National Quality Forum has 30 ways to increase safety

Representatives of leading health care and consumer groups have endorsed 30 patient safety practices they say should be universally used in health care settings to reduce the risk of harm resulting from processes, systems, or environments of care.

The list includes informing patients that they are likely to fare better if they have certain high-risk, elective surgeries at facilities that have demonstrated superior outcomes; specifying explicit protocols for hospitals and nursing homes to ensure adequate nurse staffing; hiring critical care medicine specialists to manage all patients in hospital intensive care units; making sure hospital pharmacists are more actively involved in the medication use process; and creating a culture of safety in all health care settings.

The consensus report was released recently by the National Quality Forum (NQF) and funded in part by the Agency for Healthcare Research and Quality (AHRQ). For the entire list of 30 patient safety practices in the new report, Safe Practices for Better Healthcare: A Consensus Report, see the NQF web site at

Building a better system

The report reflects consensus among the NQF’s 173 member organizations about the need to put better systems and procedures in place to help prevent medical errors like those outlined in the landmark 1999 Institute of Medicine report To Err is Human. The NQF consensus report is based in part on work by a team of researchers at AHRQ’s Evidence-Based Practice Center at Stanford University and the University of California at San Francisco that identified 73 patient safety practices for which there were varying levels of scientific evidence in 2001.

Many additional candidate measures were considered, and the 30 voluntary consensus standards in the NQF report were culled from a list of 220 candidate practices based on each practice’s specificity, effectiveness, potential benefit, ability to generalize, and readiness for implementation. The report also identified 27 practices that have great promise for reducing adverse events and should have high priority for further research.