Applied strategies for improving patient safety: a comprehensive process to improve care in rural and frontier communities.
BACKGROUND
Medical errors and patient safety have gained increasing attention throughout all areas of medical care. Understanding patient safety in rural settings is crucial for improving care in rural communities.


OBJECTIVE
To describe a system to decrease medical errors and improve care in rural and frontier primary care offices.


METHODS
Applied Strategies for Improving Patient Safety (ASIPS) was a demonstration project designed to collect and analyze medical error reports and use these reports to develop and implement interventions aimed at decreasing errors. ASIPS participants were clinicians and staff in 2 practice-based research networks: the Colorado Research Network (CaReNet) and the High Plains Research Network (HPRN). This paper describes ASIPS in HPRN.


RESULTS
Fourteen HPRN practices with a total of 150 clinicians and staff have participated in ASIPS. Participants have submitted 128 reports. Diagnostic tests were involved in 26% of events; medication errors appeared in 20% of events. Communication errors were reported in 72%. Two learning groups developed "Principles for Process Improvement" for medication errors and diagnostic testing errors. Several safety "alerts" were issued to improve care, and 2 interventions were implemented to decrease errors.


CONCLUSIONS
A safe and secure reporting system that relies on voluntary reporting from clinicians and staff can be successfully implemented in rural primary care settings. Information from reports can be used to identify processes that can be improved.
Westfall
John M
JM
Department of Family Medicine, University of Colorado Health Sciences Center, Aurora, CO 80045-0508, USA. jack.westfall@uchsc.edu
Fernald
Douglas H
DH
Staton
Elizabeth W
EW
VanVorst
Rebecca
R
West
David
D
Pace
Wilson D
WD
D003120:Colorado; D016494:Computer Security; D003219:Confidentiality; D019538:Health Care Surveys; D006751:Hospital Information Systems / Q000458:organization & administration; D006780:Hospitals, Rural / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D008498:Medical Record Linkage / Q000379:methods*; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data*; D008508:Medication Errors / Q000517:prevention & control*; D011785:Quality Assurance, Health Care / Q000458:organization & administration; D017751:Safety Management / Q000458:organization & administration* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D017749:Total Quality Management / Q000458:organization & administration