Table 3.

Evaluation Questions and Assessments for Patient Safety Epidemiology and Practices, 2006

Evaluation Question	Summary Assessment
Patient Safety Epidemiology
What information has been published over time about patient safety epidemiology, and how have the AHRQ-funded research projects contributed to this new information?	Numbers of articles published on patient safety epidemiology have grown steadily in the past four years. AHRQ projects have been important contributors, producing one-third of these articles
To what extent has the additional research strengthened the evidence regarding epidemiology of errors?	Published research has strengthened evidence for medications, diagnostic or treatment errors, general patient safety, working conditions, and other areas
What additional work is needed to strengthen the evidence regarding epidemiology and priorities for interventions to reduce adverse outcomes?	Work is needed on development of an ongoing national surveillance system, which would yield data needed to build evidence on epidemiology and identify emerging safety issues
Effective Patient Safety Practices
What do we know from evidence reports and other sources about which practices are or have the potential to be effective in improving patient safety?	The original patient safety evidence report documented evidence for many practices, which the National Quality Forum (NQF) used to develop its first list of safe practices in 2003
How are research and field tests on patient safety practices funded by AHRQ contributing new knowledge regarding practices for which further scientific evidence is needed?	AHRQ-funded projects addressed many practices in need of additional evidence. There results were used by the NQF to update its list of safe practices in 2006. More evidence synthesis is needed for other practices not addressed in the NQF update
What range of health information technology (IT) applications are being tested and studied by the health IT projects funded by AHRQ, and to what extent are they addressing patient safety issues specifically?	A wide range of health IT applications are being developed by AHRQ-funded projects. A high 90% of projects are addressing patient safety, all but three of which also addressed other quality issues
What are the field tests learning about the factors and issues that need to be managed to introduce tested new practices effectively?	The same implementation issues have been identified across many groups of projects. Through a literature review, the evaluation center systematically identified “success factors” that need to be in place to successfully implement practice improvements
What progress has been made by the AHRQ-funded projects in documenting effects of new patient safety practices on safety outcomes and the costs, cost effectiveness, and return on investment of the practices being tested?	Projects have been examining effects on outcomes and publishing those results. They have done limited work on assessing costs, cost effectiveness, or return on investment. Further work is needed to make the business case for new practices
To what extent are implementation methods and tools being developed and applied to support expanded use of tested practices across provider organizations?	Some projects have developed products or tools to support use of practices; many have not. AHRQ has packaged several tools, such as TeamSTEPPS (with DoD) and the hospital safety culture survey. More work is needed in this area

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