Clearinghouse of Safe Practices in High-Risk Situations

Work Plan

April  2006


Objective:  To promote the development of a clearinghouse of safe practices for high-risk situations regarding outpatient medications.  


Summary:  This project will promote the development of a clearinghouse of safe practices for high-risk situations in the outpatient setting. The clearinghouse would include past practices currently housed in different places.  The clearinghouse will be a comprehensive dynamic resource to which healthcare professionals can turn for guidance on safe practices when prescribing certain medications.  The clearinghouse will also contain consumer-friendly version of the safe practices.   SOS Rx is seeking an appropriate partner to develop the clearinghouse.  


The rationale for the clearinghouse is that it will fill gaps in exiting databases on safe practices.   It will focus on high-risk drugs in the outpatient setting.  Clinicians need access to evidence-based safe practices and information on how to communicate those practices to patients, and patients need to know what actions to take and questions to ask about their medications.  The clearinghouse will:

·             Collect evidence and literature about the safety practices on high-risk drugs in the outpatient setting

·             Assemble, catalogue and maintain online database

·             Include public and private sector research reports, plus generalized information from other settings

·             Make all accessible to clinicians and consumers

·             Translate research on safe practices on outpatient medications into safer, better clinical practice. 


To initiate this project, SOS Rx convened a subgroup of coalition members and external experts to frame the scope of this project.  The expert panel met on March 31, 2004 in Washington, DC and produced a consensus document on scope, operational model, governance and related issues. 


Point Person:  Lou Diamond, Medstat.


Budget: SOS Rx has initial funding from Express Scripts to host expert meetings.   NCL is seeking additional funding and support for this project.



Next steps include seeking a partner organization with capacity to help develop and house clearinghouse, and seek funding and in–kind resources. There are three phases to develop the clearinghouse:

1) Prototype - Develop prototype, a mock-up focused on only one high-risk drug (probably warfarin).  AHRQ Safe Practices Report a possible model.  Budget for prototype - $10,000 (in hand).

2) Pilot – Use prototype to pitch project to potential partners, funders, hosts. Partner develops pilot – a live online version of clearinghouse with structured evaluation of users.  Budget for pilot - $100,000 (needed).

3) Fully operational clearinghouse – once funding is secure, the partner will develop and test pilot.  Continue seeking host and resources for full-scale effort.


Organizations approached to date about partnering to develop clearinghouse:

Agency for Healthcare Research and Quality

American Health Quality Association

Centers for Evaluation and Research on Therapeutics




Stanford Evidenced-Based Practice Center



SOS Rx Clearinghouse Project

Expert Meeting Participant List

March 31, 2004


1) Jeremy Grimshaw, Coordinating Editor of the Cochrane Effective Practice and Organization of Care (EPOC) Group

2) Kathryn M. McDonald, MM, Associate Director, Stanford-USCF Evidence-based Practice Center

3) Jean Slutsky, AHRQ

4) Linda Golodner, NCL

5) Helen Wu, National Quality Forum representative

6) Francesca Cunningham, Veterans Administration 

7) Allen Vaida, Institute for Safe Medication Practices

8) William Sullivan, Centers for Medicare and Medicaid (CMS)

9) Laurie Feinberg, CMS 

10) Paula Griswold, Massachusetts Coalition for the Prevention of Medical Errors

11) Mary Jo Goolsby, American Academy of Nurse Practitioners

12) Nancy Ostrove, Food and Drug Administration

13) Susan Raetzman, AARP

14) Lou Diamond, Medstat