1. Developments in North America regarding Patient Safety – what the USA are doing?/what needs to be appraised?
Professor Bob Phillips, MD MSPH FAAFP
Vice President for Research & Policy
American Board of Family Medicine

2. US Patient Safety Efforts
Smallest Federal Health Agency maintains agenda (Agency for Healthcare Research and Quality)
Most Federal ‘Patient Safety’ focused research funding in primary care stopped in 2009
6 Centers for Education and Research on Therapeutics were funded in 2011

3. US Patient Safety Efforts
Safety subsumed under Quality, hospitals and prescribing are main focus
National body to create quality measures for private and public groups
Patient Safety Organizations established (but unclear what they do; no resources)
National Foundation offers small grants and Toolkits

5. Collection of “Classic” articles

6. Public Space to discuss bad events

7. Patient Safety Organizations
Patient Safety and Quality Improvement Act of 2005 (Patient Safety Act) PSOs conduct activities to improve patient safety and health care quality A PSO's workforce must have expertise in analyzing patient safety events, such as the identification, analysis, prevention, and reduction or elimination of the risks and hazards associated with the delivery of patient care
PSOs receive no federal funding and only limited technical support

8. Patient Safety Organizations

9. Affordable Care Act “Obama Care”
The Affordable Care Act called on the Secretary of HHS to establish a National Quality Strategy to "improve the delivery of health care services, patient health outcomes, and population health."
The Strategy, initially published in March 2011, is to concurrently pursue three aims:
better care
healthy people and communities
and affordable care

10. Better Care
Reduced preventable hospitalizations
Care transitions
Blood pressure control
Cholesterol control
Aspirin after MI
Healthier People & Communities
Community Transformation Grants
Affordable Care
Accountable Care Organizations
Patient Centered Medical Homes

11. National Measures/Priorities Setting

12. National Patient Safety Foundation
$3.4 million (US) in research grants since 1998

13. Canadian Patient Safety Efforts
Most Federal ‘Patient Safety’ focused research funding stopped in 2009
Federal legacy sites not maintained
Further along with policy development
Disclosure Guidelines and related teaching
Patient Safety Institute is main manager
Continues Annual Patient Safety Week
Primary Care remains a priority

14. No funding competitions since 2009
Canada
No funding competitions since 2009

15. Resources, Canada Journal article, live link Govt resource, dead link
Govt resource, live link

16. Canadian Patient Safety Institute
Canadian Disclosure Guidelines 2011

17. 2009

18. Canadian Patient Safety Week

19. Mexico
Signed on to WHO World Alliance for Patient Safety National policy priority Iberoamerican Advers Events = prevalence of adverse events in 5 countries in the region of Central and South America

20. Summary
Patient Safety not a research focus in North America—not in primary care! Most research funding gone or switched to hospitals and therapeutics Public foundations and institutions maintain the focus, have tools, stories for clinicians and patients Quality measures were created, also mostly in hospitals

21. Summary
We must reframe safety in the context of quality As primary care undergoes a long-needed transformation Patient Centered Medical Home Accountable Care Organizations And make sure that safety remains a metric of this transformation