A Process-centered Tool for Evaluating Patient Safety Performance and Guiding Strategic Improvement

This paper presents a patient safety applicator tool for implementing and assessing patient safety systems in health care institutions. The applicator tool consists of critical processes and performance measures identified in the context of the 2003 Malcolm Baldrige National Quality Award (MBNQA) Health Care Criteria for Performance Excellence. The Delphi technique was used for gaining consensus from a group of experts and forecasting significant issues in the field of the Delphi panel’s expertise. Data collection included a series of questionnaires where the first-round questionnaire was based on literature review and the MBNQA criteria for excellence in health care. Data were tested by an instrument review panel of experts. Twenty-three experts (MBNQA health care reviewers and senior health care administrators from quality award winning institutions) representing 18 States participated in the survey rounds. The study addressed three research questions: 1. What critical processes should be included in health care patient safety systems? 2. What performance measures can serve as indicators of quality for the processes critical for ensuring patient safety? 3. What processes will be critical for patient safety in the future? This study is significant because the results are expected to assist health care institutions seeking to develop high quality patient safety programs, processes, and services. The identified critical processes and performance measures, which extend the Malcolm Baldrige established framework into the area of patient safety and which are presented as a three-level applicator tool, can serve as a means of evaluating existing patient safety initiatives and of guiding the strategic planning of new safety processes. The patient safety applicator tool utilizes a systems approach and will support health care senior administrators in achieving and sustaining improvement results. It also will also assist health care institutions in using the MBNQA Health Care Criteria for Performance Excellence for selfassessment and quality improvement.