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VHA National Center for Patient Safety

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Publications

TIPS Newsletter

TIPS is our bimonthly newsletter that offers readers a wide range of topics on patient safety and suggestions on actions that can improve patient safety. Our objective for TIPS is to provide useful and timely topics concerning patient safety.

January/February 2014

  • Joint Commission National Patient Safety Goals, 2014: One new goal has been approved: (Goal 6) Improve the safety of clinical alarm systems. An Element of Performance for Goal 7 has also been revised: (NPSG.07.05.01) Implement evidence-based practices for preventing surgical site infections.
  • The "All-Day RCA": Conducting an RCA during a single business day, rather than over several days or weeks, has been very successful for the Central Arkansas Veterans Healthcare System.
  • 2014 Joint Commission National Patient Safety Goals Poster: The goals are presented in a summary format, to include which aspects of care each affects.

Previous issues can be found in the TIPS Archive

NCPS Patient Safety Improvement Handbook

Developed at the NCPS, last updated 2011: VHA Handbook 1050.01

Falls Toolkit

Many facilities are working to find ways to reduce the number of falls as well as the severity of the falls that do occur. In an effort to help facilities, we created the Falls Toolkit.

Moderate Sedation Toolkit for Non-Anesthesiologists

To assist VA facilities in assuring that the practice of moderate sedation is reliable and safe, the VA National Center for Patient Safety (NCPS) has developed a Moderate Sedation Toolkit for Non-Anesthesiologists, based upon work done at the Durham VAMC Patient Safety Center of Inquiry.

Cognitive Aids

We have developed a number or tools, training, and software to facilitate patient safety efforts at VA facilities around the nation, such as our cognitive aids.