Smaller, shorter-term projects
In addition to our Diagnostic Excellence Initiative and work in serious illness care, we have other projects aimed at improving the experience and outcomes of patient care. This work includes medication safety, support for investigators conducting research in patient-family engagement, as well as other select projects in patient safety.
Medication Safety in the Community
More than 1.5 million medication errors occur in the U.S. annually. In a report from the National Academy of Medicine, Improving Diagnosis in Health Care, “errors are common at every stage, from prescription and administration of a drug to monitoring of the patient's response.” The risk of harm begins with the high number of medications used, most of which are prescribed in community settings (e.g., outpatient clinics, rehabilitation centers, people’s homes). Nearly one third of U.S. adults take five or more medications and each additional medication causes a 10 percent increase in the likelihood of medication harm.
The problem is expected to grow as the U.S. population ages. Adults over 65 have been shown to experience the highest rate of adverse drug events – injury from taking a medication. One underlying driver for this is the prevalence of chronic conditions among the elderly population, who require medications for treatment. The rate of preventable harm is also exacerbated by the lack of well-functioning safety systems in community settings (physician practices, community pharmacies and patient homes). Much medication safety improvement work has been done in hospitals but comparative progress in the community lags. As more and more health care is being delivered in community settings, it makes sense that the focus on medication safety move in this direction too.
Currently, we are exploring how to improve medication safety in community settings, with an emphasis on patients with complex, chronic health conditions and functional limitations. We look forward to sharing what we learn and what we identify as the best opportunity for us to make a difference.
Meaningful patient and family engagement remains the exception, not the rule. Yet, when people are engaged in their health care, there is greater continuity of care, better outcomes, lower health care costs and more. Our work in this field examines how best to engage people in their care. This includes supporting early-career investigators who specialize in patient and family engagement research. Learn more about these investigators and their work.
Roots in Patient Safety
Patient safety has been a central focus of our work in patient care since 2003. Our previous work includes the 12-year Betty Irene Moore Nursing Initiative, which focused on improving the quality of care delivered throughout the Bay Area and greater Sacramento. We also spent four years exploring quality improvement projects in critical care. Work in this area was a partnership with four academic medical centers: Beth Israel Deaconess Medical Center, Brigham and Women’s Hospital, Johns Hopkins Medical Center and University of California, San Francisco Medical Center. Lessons from this work are shared in a report from the Evaluation Sciences Unit at Stanford School of Medicine.