Toward improving patient safety through voluntary peer-to-peer assessment.
Health care has primarily used retrospective review approaches to identify and mitigate hazards, with little evidence of measurable and sustained improvements in patient safety. Conversely, the nuclear power industry has used a prospective peer-to-peer (P2P) assessment process grounded in open information exchange and cooperative organizational learning to realize substantial and sustainable improvements in safety. In comparing approaches, it is evident that health care's sluggish progress stems from weaknesses in hazard identification and mitigation and in organizational learning. This article proposes creating and implementing a structured prospective P2P assessment model in health care, similar to that used in the nuclear power industry, to accelerate improvements in patient safety.
US Nuclear Regulatory Commission, Rockville, MD, USA.
Daniel W
DW
Hudson
Christine G
CG
Holzmueller
Peter J
PJ
Pronovost
Sebastiana J
SJ
Gianci
Zack T
ZT
Pate
Joyce
J
Wahr
Eugenie S
ES
Heitmiller
David A
DA
Thompson
Elizabeth A
EA
Martinez
Jill A
JA
Marsteller
Ayse P
AP
Gurses
Lisa H
LH
Lubomski
Christine A
CA
Goeschel
Julius Cuong
JC
Pham
D006801:Humans; D055848:Nuclear Power Plants / Q000592:standards*; D061214:Patient Safety / Q000592:standards; D010380:Peer Review / Q000379:methods*; D017064:Process Assessment, Health Care / Q000379:methods*; D011446:Prospective Studies; D011785:Quality Assurance, Health Care / Q000379:methods / Q000458:organization & administration*; D012189:Retrospective Studies; D012449:Safety / Q000592:standards*; D017751:Safety Management / Q000592:standards