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The Medical Group Management Association (MGMA), the Health Research and Educational Trust (HRET), and the Institute for Safe Medication Practices (ISMP) developed a self-assessment of patient safety in physician practices, through a grant from the Commonwealth Fund. The assessment helps physician practices to establish a baseline measure of current procedures, clarify opportunities for improvement, measure progress over time, and facilitate conversation and dialogue among staff.
The majority of patients receive most of their health care in physician practice settings, in preventive care or follow-up to inpatient stays or ambulatory procedures. Sources of variation in outpatient care settings—logistic complexity of care, increasingly complex job functions of primary care providers, increased number of patient “hand-offs,” and a lack of necessary physician support systems—are often sources of increased risk to patient safety.
Despite known risks, patient safety in physician practice settings has been largely unexplored. The Physician Practice Patient Safety Assessment (PPPSA) is the first global, comprehensive assessment of its kind. MGMA, HRET, and ISMP developed the assessment to:
Examine the state of patient safety in outpatient settings.
Aid the development of educational resources and tools specifically
tailored to support improvement of patient safety within physician
practices.
Heighten industry awareness of distinguishing characteristics of a safe
physician practice.
Create a new baseline of practice efforts to enhance and support
patient safety.
From January to May 2006, MGMA, HRET, and ISMP gathered assessment data from a selected sample of MGMA member physician practices. There were four areas in which a relatively high percentage of practices had fully implemented safe practices:
| PPPSA ITEM |
FULLY IMPLEMENTED |
| Patients are informed of HIPAA rules and regulations. |
89%
|
| Easy access to drug information |
70%
|
| Conscious sedation with two individuals—only one monitoring. |
69%
|
| Explanation of surgical procedures performed in or outside the practice. |
67%
|
There were five areas in which a relatively high percentage of practices had little or no implementation activity:
| PPPSA ITEM |
NO ACTIVITY TO IMPLEMENT |
| Up to date written information on medication provided to non-English speaking patients. |
60%
|
| Provide emotional support for staff involved in errors. |
55%
|
| All practice staff are trained in health literacy issues. |
41%
|
| Review external error literature. |
38%
|
| Patients are routinely asked to repeat back instructions |
30%
|
Currently, HRET, ISMP, and MGMA are developing Pathways for Patient Safety ™, a series of three Web-based tools to raise awareness and uptake of best practices in reducing risk of patient harm in outpatient settings. The three tools are:
Module 1: Getting Your Practice to Work as a Team
Module 2: Assessing Where You Stand
Module 3: Creating the Safer Office for Medication Safety
Pathways for Patient Safety ™ will be available in Summer 2008.
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