HRET logo, click here to go to the site home page

Transforming health care
through research and education

Hospitals in the Pursuit of Excellence logo, click here to go to the HPOE home page
Skip main navigation

HRET Mission

Transforming health care through research and education.

HRET Vision

Leveraging research and education to create a society of healthy communities, where all individuals reach their highest potential for health.

Bucket/Section Image

Patient Safety Tools for Physician Practices

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 until now.

HRET and partners at the Institute for Safe Medication Practices (ISMP) and the Medical Group Management Association (MGMA) Center for Research have developed several resources to help outpatient settings take steps to improving patient safety.

Pathways for Patient Safety

HRET, ISMP, and MGMA, with support from The Commonwealth Fund, have developed Pathways for Patient Safety ™, a three-part toolkit to help outpatient care settings improve safety in three areas:

  • Working as a Team
  • Assessing Where You Stand
  • Creating Medication Safety

The toolkit was developed with input from a panel of experts in physician practice management and patient safety. The modules provide practical tools, templates, and actionable information that require few resources to put into practice.

Download the Pathways for Patient Safety Tools

The Physician Practice Patient Safety Assessment

HRET, ISMP, and MGMA have also developed a self-assessment of patient safety in physician practices, through a grant from The Commonwealth Fund. The assessment helps physician practices to evaluate their processes, clarify opportunities for improvement, measure progress over time, and facilitate dialogue among staff.

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.

Download the Physician Practice Patient Safety Assessment

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:

Patients are informed of HIPAA rules and regulations.


Easy access to drug information


Conscious sedation with two individuals—only one monitoring.


Explanation of surgical procedures performed in or outside the practice.









There were five areas in which a relatively high percentage of practices had little or no implementation activity:

Up to date written information on medication provided to non-English speaking patients.


Provide emotional support for staff involved in errors.


All practice staff are trained in health literacy issues.


Review external error literature.


Patients are routinely asked to repeat back instructions











The PPPSA has six domains

  • Medications
  • Handoffs and Transitions
  • Surgery/Anesthesia and Sedation/Invasive Procedures
  • Personnel/Qualifications/Competency
  • Practice Management/Culture
  • Patient Education/Communication

Use the PPPSA to:

  • Gain specific ideas to improve patient safety 
  • Compare your data to aggregate results for similar practices 
  • Enhance your team's awareness of patient safety issues 
  • Heighten providers' awareness of characteristics that make a practice safer 
  • Create a new reference point and baseline to enhance and support patient safety 
  • Document your successes and track your progress

Any physician practice can provide safer and better care, reduce liability, and facilitate conversation among staff and physicians to identify opportunities to increase patient safety.

Terms of Use  | Privacy Policy

©2006-2017 by the American Hospital Association. All rights reserved. Noncommercial use of original content on is granted to AHA Institutional Members, their employees and State, Regional and Metro Hospital Associations unless otherwise indicated. AHA does not claim ownership of any content, including content incorporated by permission into AHA produced materials, created by any third party and cannot grant permission to use, distribute or otherwise reproduce such third party content. To request permission to reproduce AHA content, please click here.