient Safety and Quality Improvement Act of 2005.

Source: Assessment of the National Patient Safety Initiative: Final Report (Farley et al. 2008).