ACP American College of Physicians - Internal Medicine - Doctors for Adults

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Patient Safety: The Other Side of the Quality Equation

Patient Safety: The Other Side of the Quality Equation includes seven learning modules focusing on important aspects of safety in ambulatory care. View the PowerPoint presentations below:

Systems

Definition of the systems approach: how systems influence medical care, how physicians fit into the care delivery system
Changing the culture of "blame and shame" to systems-centered problem-solving
Safety efforts and results in anesthesiology: translating these success stories into the ambulatory care setting
Case studies and problem solving illustrating how systemic breakdowns cause adverse events
Techniques for safety improvement; take home points to help physicians apply systems thinking in their practices

Medication Errors

"Danger zones": where and how medication errors occur
Medication prescribing system components: communication
Written medication orders: illegible handwriting, getting complete information
Look-alike and sound-alike drug names
Proven strategies to reduce errors
Electronic prescribing
Role of the patient in reducing medication errors

Idealized office design

The need to address patient safety in the office
Review of systems thinking
Connection between safety and system reliability
The physician's office as a complex set of interdependent parts
Analyzing your office practices: the refill process as an example
Setting goals for reliability: working as a team
Patient registries and proactive population management for reliable care provision
Decision support: how to find information when you need it most

Electronics

How information technology improves healthcare delivery outcomes
Electronic medical records
Electronic prescribing
Pros and cons of the electronic office
Electronic decision-support tools: an overview
Handheld devices (PDAs): what they can do for the physician
Choosing the most appropriate system for your office: an algorithm

Communication

Referrals
Pharmacy communication
Test results
Creating reliable communication between team members in the physician's office: techniques
Creating reliable communication between various providers: techniques

The Role of the Patient

Communicating with the patient
Patient education
The patient as a partner in the safe delivery of care: what he/she can do
Ten questions the patient should always ask
What the physician should always ask the patient
Medication compliance
Recognizing and overcoming cultural, generational, language and low-literacy barriers

Human Cognition

Cognition-related adverse events
Why no one is to blame
The role of fatigue in cognition failures
Time pressure and medical errors
How medicine has changed in the last 30 years: new challenges to human cognitive limits
Overcoming human cognitive limits: tools and techniques

Page posted: 3/22/2004

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