Top 10 Patient-Safety Strategies Update

July 25, 2013

Top 10 Patient-Safety Strategies Update

  1. Daniel D. Dressler, MD, MSc, SFHM, FACP

Ten strategies are encouraged strongly for immediate adoption on the basis of a systematic literature review.

  1. Daniel D. Dressler, MD, MSc, SFHM, FACP

Patient-safety experts in North America and the U.K. systematically reviewed the growing evidence base for 158 patient-safety topics, including 41 strategies designated as most important to practitioners and patients. All reviews are published in the Agency for Healthcare Research and Quality (AHRQ) evidence report entitled “Making Health Care Safer II: An Updated Critical Analysis of the Evidence for Patient Safety Practices” to update the original 2001 publication. After carefully analyzing each patient-safety problem and its related safety strategy, the authors strongly recommend immediate adoption of the following 10 strategies:

  • Preoperative and anesthesia checklists to prevent operative and postoperative events

  • Bundles (with checklists) to prevent central line–associated bloodstream infections

  • Interventions to reduce urinary catheter use

  • Bundles to prevent ventilator-associated pneumonia

  • Hand hygiene

  • Do-not-use list for hazardous abbreviations

  • Multicomponent interventions to prevent pressure ulcers

  • Barrier precautions to prevent healthcare-associated infections

  • Real-time ultrasonography for central line placement

  • Interventions to improve prophylaxis for venous thromboembolism

The authors also provide a list of 12 “encouraged” (rather than “strongly encouraged”) patient-safety practices.


To formally revisit patient safety makes sense after more than a dozen years following publication of the Institute of Medicine's report, “To Err Is Human: Building a Safer Health System.” Healthcare and policy experts have learned much during that time, including how to improve healthcare delivery to lower patient risk.

Editor Disclosures at Time of Publication

  • Disclosures for Daniel D. Dressler, MD, MSc, SFHM, FACP at time of publication Editorial boards Hospital Medicine Reviews; Journal of Hospital Medicine


Reader Comments (1)

Yasmine Alhatimy MA HMPP, PhD (Med) Other Healthcare Professional, Health Law/Ethics/Public Policy, SQUH, Sultanate of Oman

It is indeed a great pleasure to see both practioners AND patients being considered when determining the updated list of patient safety strategies. From a holistic point of view, patient safety begins with safe physicians and care givers, where patient safety systems integrate with clinical information systems and create recommended strategies to support this vision. And this is something we learned from the Institute of Medicine Quality Chasm Series 2004.

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