New Tools for Ambulatory Patient Safety

Patient Safety Awareness Week presents an ideal opportunity to call attention to the importance of keeping patients safe in medical offices and other ambulatory settings, where there are nearly 1 billion patient visits per year.

While much of AHRQ’s patient safety work initially focused on hospitals, over time we have expanded our patient safety focus beyond acute care to all health care settings. Since 2015, AHRQ has funded over $26 million in grants and contracts to improve patient safety in ambulatory and long-term care settings. This work has paid off with several new ambulatory care patient safety tools and resources that AHRQ has published in recent months.

The most recent is the Community-Acquired Pneumonia Patient Safety Clinical Decision Support Implementation Toolkit. Released in January, this toolkit helps ambulatory care practices (as well as emergency departments) and clinical informatics personnel implement clinical decision support to determine the safest and most appropriate place of treatment for patients with pneumonia—outpatient, hospital, or intensive care unit.

A second is an update to our Improving Your Laboratory Testing Process, a step-by-step guide to improve standardization and systemization of laboratory testing processes—where safety issues commonly arise in primary care practices. A third is the Toolkit to Engage High-Risk Patients in Safe Transitions Across Ambulatory Settings, which is designed to help ambulatory care teams actively engage patients and their care partners to prevent safety lapses during transitions and new appointments.

These resources share some commonalities. First, of course, is their focus on the ambulatory setting and on patient safety. Beyond that, they share in common a focus both on high-level actions and on technical, step-by-step guidance to improve feasibility to implement the interventions.

Finally, let us say a word about the importance of engaging patients and, by extension, patients’ caregivers and families. This is something that many of our tools emphasize, either implicitly or explicitly. We believe that more complete patient and family engagement leads to better, safer outcomes, and improved patient experience. AHRQ’s resources to encourage patients to speak up and ask questions and to foster engagement across settings are prime examples of tools to engage patients and families and create a culture of safety in ambulatory settings.

As with all research areas, gaps remain to be filled in ambulatory safety research, particularly in how to engage patients and families in ways that lead to improvements in patient safety. If you’re a researcher interested in this or any other aspect of ambulatory patient safety, we urge you to visit AHRQ’s Funding Opportunity Announcements page to see what the possibilities are.

One thing we have learned over the years is that, to borrow a phrase, it takes a village to keep patients safe. We can’t confine our fixes to one setting or one profession; we need team-based, interprofessional approaches to patient safety. It starts with culture and with leadership. With everyone on the same team, oriented toward the same goal, we are confident that we ultimately can achieve the goal of zero patients harmed from the care they receive.

Dr. Ricciardi is the Director of the Division of Practice Improvement in AHRQ’s Center for Evidence and Practice Improvement. He is the Agency’s Senior Nursing Advisor. Ms. Shofer is the Director of the Patient Safety Program within AHRQ’s Center for Quality Improvement and Patient Safety.