Survey of staff and administrators in outpatient clinics finds concerns with workload, safety culture, and referral process.Med Care. 2014 Nov 27; [Epub ahead of print].
Evaluating ambulatory practice safety: the PROMISES Project administrators and practice staff surveys.
Singer SJ, Reyes Nieva H, Brede N, et al. Med Care. 2014 Nov 27; [Epub ahead of print].
In order to characterize outpatient safety, this study of small- and medium-sized ambulatory clinics surveyed administrators about organizational safety and staff about communication and existing safety processes. Administrators reported a lack of safety systems, consistent with prior discussion of ambulatory settings. As with earlier research in hospitals, frontline staff describe difficulty speaking up about errors. Staff responses suggested that insufficient time to manage their workload leads to safety problems, echoing a recent focus group study of physicians. Respondents also reported weaknesses in outpatient referral processes. Overall, staff and administrators in ambulatory practices continue to identify gaps in care that contribute to adverse events, highlighting opportunities to improve safety in primary care settings. A recent AHRQ WebM&M interview and perspective discuss patient safety in ambulatory care.
Beyond our walls: impact of patient and provider coordination across the continuum on outcomes for surgical patients.
Weinberg DB, Gittell JH, Lusenhop RW, Kautz CM, Wright J. Health Serv Res. 2007;42:7-24.
Deficits in communication and information transfer between hospital-based and primary care physicians: implications for patient safety and continuity of care.
Kripalani S, LeFevre F, Phillips CO, Williams MV, Basaviah P, Baker DW. JAMA. 2007;297:831-841.
Barriers and motivators for making error reports from family medicine offices: a report from the American Academy of Family Physicians National Research Network (AAFP NRN).
Elder NC, Graham D, Brandt E, Hickner J. J Am Board Fam Med. 2007;20:115-123.
ORGANIZATIONAL POLICY/GUIDELINESView all related resources...
Transitions of Care Consensus Policy Statement American College of Physicians-Society of General Internal Medicine-Society of Hospital Medicine-American Geriatrics Society-American College of Emergency Physicians-Society of Academic Emergency Medicine.
Snow V, Beck D, Budnitz T, et al. J Gen Intern Med. 2009;24:971-976.