Community Based Patient Safety Education for the Elderly

Nancy C. Elder, MD, MSPH, University of Cincinnati Department of Family and Community Medicine

Historically, most research on patient safety has occurred in the hospital setting, yet most health care is provided in the outpatient, office-based setting. Our research with primary care patients revealed that experiencing problems and errors during health care frequently led to the adoption of safety-enhancing and advocacy behaviors. It was our desire to assist patients in making these changes without experiencing such events, in order to prevent their likelihood of occurring or, if errors occur, to decrease their likelihood of leading to harm. Our study trained elderly people, who are at increased risk of experiencing error from their office-based care, to serve as their own safety advocates for care.

Using a newly developed instrument, the Seniors Empowerment and Advocacy for Patient Safety (SEAPS) survey, we assessed behaviors, self-efficacy, outcome efficacy and attitudes toward recommended patientbased safety activities both before and after a two-part educational intervention. The intervention was comprised of an interactive group session and an individual training session using the PACE (Present, Ask, Check and Express) communication system. The intervention was successful in improving participants’ mean total SEAPS scores.

All demographic groups (sex, race, education, and frequency of doctor visits) showed significant improvement except for those with more than a high school education. All participants acknowledged learning new skills and ideas, as well as new ways of organizing their own health care information. Although intensive in effort, this pilot intervention demonstrated that elderly patients can improve their beliefs and self-reported safety behaviors in the ambulatory setting.

Improve Patients’ Safety: Learning Model to Reduce Errors in Occupational Therapy and Physical Therapy Practice

Keli Mu, PhD, OTR/L, Creighton University

This two-year grant project is an interprofessional endeavor that aims at understanding the phenomenon of practice errors in occupational therapy and physical therapy; exploring preventive strategies; and developing a learning model and disseminating educational materials in an effort to improve patient safety. Using quantitative and qualitative research methods, this project draws upon professional expertise from various professions including OT, PT and bioethics to investigate preventive strategies and develop learning modules for error reduction.

Results of the project reveal that “to err is human”—occupational therapists and physical therapists make errors in their practice. Causes of errors vary considerably and include both individual and systemic factors. Although errors are inevitable, various discrete and specific strategies can be implemented to help significantly prevent, reduce or even eliminate practice errors and improve safety. Such strategies consist of: (1) strengthen orientation and mentoring to new therapists; (2) ensure competency through performance competency checks; (3) establish new or capitalize on existing safety policies and procedures; (4) advocate for the profession and systematic change.

Research literature on practice errors and patient safety is very scarce currently in occupational therapy and physical therapy. Findings of this project greatly contribute to the body of knowledge on patient safety in occupational therapy and physical therapy. Occupational therapists, physical therapists and other health care providers can implement specific strategies found in this project to prevent/reduce practice errors and ultimately improve patient safety.