title: Evaluation of the AHRQ patient safety initiative: synthesis of findings.
abstract: OBJECTIVE
  To present overall findings from the 4-year evaluation of the national patient safety initiative operated by the Agency for Healthcare Research and Quality (AHRQ).
  
  
  METHODS
  Interviews with AHRQ staff, grantees, and other patient safety stakeholders; published materials; and internal AHRQ documents.
  
  
  METHODS
  The evaluation was structured to address a system framework of five components involved in improving safety. The initiative's contributions to improving each system component were assessed qualitatively, comparing results from three separate analyses—AHRQ's achievement of its patient safety goals, our own assessment of the initiative's activities, and independent stakeholder ratings of AHRQ's contributions.
  
  
  CONCLUSIONS
  AHRQ has faced a daunting challenge for improving patient safety, given the complex problems of the U.S. health care system and the limited resources AHRQ has had to address them. The patient safety initiative achieved strongest progress for its contributions to knowledge of patient safety epidemiology and effective practices, where AHRQ has considerable experience, and to strengthening infrastructure to support adoption of safe practices. Progress was slower in establishing a national monitoring capability and dissemination of safe practices for adoption. AHRQ needs to expand efforts to apply new knowledge for stimulating use of safe practices in the field.
authors: RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, USA. farley@rand.org
authors: Donna O
authors: DO
authors: Farley
authors: Cheryl L
authors: CL
authors: Damberg
mesh_terms: D005069:Evaluation Studies as Topic; D019538:Health Care Surveys / Q000706:statistics & numerical data; D006801:Humans; D033181:Information Dissemination; D019300:Medical Errors / Q000517:prevention & control*; D010043:Outcome and Process Assessment, Health Care; D010353:Patient Education as Topic / Q000458:organization & administration; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D058996:Quality Improvement / Q000458:organization & administration*; D019984:Quality Indicators, Health Care / Q000458:organization & administration*; D012189:Retrospective Studies; D017751:Safety Management / Q000458:organization & administration*; D014481:United States / Q000453:epidemiology; D016270:United States Agency for Healthcare Research and Quality