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Table 4. Classification dimensions for patient safety practices

Assessing the Evidence for Context-Sensitive Effectiveness and Safety

DimensionDefinition and examples
Regulatory versus voluntaryWhether required by external entity, such as the Joint Commission
SettingHospital, nursing home, ambulatory
FeasibilityAbility to implement PSP in a variety of settings, even in small facilities12
Individual activity vs. organizational changeWhether the target of the PSP is individual providers' behavior (e.g., handwashing) or the structure of the organization
Temporal (one-time vs. repeated/long-term)Structural change (e.g., switch to antibiotic-impregnated catheters) or change that requires regular maintenance (e.g., hand hygiene education)
Pervasive in setting vs. targeted to specific units or providersWhether the PSP addresses a safety issue that applies to all patients in a unit or setting (universal protocol would apply to all surgeries, but fall prevention would be targeted to at-risk patients)
Common vs. rare event as targetWhether the patient safety event that the PSP is intended to address is relatively common (e.g., medication errors) or rare (e.g., wrong-site surgery)
PSP maturity, established vs. newerWhether the PSP has been well-studied, and implementation needs are well-known
Degree of controversy or conflicting evidence (or both)Whether the PSP is widely accepted; whether examples of ineffective PSPs exist
Degree of behavioral change required for implementationHow much the PSP implementation involves human factors issues (e.g., an institutional policy switching to use of chlorhexidine would not depend on provider behavior)
Sensitivity to contextWhether the success of PSP implementation depends on issues such as leadership, patient safety culture, or teamwork

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Current as of December 2010
Internet Citation: Table 4. Classification dimensions for patient safety practices: Assessing the Evidence for Context-Sensitive Effectiveness and Safety . December 2010. Agency for Healthcare Research and Quality, Rockville, MD.