November 2, 2001

Quality Forum's Safe Practices Steering Committees Reviews Practices, Discusses Dissemination

The Safe Practices Steering Committee of the National Forum for Health Care Quality Measurement and Reporting met on Oct. 29 to guide the Forum's work on developing a compendium of evidence-based safe practices for all health care settings. The Forum's goal is to have this compendium serve as a guide for all health care stakeholders to recognize, implement, and support practices which improve the quality of care. The project stems from the Quality Interagency Task Force's (QuIC) February 2000 report to the President on patient safety initiatives in the federal government.

Forum staff presented the steering committee with an augmented list of practices based on the comments they received at the July meeting [see Washington Highlights, July 20]. Measures on the list met at least one of the following criteria:

• The effectiveness of the practice is supported by a preponderance of evidence;
  
• It is possible for patients, consumers, or purchasers to discern whether a practice is actually absent or present; or
  
• The practice has face validity that is as "obviously beneficial" practice.

All included practices were than rated against four additional criteria reflecting different dimensions of impact:

• Applicability to multiple care settings;
  
• Applicability to multiple health care conditions;
  
• Broad relevance to general acute care hospitals, regardless of the location or type of hospital; and
  
• Whether the practice reduces the likelihood of the most serious adverse events, as identified by the National Quality Forum's consensus list of serious reportable events.

The practices on the list included those from the Agency for Healthcare Research and Quality (AHRQ) report Making Health Care Safer: A Critical Analysis of Patient Safety Practices, and additional measures agreed upon at the July meeting. The steering committee reviewed the list and discussed the practices in terms of impact, measurement, and the difference between patient safety and quality. They asked Forum staff to reorganize the list into specific practice areas, which included, among others, surgery, anesthesiology, devices and other chemical agents. Then they would re-rank the practices into each area incorporating any new practices.

The steering committee also addressed the dissemination of the document and potential audiences. The Forum has been working with other organizations so that these potential practices will compliment other work that is occurring in this area. Other issues raised during this discussion included: updating the practices and evaluating the impact of the document.

Information: Jeff Patyk, AAMC Division of Health Care Affairs, 202-828-0498.