Improving Patient Safety in Medical Offices: A Resource List for Users

Overall Ratings on Quality and Patient Safety

Patient Centered

  1. CAHPS® Clinician and Group Survey
    https://cahps.ahrq.gov

    The CAHPS® program is a public-private initiative to develop standardized surveys of patients' experiences with ambulatory and facility-level care. This Web site provides information on the CAHPS Clinician and Group Survey, as well as links to the survey and reporting kit.

  2. CAHPS® Health Information Technology Item Set
    https://cahps.ahrq.gov

    The CAHPS® Team has initiated the development of a new set of supplemental items for the CAHPS Clinician and Group Survey that focuses on patients' experiences with health information technology (Health IT). In a physician's office, uses of Health IT include secure electronic messaging, electronic medical records, medication lists, personal health records, and appointment scheduling. This item set is expected to help organizations assess the patient centeredness of physician practices and groups that have adopted different kinds of information technologies.

  3. CAHPS® Health Literacy Item Set
    https://cahps.ahrq.gov

    The CAHPS® Consortium has been developing a supplemental set for the CAHPS Clinician and Group Survey that focuses on assessing providers' activities to foster and improve the health literacy of patients. Health literacy is commonly defined as patients' ability to obtain, process, and understand the basic health information and services they need to make appropriate health decisions. This work on promoting health literacy is part of AHRQ's continuing efforts to encourage greater emphasis in the provider community on patient-centered care.

  4. Health Literacy Universal Precautions Toolkit
    http://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/literacy-toolkit/index.html

    AHRQ commissioned the University of North Carolina at Chapel Hill to develop and test this Health Literacy Universal Precautions Toolkit. The toolkit offers primary care practices a way to assess their services for health literacy considerations, raise awareness of the entire staff, and work on specific areas.

  5. Institute for Patient- and Family-Centered Care
    http://www.familycenteredcare.org/tools/downloads.html

    The Institute for Patient- and Family-Centered Care offers a wide variety of free downloadable PDFs to use in your organization. This Web site features many free resources, including a toolkit to enhance safety and quality and a workplan for starting a patient and family advisory council.

  6. Patient-Centered Primary Care Collaborative
    http://www.pcpcc.net/

    The Patient-Centered Primary Care Collaborative is a coalition of major employers, consumer groups, patient quality organizations, health plans, labor unions, hospitals, physicians, and many others who have joined together to develop and advance the patient-centered medical home. The collaborative has more than 200 members.

  7. Producer/Customer Interface
    http://www.ihi.org/IHI/Topics/Improvement/ImprovementMethods/Changes/Producer+Customer+Interface.htm

    To benefit from improvements in quality of products and services, the customer must recognize and appreciate the improvements. This IHI Web page provides information about the interface between producers and providers and their customers.

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Effective

  1. Placing Mental Health Specialists in Primary Care Settings Enhances Patient Engagement, Produces Favorable Results Relative to Evidence-Based Care
    http://www.innovations.ahrq.gov/content.aspx?id=1882

    This featured profile is available on AHRQ's Health Care Innovations Exchange Web site. An integrated care program places mental and behavioral health specialists in more than 50 primary care locations to treat patients age 65 years and over with depression or anxiety and those who engage in risky alcohol use. The model uses comprehensive assessments and promotes coordinated care planning and treatment based on chronic disease management principles and established treatment guidelines.

  2. Team-Based Ownership Over Defined Patient Panels Supported by Information Technology Enhances Provision of Evidence-Based Care
    http://www.innovations.ahrq.gov/content.aspx?id=1699

    This featured profile is available on AHRQ's Health Care Innovations Exchange Web site. Total Panel Ownership, developed by Kaiser Permanente Hawaii and Kaiser Permanente Northwest, represents a population-based approach to care delivery. Self-governing teams of primary health care providers develop and execute proactive plans to address gaps in care for a defined panel of patients during office visits and through followup services and outreach. Kaiser's newly developed Web-based Panel Support Tool facilitates these efforts by highlighting discrepancies between recommended and actual care. A number of care gaps have been reduced as a result of these efforts.

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Timely

  1. Manage Time
    http://www.ihi.org/IHI/Topics/Improvement/ImprovementMethods/Changes/Manage+Time.htm

    This age-old concept provides an opportunity to make time a focal point for improving any organization. This IHI Web page provides information and links to strategies for managing time.

Cross-reference to resources already described:

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Efficient

  1. Eliminate Waste
    http://www.ihi.org/IHI/Topics/Improvement/ImprovementMethods/Changes/Eliminate+Waste.htm

    In a broad sense, waste can be considered as any activity or resource in an organization that does not add value to an external customer. This IHI Web page provides information about eliminating waste.

  2. Going Lean in Health Care
    http://www.ihi.org/IHI/Results/WhitePapers/GoingLeaninHealthCare.htm

    This is a white paper on the IHI Web site that defines going lean in health care. In addition, it provides examples of lean thinking applied to health care that, when applied rigorously and throughout an entire organization, demonstrate a positive impact on productivity, cost, quality, and timely delivery of services.

  3. Improve Workflow and Remove Waste
    http://www.ihi.org/IHI/Topics/OfficePractices/Access/Changes/ImproveWorkFlowandRemoveWaste.htm

    Improving the flow of work and eliminating waste ensures that the clinical office runs as efficiently and effectively as possible. This IHI Web page provides information about how to improve work flow.

  4. Optimize Inventory
    http://www.ihi.org/IHI/Topics/Improvement/ImprovementMethods/Changes/Optimize+Inventory.htm

    Inventory of all types is a possible source of waste in organizations. This IHI Web page provides information about how to optimize inventory.

  5. Patient Cycle Tool
    http://www.ihi.org/IHI/Topics/OfficePractices/Access/Tools/Patient+Cycle+Tool+IHI+Tool.htm

    The Patient Cycle Tool is available through the IHI Web site and allows health care providers to record the time of each step in a patient visit, which can help staff note where delays occur.

  6. Time and Motion Studies To Measure the Impact of Health IT on Clinical Workflow
    http://healthit.ahrq.gov/portal/server.pt?open=514&objID=5554&mode=2&holderDisplayURL= http://wci-pubcontent/publish/communities/k_o/knowledge_library/features_archive/features/using_time_and_motion_studies _to_measure_the_impact_of_health_it_on_clinical_workflow.html

    Partners Healthcare developed a set of resources to help medical offices collect and study time and motion data on activities involving health information technology applications, such as electronic prescribing and computerized provider order entry. These data are then used to evaluate when and where health information technologies may be helpful in increasing efficiency.

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Equitable

  1. 2009 National Healthcare Disparities Report
    Examining health care disparities is an integral part of improving health care quality. Health care disparities are the differences or gaps in care experienced by one population compared with another population. This 2009 report is the seventh National Healthcare Disparities Report produced by AHRQ.

  2. Bilingual, Culturally Competent Managers Enhance Access to Prenatal Care for Migrant Women, Leading to Potential for Improved Birth Outcomes
    http://www.innovations.ahrq.gov/content.aspx?id=1685

    This featured profile is available on AHRQ's Health Care Innovations Exchange Web site. The Migrant Clinicians Network Prenatal Care Program seeks to ensure continuity of care for expectant mothers who begin prenatal care in one location and move for employment purposes during their pregnancy. Bilingual, culturally competent staff link these migrant patients with prenatal services and manage their medical records throughout the pregnancy. While the health outcomes of participants have not been formally evaluated, postimplementation data suggest that the program is enhancing access to prenatal services and continuity of care in a population that has no other way to access such services.

  3. Health Research & Educational Trust (HRET) Disparities Toolkit
    http://www.hretdisparities.org

    The Health Research & Educational Trust (HRET) Disparities Toolkit provides resources and information to help medical offices collect demographic information from patients, such as race, ethnicity, and primary language data. This toolkit helps offices plan to improve quality of care for all populations.

  4. Plan-Funded Team Coordinates Enhanced Primary Care and Support Services to At-Risk Seniors, Reducing Hospitalizations and Emergency Department Visits
    http://www.innovations.ahrq.gov/content.aspx?id=2243

    This featured profile is available on AHRQ's Health Care Innovations Exchange Web site. Commonwealth Care Alliance developed a health plan that provides low-income, dual eligible, elderly enrollees in Massachusetts with a primary care team made up of a physician, nurse practitioner, and geriatric specialist who work out of the enrollee's primary care clinic.

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Current as of June 2011
Internet Citation: Improving Patient Safety in Medical Offices: A Resource List for Users: Overall Ratings on Quality and Patient Safety. June 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/patientsafetyculture/medical-office/2010/moimpratings.html