Ambulatory Care Patient Safety Proactive Risk Assessment, a Necessary Fist Step

摘要

Much of the health care in the United States and around the world is delivered in ambulatory settings. Most medical and surgical procedures that were once provided only in hospitals are now routinely performed in ambulatory settings. However much of the focus on patient safety has been in the in patient setting. There is insufficient information on risks, hazards, and their consequences in ambulatory care. Unlike in the hospital setting there are no identified safe practices that should be implemented in the ambulatory setting. Evidence based safe practices in ambulatory care are yet to be identified. A significant starting point for improvement in the safety of care in ambulatory care is to identify the risks and hazards imbedded in the process and structure of ambulatory care. Prior to implementing interventions de jour, knowing where these risks and hazards are will inform the design, planning and development of appropriate interventions that will in fact eliminate or minimize the actual risks and hazards. Using proven proactive risk assessment/modeling methods it is possible to begin to move to risks informed design and intervention. AHRQ has funded 20 risk assessment projects using a variety of methods and approaches to identifying risk and hazards in ambulatory setting. Clearly identifying risks and hazards is an essential first step in improving the quality and safety of ambulatory care. Proactive risk assessment is a vital first step in the design and development of interventions and safe practices. If you do not know where the risks and hazards are how one can make progress in eliminating or mitigating them. The use of established proactive risk assessment is a essential aspect of an going patient safety activities.