Clinical Toward Ensuring Patient Safety in Urgent Care Urgent message: As urgent care’s role in the continuum of care con- tinues to evolve, the practitioner must take steps to create a culture that supports proper patient identification, drug safety, and adherence to lab standards. Phillip Disraeli MD, FAAFP I Safety Culture in the Urgent Care Center A culture that emphasizes patient safety should begin with the physicians and ad- ministration of the urgent care center. Physicians can model be- havior oriented toward in- tellectual curiosity, continu- ous quality improvement, and patient advocacy. Suc- cessful practices will use “near misses” as opportuni- ties for learning for the en- tire staff, and not react by singling out individual staff for blame or ridicule. In an approach similar to the airline industry’s, sen- tinel events can spur the practice to perform a root- cause analysis to prevent other medical errors of the same type. It is helpful to designate a safety officer for the practice—someone responsible for keeping the center up to date on the latest recommendations from reg- © iStockPhoto: Michael Krinke; Composite: Tom DePrenda n the 1998 report To Err is Human, the Institute of Medicine defined patient safety as “freedom from ac- cidental injury.” The ensu- ing media coverage focused on the 98,000 deaths that IOM estimated occur each year due to adverse events in U.S hospitals. Yet, the report also dis- cussed errors that lead to in- jury and death across the continuum of healthcare, from medical offices, to pharmacies, home health- care, and long-term care. Ten years after the report, urgent care centers are an important component in the continuum of care for patients. As such, we need to evaluate our systems to ensure patient safety. The purpose of this two-part article is to outline the common areas of risk inherent to the urgent care en- vironment and to discuss concrete recommendations for mitigating that risk.* * The majority of the recommendations were adapted from the Joint Commission, with whom the Urgent Care Association of America recently agreed on a vol- untary accreditation process for urgent care centers. This article is not intended to be a legally binding guideline. Other useful resources on the topic are the Insti- tute of Medicine, the American Board of Medical Specialties, and the Institute for Safe Medication Practices. w w w. j u c m . c o m JUCM T h e J o u r n a l o f U r g e n t C a r e M e d i c i n e | M a y 2 0 0 9 11