![]() The suggested interventions for wrong-site surgery are applicable to hospitals throughout the United States (see Figure 1: PPC Wrong-Site Surgery Prevention Action Goals). Based on the Authority’s reports from participating hospitals, a 72% reduction in incidence of wrong-site surgery events was demonstrated in the most recent reporting period (the 2nd quarter of 2009 through the 1st quarter of 2010) in comparison with the baseline period (the 4th quarter of 2007 through the 3rd quarter of 2008). ![]() The 30 participating hospitals saw improvement in preventing wrong-site surgery as measured by surveys conducted at the hospitals before and after the workshops, as indicated by observational assessments conducted after each workshop, and based on the incidence of wrong-site surgery event reports submitted to the Patient Safety Authority. Starting with the patient being scheduled for surgery, there are many opportunities to make sure that the correct procedure is being performed on the correct patient, with the time out being the final opportunity to verify that information (Pennsylvania Patient Safety Authority, 2007). Interventions focused on the premise that “the opportunities for wrong-site surgery are minimized when all salient information is in agreement” and “all members of the OR team assume a personal responsibility to have first-hand knowledge that the right person is getting the right procedure at the right location.” Careful attention is required to the many steps leading up to surgery in order to prevent wrong-site surgery. The Pennsylvania Patient Safety Authority staff analyzes near-misses and serious events reported by Pennsylvania healthcare facilities and has issued reports on wrong-site surgery prevention based on the analyses. Proposed interventions (Action Goals) were developed based on the data collection, analyses, on-site observation of select hospitals, and interviews conducted with hospital staff by staff from the Pennsylvania Patient Safety Authority. The PPC wrong-site surgery prevention program bolstered hospitals’ accelerated adoption and implementation of evidence-based practices and proposed interventions and provided a solid foundation for continued improvement and sustainability. Building on the success of previous PPC initiatives where improvement was demonstrated through a collaborative effort, the wrong-site surgery prevention initiative adopted an approach in which participating organizations share common goals, apply interventions shown to improve performance, and share experiences with one another. The partnership has made a meaningful difference in improving patient safety in the Greater Philadelphia area. HCIF partnered with ECRI Institute, a non-profit organization researching best practices to improve patient care, to facilitate the collaborative’s shared approach. The PPC is led by HealthCare Improvement Foundation (HCIF), an independent non-profit organization promoting innovative efforts to improve health services and the enhancement of public trust and confidence in the region’s health care systems. Primarily funded by Independence Blue Cross and the hospital community, PPC’s goal is to accelerate the adoption of evidence-based clinical practices by pooling the resources, knowledge, and efforts of healthcare providers and other stakeholders. The wrong-site surgery prevention program is one of numerous patient safety initiatives undertaken collaboratively by hospitals in the Greater Philadelphia region since 2006 under the direction of the Partnership for Patient Care (PPC). Hospitals Collaborate to Prevent Wrong-Site Surgeryīy Kathryn M.
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