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Organizing patient safety research to identify risks and hazards
  1. J B Battles1,
  2. R J Lilford2
  1. 1United States Department of Health and Human Services, Agency for Healthcare Quality and Research, Center for Quality Improvement and Patient Safety
  2. 2University of Birmingham, UK National Health Service, Research and Development Directorate Methodology Programme
  1. Correspondence to:
 Dr J B Battles
 Agency for Healthcare Research and Quality, Center for Quality Improvement and Patient Safety, 540 Gaither Road, Rockville, MD 20850, USA; jbattles{at}


Patient safety has become an international priority with major research programmes being carried out in the USA, UK, and elsewhere. The challenge is how to organize research efforts that will produce the greatest yield in making health care safer for patients. Patient safety research initiatives can be considered in three different stages: (1) identification of the risks and hazards; (2) design, implementation, and evaluation of patient safety practices; and (3) maintaining vigilance to ensure that a safe environment continues and patient safety cultures remain in place. Clearly, different research methods and approaches are needed at each of the different stages of the continuum. A number of research approaches can be used at stage 1 to identify risks and hazards including the use of medical records and administrative record review, event reporting, direct observation, process mapping, focus groups, probabilistic risk assessment, and safety culture assessment. No single method can be universally applied to identify risks and hazards in patient safety. Rather, multiple approaches using combinations of these methods should be used to increase identification of risks and hazards of health care associated injury or harm to patients.

  • health care associated injury
  • medical error
  • patient safety research

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  • The opinions and assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Agency for Healthcare Research and Quality, the United States Department of Health and Human Services, or the UK Department of Health.