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Implementing the Comprehensive Unit-Based Safety Program (CUSP) to Improve Patient Safety in an Academic Primary Care

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    The Comprehensive Unit-based Safety Program (CUSP) shows promise for improving patient safety in primary care. Implementing CUSP in an academic practice identified key concerns and positively impacted safety climate and teamwork.

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    Area of Science:

    • Healthcare Management
    • Patient Safety
    • Quality Improvement

    Background:

    • Patient safety efforts traditionally prioritize inpatient settings, overlooking ambulatory care risks.
    • The Comprehensive Unit-based Safety Program (CUSP) has demonstrated success in improving safety within hospitals.
    • In 2014, CUSP was adapted and implemented in an academic primary care practice setting.

    Purpose of the Study:

    • To assess the feasibility and impact of implementing the Comprehensive Unit-based Safety Program (CUSP) in an ambulatory primary care setting.
    • To identify specific patient safety concerns within the primary care practice through staff assessments.
    • To evaluate the effect of CUSP implementation on the safety climate and teamwork.

    Main Methods:

    • Staff and clinicians received training on the science of safety as part of CUSP implementation.
    • A two-question safety assessment survey was administered to identify practice-specific safety concerns.
    • The Safety Attitudes Questionnaire (SAQ) was used for pre-post comparison to measure changes in safety climate and teamwork.

    Main Results:

    • High participation rates were achieved for safety training (96%) and safety assessments (100%).
    • Top identified safety concerns included medications (28.2%), diagnostic testing (25%), and communication (14%).
    • Post-implementation, non-statistically significant improvements were observed in reporting safety concerns and learning from errors.

    Conclusions:

    • The Comprehensive Unit-based Safety Program (CUSP) is a viable strategy for enhancing patient safety in ambulatory care.
    • CUSP effectively identifies and facilitates the addressing of safety concerns in primary care settings.
    • Further research is warranted to confirm the statistically significant impact of CUSP on safety climate in ambulatory care.