Table 2

Classification dimensions for patient safety practices (PSPs)

DimensionDefinition and examples
Regulatory versus voluntaryWhether required by external entity, such as the Joint Commission
SettingHospital, nursing home, ambulatory
FeasibilityAbility to implement PSP in a variety of settings, even in small facilities18
Individual activity versus organisational changeWhether the target of the PSP is individual providers' behaviour (eg, handwashing) or the structure of the organisation
Temporal (one-time vs repeated/long-term)Structural change (eg, switch to antibiotic-impregnated catheters) or change that requires regular maintenance (eg, hand hygiene education)
Pervasive in setting versus targeted to specific patientsWhether the PSP addresses a safety issue that applies to all patients in a unit or setting (universal protocol would apply to all surgeries, but fall prevention would be targeted to at-risk patients)
Common versus rare event as targetWhether the patient safety event that the PSP is intended to address is relatively common (eg, medication errors) or rare (eg, wrong-site surgery)
PSP maturity—established versus newerWhether the PSP has been well-studied and implementation needs are well-known
Degree of controversy/conflicting evidenceWhether the PSP is widely accepted; whether there are examples where the PSP has been ineffective
Degree of behavioural change required for implementation (on the provider level)How much the PSP implementation involves human factors issues (eg, switch to use of chlorhexidine as institution policy would not depend on provider behaviour)
Sensitivity to contextWhether the successfulness of PSP implementation is dependent on issues such as leadership, culture, or institutional financial status or quality-improvement infrastructure