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How to improve patient safety?

This summary of evidence is based on the Annals of Internal Medicine Supplement (Ann Intern Med. 2013;158:365-368) and on the report by the Agency for Healthcare Research and Quality: Making Health Care Safer II: An Updated Critical Analysis of the Evidence for Patient Safety Practices

Annals of Internal Medicine Supplement

Full Report (PDF)

Structured Abstract

Study Objective

To review important patient safety practices for evidence of effectiveness, implementation, and adoption.

Data Sources

Searches of multiple computerized databases, gray literature, and the judgments of a 20-member panel of patient safety stakeholders.


From an initial list of over 100 patient safety practices, the stakeholders identified 41 practices as a priority for this review: 18 in-depth reviews and 23 brief reviews. Of these, 20 practices had their strength of evidence of effectiveness rated as at least “moderate,” and 25 practices had at least “moderate” evidence of how to implement them. Ten practices were classified by the stakeholders as having sufficient evidence of effectiveness and implementation and should be “strongly encouraged” for adoption, and an additional 12 practices were classified as those that should be “encouraged” for adoption.


The evidence supporting the effectiveness of many patient safety practices has improved substantially over the past decade. Evidence about implementation and context has also improved, but continues to lag behind evidence of effectiveness. Twenty-two patient safety practices are sufficiently well understood, and health care providers can consider adopting them now.

Strongly encouraged PSPs












Encouraged PSPs













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