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Patient safety
What is the role of healthcare managers in delivering safe care?
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  1. A Hutchinson1,
  2. P Barach2
  1. 1School of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA, UK
  2. 2Department of Anesthesia and Critical Care, University of Chicago, Chicago, IL 60637, USA
  1. Correspondence to:
 Professor A Hutchinson, School of Health and Related Research (ScHARR), Sheffield S1 4DA, UK;
 allen.hutchinson{at}sheffield.ac.uk

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To what extent should healthcare boards be held accountable for clinical practice at the institutions they govern?

When the State of New York Department of Health recently commissioned three quality improvement projects the topics seemed, at first sight, to be like many other quality projects before them. Each clinical topic is aimed at preventing recognised complications of interventions and each has an evidence base: perioperative use of beta blockers in non-cardiac surgery, prevention of thromboembolism, and surgical antimicrobial prophylaxis. Each group of hospitals that won the competition to run the projects has developed an evidence-based standard of care. Implementation of each clinical standard might be thought to run the risk that taking the evidence into practice may suffer from the usual barriers.1 This all seems routine, so what is new?

The differences, and the enhanced opportunities for success, lie in the context of the projects which are part of an initiative that aims to change practice and improve outcomes and, hence, improve safety. Each of the topics represents a type of adverse event regularly reported in the New York State Patient Occurrence Reporting and Tracking System (NYPORTS).2 Topic related pre-implementation adverse event data are already available on the NYPORTS system for each participating hospital, and post-implementation data will be …

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