title: A checklist for patient safety rounds at the care pathway level.
abstract: OBJECTIVE
  To define a checklist that can be used to assess the performance of a department and evaluate the implementation of quality management (QM) activities across departments or pathways in acute care hospitals.
  
  
  METHODS
  We developed and tested a checklist for the assessment of QM activities at department level in a cross-sectional study using on-site visits by trained external auditors.
  
  
  METHODS
  A sample of 292 hospital departments of 74 acute care hospitals across seven European countries. In every hospital, four departments for the conditions: acute myocardial infarction (AMI), stroke, hip fracture and deliveries participated.
  
  
  METHODS
  Four measures of QM activities were evaluated at care pathway level focusing on specialized expertise and responsibility (SER), evidence-based organization of pathways (EBOP), patient safety strategies and clinical review (CR).
  
  
  RESULTS
  Participating departments attained mean values on the various scales between 1.2 and 3.7. The theoretical range was 0-4. Three of the four QM measures are identical for the four conditions, whereas one scale (EBOP) has condition-specific items. Correlations showed that every factor was related, but also distinct, and added to the overall picture of QM at pathway level.
  
  
  CONCLUSIONS
  The newly developed checklist can be used across various types of departments and pathways in acute care hospitals like AMI, deliveries, stroke and hip fracture. The anticipated users of the checklist are internal (e.g. peers within the hospital and hospital executive board) and external auditors (e.g. healthcare inspectorate, professional or patient organizations).
authors.affiliation: PO Box 1568, Utrecht 3500 BN, The Netherlands. c.wagner@nivel.nl.
authors.forename: Cordula
authors.initials: C
authors.lastname: Wagner
authors.forename: Caroline A
authors.initials: CA
authors.lastname: Thompson
authors.forename: Onyebuchi A
authors.initials: OA
authors.lastname: Arah
authors.forename: Oliver
authors.initials: O
authors.lastname: Groene
authors.forename: Niek S
authors.initials: NS
authors.lastname: Klazinga
authors.forename: Maral
authors.initials: M
authors.lastname: Dersarkissian
authors.forename: Rosa
authors.initials: R
authors.lastname: Suñol
mesh_terms: D057189:Checklist; D019091:Critical Pathways; D003430:Cross-Sectional Studies; D005060:Europe; D006748:Hospital Departments / Q000592:standards; D006761:Hospitals / Q000592:standards*; D006801:Humans; D017063:Outcome Assessment, Health Care; D061214:Patient Safety / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000379:methods*
keywords: external quality assessment; hospital care; measurement of quality; professions; quality improvement; quality management; surgery