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AHRQ Quality Study

By January 25, 2011Commentary

The Agency for Healthcare Research and Quality released preliminary results on its new study of medical offices in regard to patient safety culture.  The results combine two surveys, one of 292 medical offices in 2009 and one of 182 offices in 2007.  The survey is intended to assess patient safety culture, a somewhat nebulous concept, with the goal of encouraging the medical offices to recognize potential shortcomings and engage in continuous learning and improvement.  The finalized survey includes about 52 items in 12 culture areas, which include error communication, office processes and standardization, organizational learning, leadership support for patient safety and work pressure and pace.   (AHRQ Study)

Most of the practices participating in the survey were medium sized.  Because participation was voluntary, they may not be representative of all offices.  Most were single-specialty groups and were in a primary care field.  A large number were part of a hospital or health system.  There appears to be greater than average adoption of various HIT capabilities among the respondents.  The survey results basically relate staff perceptions about possible attributes of the patient safety culture in the medical office where they work.  The highest positive responses were for teamwork, patient care tracking and followup, organizational learning and overall perception of patient safety.  The lowest were for work pressure and pace; information exchange with other settings and office process standardization.

Overall, about 20% of the offices rated excellent and 44% very good.  Very few were poor, which does suggest self-selection bias, as well as self-reporting dissonance with what an objective observation might be.  Physicians tend to rate their offices higher than do other health professionals or staff in the office; lets go with the non-physicians on this.  The survey can be an important contributor to better quality but should be married with some outside or objective assessment to help practices pinpoint blind spots.

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