Checklists, hand hygiene star in AHRQ's top 10 safety list

Preoperative checklists, proper hand hygiene and barrier precautions to prevent healthcare-associated infections are among the top 10 patient-safety strategies that the Agency for Healthcare Research and Quality says providers can implement immediately to improve healthcare quality.

AHRQ released the report Monday as an updated follow-up to its 2001 analysis of patient-safety practices, Making Care Safer.

For this latest report, the authors reviewed 41 safety practices, taken from an initial list of more than 100. A 20-member panel of healthcare stakeholders classified 10 of those 41 safety practices as “strongly encouraged” for adoption, including prevention bundles for central line-associated bloodstream infections and ventilator-associated pneumonia.

Another 12 practices were deemed “encouraged” for adoption, such as medication reconciliation, team training, practices to reduce radiation exposure and computerized provider order entry.

Panelists reviewed available data on each safety practice, including information related to the scope of the targeted problem, evidence of effectiveness, ease of implementation, potential for harm and related costs, according to the 955-page report.

AHRQ officials said the top 10 strategies, if adopted widely, could lead to meaningful safety gains and improved patient outcomes.

“We have the evidence to show what really works to make care safer,” AHRQ Director Dr. Carolyn Clancy said in a news release. “Armed with this knowledge about what works and how to apply it, we can continue to advance our efforts to ensure patient safety.”

The authors' reviews of the top 10 strategies were published in a special supplement in the Annals of Internal Medicine.