Development and testing of Baylor Scott & White Health's "Attitudes and Practices of Patient Safety Survey".

Improving the quality of patient care requires a culture attuned to safety. We describe the development, implementation, and psychometric evaluation of the Attitudes and Practices of Patient Safety Survey (APPSS) within the Baylor Scott & White Health system. The APPSS was designed to enable safety culture data to be collected and aggregated at the unit level to identify high-priority needs.

Characterization of adverse events detected in a large health care delivery system using an enhanced global trigger tool over a five-year interval.

Objective: To report 5 years of adverse events (AEs) identified using an enhanced Global Trigger Tool (GTT) in a large health care system.

Study Setting: Records from monthly random samples of adults admitted to eight acute care hospitals from 2007 to 2011 with lengths of stay ≥3 days were reviewed.

Study Design: We examined AE incidence overall and by presence on admission, severity, stemming from care provided versus omitted, preventability, and category; and the overlap with commonly used AE-detection systems.

Description and evaluation of adaptations to the global trigger tool to enhance value to adverse event reduction efforts.

Objective: To adapt the Global Trigger Tool (GTT) as a sustainable monitoring tool able to characterize adverse events (AEs) for organizational learning, within the context of limited resources.

Methods: Baylor Health Care System (BHCS) expanded the AE data collected to include judgments of preventability, presence on admission, relation to care provided or not provided, and narrative descriptions. To reduce costs, we focused on patients with length of stay (LOS) of 3 days or more, suspecting greater likelihood they had experienced an AE; adapted the sample size and frequency of review; and used a single nurse reviewer followed by quality assurance review within the Office of Patient Safety.