Prioritizing Patient Safety Interventions in Small and Rural Hospitals.

Authors

Michelle M. Casey, University of Minnesota, Rural Health Research Center
Mary Wakefield PhD, RN, University of North Dakota, School of Medicine and Health Sciences, Center for Rural Health
Andrew F. Coburn PhD, University of Southern Maine, Muskie School of Public Service, Maine Rural Health Research CenterFollow
Ira S. Moscovice PhD, University of Minnesota, Division of Health Policy and Management, Rural Health Research Center
Stephenie Loux MS, University of Southern Maine, Muskie School of Public Service, Maine Rural Health Research Center

Document Type

Article

Publication Date

12-1-2006

Keywords

Consensus, Decision Making, Organizational, Feasibility Studies, Health Priorities, Health Services Research, Hospital Bed Capacity, under 100, Hospitals, Rural, Humans, Medical Errors, Patient Care, Practice Guidelines as Topic, Safety Management, United States

Publication Title

Joint Commission journal on quality and patient safety / Joint Commission Resources

Abstract

BACKGROUND: A study was conducted in 2004 to determine if 26 interventions--distributed among nine patient safety areas and as recommended by an expert panel as relevant to rural hospitals--would be validated in terms of relevance and implementability for small and rural facilities.

METHODS: The chief executive officers (CEOs) and/or key managers responsible for patient safety activities in a diverse group of 29 small and rural hospitals assessed the potential effectiveness and feasibility of the 26 interventions. Representatives of 25 hospitals participated in structured, follow-up phone discussions.

RESULTS: Adverse drug events were the highest-priority area for 14 hospitals, followed by patient falls (selected by 5 hospitals). Some hospitals had already implemented intervention 1 (use at least two patient identifiers) and intervention 6 (read back of verbal orders) and thus ranked them highly, especially for implementability. Intervention 3 (24-hour pharmacist coverage) was ranked low, especially on implementability. Interventions involving health information technology were ranked lower by the hospitals than by the expert panel.

DISCUSSION: Safety interventions should reflect the general state of the science of safe practices while incorporating relevant contextual issues unique to rural hospitals. The results have important implications for survey and accreditation activity, and the focus of technical assistance and research efforts.

Recommended Citation

Casey, M., Wakefield, M., Coburn, A. F., Moscovice, I., & Loux, S. (2006). Prioritizing patient safety interventions in small rural hospitals. Joint Commission Journal on Quality and Patient Safety, 32(12), 693-702.