TABLE E-1: Goals, Sources of Specific Guidance, and Initiatives

TABLE E-1: Goals, sources of specific guidance, and initiatives

General goals / Approaches to improvement / Patient safety (PS) activities and projects
Aware- ness / Increase information and understanding of sources of errors and preventive steps / Media: AAN publications (Neurology, AANews, Neurology Today, Neurology Now);
Web-based AAN Sources: PS Tips; Health Literacy Tips;
Online PS Case Conferences; posted papers and advisories;
AAN Annual Meeting Events: Patient Safety Colloquium; Health Policy Open House (guidelines, advocacy);
Informational outreach initiatives to and by state and local neurologic societies, practice groups, and academic departments
Culture Change / Foster openness and constructive response to errors,
patient-centered care, and professional-ism / Participate in confidential sharing of incidents within practice groups and peer-review committees;
Participate in reporting to Patient Safety Organizations (PSOs), when implemented;
Incorporate into practice non-traditional topics, such as abuse and violence in neurologic care;
Seek training in cultural competence, health literacy (available through or facilitated by AAN and regional and local societies and academic centers);
Engage in PS improvement projects (e.g. falls prevention).
Practice changes, including improved communi-cations / Utilize techniques and tools to enhance therapeutic alliances for error prevention / Access techniques to augment patient adherence and partnering for safety , e.g. “Ask me 3” (questions for provider about what has been discussed) and “teach back” methods (explain the status and plan back to the provider); the AAN offers materials and trainings on communication issues (see Website/patient safety);
Utilize protocols (available via Website) for information transfer at hospital discharge and for “hand-offs” (sign-outs) of care;
Adopt electronic information and decision-support tools, with guidance from AAN task force; utilize “tool-kits” for safer practice, e.g. PS Tips, Health Literacy Tips, tracking lab and imaging results (in development).
Adopt AAN-developed quality indicators to
demonstrate safe, preventive practices and good outcomes.
Educa-tion of Neuro-logists, Resi-dents, Students, Non-Neuro-logists; Patients) / Prepare for Board Certification/
Recertificationand Residency Core Compet-encies / Access AAN-coordinated information on neurologic quality/ “pay-for performance” indicators (in development); also, competencies (required by the Accreditation Council for Graduate Medical Education) in systems-based practice improvement, communication skills (including health literacy training), professionalism, and practice-based learning.
Learn patterns of error, vulnerabilities, and prevention:
disease-specific (e.g. stroke) or venue-specific (e.g.
Emergency Departments). Consult references provided by AAN on patient safety literature; eventually data from PSOs.
Improve the evidence base of patient safety interven-tions / Participate in or critically review research on prevention, outcomes, educational interventions / Access information from AAN on proposed studies, including: errors in ambulatory practices; neurologic causes and sequelae of daytime sleepiness; utility of patient safety “tools,” such as discharge or sign-out/hand-off instruments and lab tracking instruments; evaluate patient safety curricula in neurology residency programs, medical schools, continuing medical education.