Table 1

Overview of national patient safety agencies

	UK*	Canada†	Australia	USA‡
*Other UK safety stakeholders include National Clinical Assessment Authority, NHS Litigation Authority, Commission for Health Improvement, Coroner, Health Authority, Medical Devices Agency, Health and Safety Agency, Medicines Control Agency, and Serious Hazards of Transfusion (SHOT).
†Other initiatives are from the Canadian Council on Health Services Accreditation (CCHSA), Canadian Society of Hospital Pharmacists (CSHP), the Institute for Safe Medication Practices (ISMP Canada), Canadian Coalition on Medical Incident Reporting and Prevention (CCMIRP), Canadian Healthcare Association (CHA), Canadian Nurses Association (CNA), and provincial/territorial patient safety initiatives.
‡Other national agencies in the US include the US Pharmacopoeia (USP), Food and Drug Administration (FDA), the Institute for Safe Medication Practices (ISMP), Centers for Disease Control and Prevention (CDC), Centers for Medicare and Medicaid Services (CMS), the National Forum for Health Care Quality Measurement and Reporting (NQF), the Quality Interagency Coordination Task Force (QuIC), the Leapfrog Group for Patient Safety.
§JCAHO’s sentinel event policy.
**For JCAHO’s national patient safety goals.
Leading patient safety organization(s)	National Patient Safety Agency*	Health Canada (HC); Canadian Institute for Health Information (CIHI) and the Canadian Institutes of Health Research (CIHR); National Steering Committee on Patient Safety (NSCPS)	Australian Council for Safety and Quality in Health Care (ACSQHC); Australian Patient Safety Foundation (APSF)	Agency for Healthcare Research and Quality (AHRQ); National Patient Safety Foundation (NPSF); Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
Nature	Special health authority set up by the UK government (Statutory Instrument 2001 No. 1743)	HC: Federal Ministry of Health, Canada; CIHI: independent, not-for-profit body for quality health information; CIHR: premier federal agency for health research; NSCPS: an organ of the Royal College of Physicians and Surgeons	ACSQHC: national council set up by the Australian Federal Health Ministers; APSF: non-profit independent organization dedicated to the advancement of patient safety	AHRQ: nationally authorized agency for quality and safety research; NPSF: not-for-profit, multi-disciplinary body; JCAHO: independent, not-for-profit, standards setting and accrediting body in health care
Web address	www.npsa.nhs.uk	www.hc-sc.gc.ca	www.safetyandquality.org	www.ahrq.org
		www.cihi.ca	www.apsf.net.au	www.npsf.org
		www.cihr.cahttp://rcpsc.medical.org		www.jcaho.org
Year national safety program started	July 2001	May 2002 (CIHI/CIHR hospital safety study funding)	2000 (ACSQHC);	2000 (AHRQ);
		May 2002 (CIHI/CIHR hospital safety study funding)	1989 (APSF)	1998 (NPSF);
				1996§; 2002** (JCAHO)
Mission	To coordinate efforts to learn from adverse events and ‘near misses’ in the NHS; to promote openness and fairness, lead reporting and feedback; to monitor progress; to promote an open and fair culture in the NHS	HC: To coordinate national safety agenda; CIHI/CIHR: To examine the extent of adverse events in Canadian acute care hospitals and availability of data for continuous monitoring and reduction of events; RCPS NSCPS: To develop framework and plan for Canadian patient safety efforts	ACSQHC: To lead a national and collaborative approach to improve safety and quality of patient care; to develop a national framework, put the consumer first and promote research; APSF: To eliminate preventable harm in health care	AHRQ: To support research designed to improve the outcomes and quality of health care, reduce its costs, address patient safety and medical errors; NPSF: To improve patient safety knowledge and awareness JCAHO: To ensure a greater focus on priority safe practices
Operational mechanism	Establishing and operating a new, mandatory national reporting system for adverse events and “‘near misses”; provision of national leadership and guidance	CIHI/CIHR: Reviewing randomly selected patient hospital records by specially-trained physicians and nurses who belong to the research team	ACSQHC: Using annual action plans to achieve its priority areas; committing to a National Patient Safety Research Centre, a National Centre for Patient Safety Improvement, system capacity building, accreditation and standard setting mechanisms;	AHRQ: Developing error-reduction technologies; conducting safety demonstration projects and error reporting strategies; supporting safety research NPSF: Identifying and applying safety pathways; raising public awareness; JCAHO: Rolling safety goals for accreditation; reporting and analysis of sentinel events
			APSF: Using its Australian Incident Monitoring System
Remarkable public event(s) on patient safety	Shipman and Ledward affairs;^29, ³⁰ high profile intrathecal vincristine deaths,³¹ etc; Bristol case 1996 (2001 inquiry report);^27, ²⁸ An Organization with a Memory, Building a Safer NHS for Patients ^8, ⁹	Lack of prior nationally coordinated safety initiative; error incidence unknown^10, ¹¹	Incident monitoring in anesthesia (1987/88);⁴³ the Quality in Australian Health Care Study (1995)³⁸	Harvard Medical Practice studies (1991/1995);^36, ³⁷ NPSF’s Annenberg conferences (1996, 1998, 2001, 2002);⁵¹ IOM’s report: ‘To Err is Human’ (1999/2000)⁵