More needs to be done to improve patient safety in the outpatient setting, the American College of Physicians says in a new policy paper that offers a set of recommendations aimed at improving patient care in office-based practices.
Hospitals have been the main target of ongoing patient safety improvements in recent years, but it's the authors' contention that the focus should be extended to include ambulatory care, and preventing medical errors that occur outside the hospital setting.
ACP's paper outlines a number of principles -- firstly, that physicians and healthcare organizations have a responsibility to promote a culture of patient safety within their practices, as well as among colleagues with whom they collaborate.
ACP recommends that physicians and other healthcare professionals -- as well as payers, government and other relevant stakeholders -- should work to address physician stress, burnout and organizational culture that may impact medical errors.
The authors also said that patient and family education, engagement, and health literacy efforts are needed to educate the public about asking the right questions and providing the necessary information to their physician or other healthcare professional. Materials should reflect the linguistic and cultural characteristics of the audience.
ACP also said it supports the continued research into and development of a comprehensive collection of standardized patient safety metrics and strategies, with particular attention to primary care and other ambulatory settings. Domains could include medication safety, diagnosis, transitions, referrals and testing issues. ACP recommends expanded patient safety research efforts to better understand the ambulatory medical errors and the efficacy of patient safety practices.
Team-based care models, such as the patient-centered medical home, should be encouraged and optimized to improve patient safety and facilitate communication and information sharing among team members, according to the paper. And health information technology systems should be tailored to emphasize patient safety improvement.
ACP backs the establishment of a national effort to prevent patient harm across the healthcare sector. A national entity, the group said, could be charged with coordinating and collaborating with stakeholders, defining the problem, setting national goals, and developing and assisting in the implementation of a patient safety action plan, with attention given to the ambulatory setting.