Patient safety collaborative: Rapid-cycle implementation of safe medication practices in communities nationwide

Purpose: The aim of the Patient Safety and Clinical Pharmacy Services Collaborative (PSPC) is to achieve optimal health outcomes and eliminate adverse drug events among high-risk patients -- those with multiple chronic conditions, multiple providers, and complex drug regimens -- in communities nationwide. Led by the US Department of Health and Human Services' Health Resources and Services Administration, the PSPC facilitates the implementation of integrated, patient-centered care and comprehensive medication management by safety net providers working in transdisciplinary health teams. Methods: The PSPC uses a fast-paced, iterative improvement process adapted from the Institute for Healthcare Improvement's Breakthrough Collaborative Series method. Upon enrollment in the PSPC, community-based teams -- comprised of health centers and partners such as schools of pharmacy, hospitals, and primary care associations -- implement leading practices from high-performing organizations that have successfully improved health outcomes and increased patient safety. Through an intensive series of Learning Sessions and Action Periods, PSPC teams learn from expert national faculty and adapt, refine, and implement changes within their health care organizations. Results: Now in its third year, the PSPC has expanded to 128 teams, consisting of more than 300 organizations and representing 43 states. Every month, PSPC teams reported on their progress both on process measures, such as the implementation of clinical pharmacy services, and on outcome measures -- particularly improvements in patient safety and health. During the second year, 65 teams introduced clinical pharmacy services to serve their respective patient populations. Nationally, PSPC teams reduced their patients' rate of adverse drug events by 49% and the rate of avoidable medication errors by 60%. Teams reported an aggregate improvement of 54% in the number of high-risk patients whose health conditions were brought under control across a range of chronic diseases, including diabetes, hypertension, dyslipidemia, depression, and HIV/AIDS. Conclusion: Based on results from the PSPC's second year, participation in the collaborative has demonstrable effects on reducing patients' risk for avoidable medication errors and adverse drug events, as well as on improving health status for patients across a range of chronic conditions. PSPC community partnerships generate and strengthen patient-centered health homes, yielding tangible results in patient safety and quality of care. With the enrollment of additional community teams from across the country, PSPC is expanding to deliver needed services to an increasing number of high-risk patients, as well as hardwiring a new model of safer, better care into the nation's health care delivery system.