Assessing patient safety in the United States: challenges and opportunities.
BACKGROUND
In 1999, the US Congress mandated the Agency for Healthcare Research and Quality (AHRQ), Department of Health and Human Services (DHHS), to report annually to the nation about healthcare quality. One chapter in the National Healthcare Quality Report (NHQR) is focused on patient safety.


OBJECTIVE
The objectives of this study were to describe the challenges in reporting the national status on patient safety for the first NHQR and discuss emerging opportunities to improve the comprehensiveness and reliability of future reporting.


METHODS
This study is a selective review of definitions, frameworks, data sources, measures, and emerging developments for assessing patient safety in the United States.


RESULTS
Available data and measures for patient safety assessment in the nation are inadequate, especially for comparing regions and subpopulations and for trend analysis. However, many opportunities are emerging from the recently increased investments in patient safety research and many ongoing safety improvement efforts in the private sector and at the federal, state, and local government levels.


CONCLUSIONS
There are many challenges in assessing national performance on patient safety today. Ongoing developments on multiple fronts will provide data and measures for more accurate and more comprehensive assessments of patient safety for future NHQRs.
Zhan
Chunliu
C
Center for Quality Improvement and Patient Safety, Agency for Healthcare Research and Quality, US Department of Health and Human Services, Rockville, MD 20850, USA. czhan@ahrq.gov
Kelley
Ed
E
Yang
Hannah P
HP
Keyes
Marge
M
Battles
James
J
Borotkanics
Robert J
RJ
Stryer
Daniel
D
D000847:Annual Reports as Topic; D003428:Cross Infection / Q000517:prevention & control; D003625:Data Collection; D006801:Humans; D008484:Medicaid; D019300:Medical Errors / Q000517:prevention & control; D016347:Medical Records Systems, Computerized; D006278:Medicare; D010361:Patients / Q000331:legislation & jurisprudence; D011785:Quality Assurance, Health Care; D012449:Safety; D017751:Safety Management; D014481:United States; D016270:United States Agency for Healthcare Research and Quality