Increasing nurse staffing levels in acute-care hospitals and nursing homes and enhancing systems for communicating between hospitals and other health care settings are among the strategies that are likely to lead to improved patient safety, according to a new evidence report summary released today by the Agency for Healthcare Research and Quality. A summary of the report is available on the AHRQ Web site at http://www.ahrq.gov/clinic/epcsums/worksum.htm and from the National Guideline Clearinghouse at http://www.guideline.gov (select "NGC Resources"). The full report will be available later this spring.
The report, developed for AHRQ by the Oregon Health & Science University Evidence-based Practice Center, details the effects of health care working conditions on patient safety. Based on a review of 115 existing studies conducted in health care and non-health care settings, the report concluded that there is enough evidence in the scientific literature to make specific recommendations about these strategies for improving patient safety. The researchers also found that when complex procedures are performed by physicians who do them frequently, preventable complications are less likely. In addition, they found that fewer interruptions and distractions to staff can reduce errors and that systems to improve information exchange and "handing off" care between hospital and nonhospital settings can decrease medication errors.
However, researchers found that there is insufficient evidence to draw clear conclusions for several other specific working conditions, including workplace stress, lighting conditions, and several organizational factors.
Beginning in 2001, AHRQ began funding a large portfolio of patient safety research projects to address key unanswered questions about how errors occur and provide science-based information on what patients, clinicians, hospital leaders, policymakers and others can do to make the health care system safer. The results of this research will identify strategies to improve the quality of care in hospitals, doctors' offices, nursing homes, and other health care settings across the nation, including home care.
Prominent among these projects are a number focusing specifically on working conditions that will address some of the issues this new report cites as needing further research. For example, some projects are examining the impact of nurses' stress and fatigue on patient safety and potential interventions that could enhance patient safety. AHRQ has published a fact sheet summarizing the working conditions research projects in AHRQ's portfolio, which is available at http://www.ahrq.gov/news/workfact.htm.
The summary of the evidence report, The Effect of Health Care Working Conditions on Patient Safety, and the fact sheet, AHRQ Research Relevant to Understanding the Impact of Working Conditions on Patient Safety also are available from the AHRQ Publications Clearinghouse by sending an e-mail to [email protected] or by calling (800) 358-9295.
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