Assessing the Evidence for Context-Sensitive Effectiveness and Safety

Developing Criteria

Contract Final Report

In this contract final report, RAND Health identifies criteria for assessing the context-sensitive effectiveness and safety of patient safety practices and presents recommendations for future research on this topic.

Prepared for:
Agency for Healthcare Research and Quality
U.S. Department of Health and Human Services
540 Gaither Road
Rockville, MD 20850
www.ahrq.gov
Contract No. HHSA-290-2009-10001C

Prepared by:
RAND Health
Santa Monica, CA

Project Leaders
Paul G. Shekelle, M.D., Ph.D.
Peter J. Pronovost, M.D., Ph.D.
Robert M. Wachter, M.D. 

Contents

Executive Summary
Chapter 1. Introduction
Chapter 2. Methods
Chapter 3. Forming an Interdisciplinary Panel of Experts
Chapter 4. Determining the Target Patient Safety Practices
Chapter 5. Key Evaluation Questions
Chapter 6. Description of Ideal Evaluation Methods: Overview
Chapter 7. The Importance of Theory
Chapter 8. Description of Ideal Evaluation Methods: Describing Patient Safety Practices
Chapter 9. Description of Ideal Evaluation Methods: Selecting Key Domains of Context
Chapter 10. Description of Ideal Evaluation Methods: Measuring and Describing the Implementation Context
Chapter 11. Description of Ideal Evaluation Methods:Assessing for Possible Harms
Chapter 12. Description of Ideal Evaluation Methods: Quantitative Approaches to Context Heterogeneity
Chapter 13. Description of Ideal Evaluation Methods: Assessing the Strength of Evidence Across Studies of Patient Safety Practices
Chapter 14. Results: Needs for Future Development
Chapter 15. Discussion

Note: Appendixes are available on request from Patty Smith, RAND Health, 1776 Main Street, Mailstop M4E, Santa Monica, CA 9040; phone 310-393-0411; E-mail psmith@rand.org.

The project leaders gratefully acknowledge the contributions of the following individuals:

Content Experts:
Lauren Carr, M.P.H.
Robbie Foy, MBChB, Ph.D., M.Sc.
Sydney Dy, M.D.
Susanne Hempel, Ph.D.
Kathryn M. McDonald, M.M.
John vretveit Ph.D., C.Psychol.
Lisa Rubenstein, M.D., MSPH, FACP

Project Director:
Stephanie Taylor, Ph.D.

Librarian:
Roberta Shanman, M.L.S.

Research Assistant:
Breanne Johnsen, B.S.

Administrative Experts:
Jerome Hawkins, B.A.
Aneesa Motala, B.A.
Patricia Smith

This report was prepared for the Agency for Healthcare Research and Quality by RAND Health, Santa Monica, CA, under contract HHSA-290-2009-10001C. The opinions expressed herein are those of the authors and do not necessarily represent the views of the U.S. Department of Health and Human Services or the Agency for Healthcare Research and Quality.

This document is in the public domain and may be used and reprinted without permission except those copyrighted materials noted, for which further reproduction is prohibited without the specific permission of copyright holders.

Current as of December 2010
Internet Citation: Assessing the Evidence for Context-Sensitive Effectiveness and Safety: Developing Criteria . December 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/final-reports/contextsensitive/index.html