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Evaluation of the implementation of a four-year national hospital patient safety program in the Netherlands.

Schilp, J., Blok, C. de, Wagner, C. Evaluation of the implementation of a four-year national hospital patient safety program in the Netherlands. Abstract. In: Abstractbook Poster presentations. International Society for Quality in Health Care (ISQUA) 30th International Conference 'Quality and safety in population health and healthcare'. Edinburgh: ISQUA, 2013. 1996
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Objectives: To evaluate the implementation of five safety themes within a four-year national
hospital patient safety program in the Netherlands. Methods: In 2008, a national hospital patient safety program was started to improve patient safety in Dutch hospitals. The safety program focussed on 10 safety themes, chosen through consultation with experts in the relevant professional groups and medical specialism. For each safety theme a module was developed to support hospitals with the implementation of interventions concerning this theme. An observational prospective study was performed to evaluate the quality of the implementation of the themes. This evaluation study was performed in a representative sample of 38 hospitals, stratified by area and type of hospital, during the final year of the safety program between November 2011 and December 2012. The present study focussed on the results of the implementation of five themes: 1) pain; 2) mix-ups in and among patients; 3) renal insufficiency; 4) medication reconciliation; and 5) administration of high-risk medication. During 10 monthly visits, the implementation of the themes was evaluated by patient record research (theme 1, 3 and 4) or observations (theme 2 and 5) by trained research assistants. Process indicators were formulated for each theme to evaluate the degree of implementation of this particular theme. Multilevel analysis was used to determine if the percentage of achievement of the process indicators changed in the total population and in different hospital types (teaching versus non-teaching) during the study. Results: The outcomes of the process indicators of the five safety themes during the 1-year follow-up were calculated. The mean percentage of patient records/observations meeting the process indicators for the five themes during the follow-up are shown for the first, median and final measurement in Table 1. Furthermore, a mean percentage for every process indicator during the study was calculated and shown in Table 1. Differences were determined between the hospital types in meeting the process indicators. Conclusion: After a four year patient safety program, in which hospitals gave a lot of attention to the importance of patient safety themes, the implementation of various safety themes does not seem to be optimally fulfilled in Dutch hospitals. The percentage patient records/observations meeting the process indicators remained relatively stable during the 1-year follow-up for the five themes. Slight differences were observed between teaching and non-teaching hospitals in the implementation of the safety themes. Points of attention were formulated to achieve better implementation of the safety themes in the future.