Implementation of patient safety initiatives in US hospitals

Kathleen L. McFadden, Gregory N. Stock, Charles R. Gowen

Research output: Contribution to journalArticlepeer-review

48 Scopus citations


Purpose - The purpose of this study is to explore the use of patient safety initiatives (PSIs) at the US hospitals. These PSIs include such approaches as open discussion of errors, education and training, and system redesign. In particular, the paper seeks to examine factors that influence the implementation of PSIs as well as the benefits realized from their implementation. Design/methodology/approach - The paper draws on the TQM and medical safety literatures to develop a conceptual framework for improving patient safety. Extensive survey data were gathered from 252 hospitals throughout the US to test McFadden et al.'s model of the factors influencing successful implementation of PSIs. Findings - Certain barriers (lack of top management support, lack of resources, lack of incentives and lack of knowledge) significantly impeded implementation while other factors (perceived importance of PSIs) facilitated implementation. It was also found that implementation of PSIs was associated with benefits to the hospital in areas such as medical error reduction, cost reduction, and patient satisfaction. Research limitations/implications - The use of a single respondent represents a possible limitation. Future research will explore organizational culture and its relationship to patient safety. Practical implications - The findings provide direction for implementing more effective PSIs at hospitals. Originality/value - The paper contributes to the literature on patient safety and medical errors by testing specific mechanisms that are associated with successful implementation of PSIs.

Original languageEnglish (US)
Pages (from-to)326-347
Number of pages22
JournalInternational Journal of Operations and Production Management
Issue number3
StatePublished - 2006
Externally publishedYes


  • Health and safety
  • Hospitals
  • Patient care
  • Patients
  • United States of America

ASJC Scopus subject areas

  • General Decision Sciences
  • Strategy and Management
  • Management of Technology and Innovation


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