Creating a Culture of Safety in the Ambulatory Surgery Environment: Implementation Guide

AHRQ Safety Program for Ambulatory Surgery

Prepared by:

Health Research & Educational Trust of the American Hospital Association with contract funding provided by the Agency for Healthcare Research and Quality through Contract No. HHSA2902010000251.

Disclaimer: The opinions expressed in this document are those of the authors and do not reflect the official position of AHRQ or the U.S. Department of Health and Human Services.

None of the investigators have any affiliations or financial involvement that conflicts with the material presented in this document.

This document may be used and reprinted without permission except those copyrighted materials that are clearly noted in the document. Further reproduction of those copyrighted materials is prohibited without the express permission of copyright holders.


   Purpose of This Guide
   How To Use This Guide
   Program Elements
      The Comprehensive Unit-based Safety Program (CUSP)
      Surgical Safety Checklist
      Infection Prevention
      Planning for Sustainability
The Comprehensive Unit-based Safety Program (CUSP)
   The CUSP Toolkit
   Ambulatory Surgery Center Implementation Training and Tools
      Communication and Teamwork in the Surgical Environment
      Coaching Clinical Teams
      Patient and Family Engagement in the Surgical Environment
   Safety Culture Survey
Implementing the Surgical Safety Checklist
   Phase 1: Prepare
      Assess Your Culture Using the Safety Culture Survey
      Recruit Your Implementation Team
      Engaging Physicians
   Phase 2: Own
      Observe, Modify, and Test
      Plan for Expansion
   Phase 3: Expand
      Watch and Coach
   Phase 4: Continually Expand
Infection Prevention
Planning for Sustainability
   IHI: Sustaining Improvements in Ambulatory Surgical Safety
      Step One: Determine Change Has Achieved Acceptable Levels of Capability and Reliability
      Step Two: Develop and Use a Sustainability Prediction Tool To Understand Nature of Change and Context
      Step Three: Develop Infrastructure for Sustainability
      Step Four: Change Relevant Support Systems 
   More Sustainability Resources
      Sustainability Module
      Management Practices for Sustainability

Page last reviewed May 2017
Page originally created April 2017
Internet Citation: Creating a Culture of Safety in the Ambulatory Surgery Environment: Implementation Guide. Content last reviewed May 2017. Agency for Healthcare Research and Quality, Rockville, MD.