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Patient Safety

National Quality Forum of Safe Practices/Leapfrog

The National Quality Forum is a not-for-profit organization created to develop and implement a national strategy for quality measurement and reporting. Quality and patient safety measures are developed and adopted through a rigorous national consensus process. In May of 2003, the National Quality Forum released the "Safe Practices for Better Healthcare Report". This was in response to the Institute of Medicine’s report that stated 44,000 to 98,000 people die each year because of a medical error. The National Quality Forum updated the "Safe Practices for Healthcare Report" in 2006.

The "Safe Practices for Better Healthcare Report" endorsed 30 safe practices that if fully implemented would affect the safety of patients in health care settings. These 30 safe practices focus on high-priority practices that:

  • have strong evidence that they are effective in reducing the likelihood of harming a patient;
  • are generalizable in multiple clinical care settings for multiple patient types;
  • are likely to have a significant impact on patient safety if fully implemented; and
  • have knowledge about them that is usable by consumers, purchaser, providers, and researchers.

The National Quality Forum’s Safe Practices are organized in seven broad categories for improving patient safety by or through:

  • creating and sustaining a culture of safety;
  • informed consent, honoring patient wishes, and disclosure;
  • matching health care needs with service delivery capability;
  • information management and continuity of care;
  • medication management;
  • preventing healthcare-associated infections; and
  • condition and site-specific practices.

Some examples of the National Quality Forum’s Safe Practices include:

  • communication of critical information;
  • nurse staffing ratios;
  • active participation of pharmacists in the medication use process;
  • read back of verbal and telephone orders;
  • medication reconciliation;
  • standardized medication labeling and packaging;
  • hand hygiene to prevent the spread of infection;
  • anticoagulation therapy;
  • standardized abbreviations and dose designations;
  • means for patients to recount what they are told during the informed consent process;
  • standardized protocol to prevent the mislabeling of diagnostic studies;
  • protocols to prevent wrong-site/side surgeries;
  • protocols to prevent pressure ulcers;
  • prevention of central venous catheter related blood stream and surgical site infections; and
  • prevention of contrast media-induced renal failure.

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