Table 4.

Evaluation Questions and Assessments for Infrastructure for Effective Practices, 2006

Evaluation Question	Summary Assessment
How are AHRQ and its funded patient safety projects contributing to establishment of infrastructure to support patient safety in health care organizations across the country?	Significant contributions have been made in several areas, including the hospital patient safety culture survey, funding of projects to develop information systems and reporting systems, growth in partnerships at the national and local levels, and measurement capability
What have we learned from existing research and practice networks funded by AHRQ about how to establish infrastructures that stimulate and support effective practices?	Funded projects have yielded lessons regarding factors necessary for successful implementation of practice improvements, some of which involve infrastructure (e.g., safety culture, data systems)
To what extent is there an infrastructure of inter-organization partnerships that is pursuing collaborative approaches to improving patient safety practices?	Between 2004 and 2006, the number of national-level, inter-organizational partnerships focused on patient safety grew substantially, as did AHRQ's involvement in these partnerships
How well are payment systems structured to provide appropriate incentives for safe delivery of safe health care?	There has been growing use of financial incentives by insurers for adoption of safe practices in hospital settings, with little information on their effects yet available. Such financial incentives are largely absent in ambulatory settings, in part due to the lack of readily available safety measures
What additional research or development work is needed to strengthen effective infrastructures for patient safety practices in the health care system?	Future efforts should focus on how to implement health IT to improve safety, increasing the role of leadership in establishing a strong safety culture, and supporting front-line staff in their efforts to improve safety. Additional training is still needed to expand the network of individuals with safety knowledge and the ability to apply that knowledge

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