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What’s New this Week | 05/22/13
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The latest annotated links to patient safety literature, news, and more.
JOURNAL ARTICLE
 Finding and fixing mistakes: do checklists work for clinicians with different levels of experience? Sibbald M, De Bruin ABH, van Merrienboer JJG. Adv Health Sci Educ Theory Pract. 2013 Apr 27; [Epub ahead of print].
The Quality and Safety Educators Academy: fulfilling an unmet need for faculty development. Myers JS, Tess A, Glasheen JJ, et al. Am J Med Qual. 2013 Apr 11; [Epub ahead of print].
Improving the quality of the surgical morbidity and mortality conference: a prospective intervention study. Mitchell EL, Lee DY, Arora S, et al. Acad Med. 2013 Apr 24; [Epub ahead of print].
The science of human factors: separating fact from fiction. Russ AL, Fairbanks RJ, Karsh BT, Militello LG, Saleem JJ, Wears RL. BMJ Qual Saf. 2013 Apr 16; [Epub ahead of print].
What do patients think about year-end resident continuity clinic handoffs?: a qualitative study. Pincavage AT, Lee WW, Beiting KJ, Arora VM. J Gen Intern Med. 2013 Apr 18; [Epub ahead of print].
Flow disruptions in trauma care handoffs. Catchpole KR, Gangi A, Blocker RC, et al. J Surg Res. 2013 Mar 13; [Epub ahead of print].
Current approaches to punitive action for medication errors by boards of pharmacy. Holdsworth M, Wittstrom K, Yeitrakis T. Ann Pharmacother. 2013;47:475-481.
SPECIAL OR THEME ISSUE
 Safety in Numbers: Evidence-based Development of a Medicine Management Learning Tool. Holland K, ed. Nurse Educ Pract. 2013;13:e1-e87.
BOOK/REPORT
 Second Victim: Error, Guilt, Trauma, and Resilience. Dekker S. Boca Raton, FL: CRC Press; 2013. ISBN: 9781466583412.
NEWSPAPER/MAGAZINE ARTICLE
 Misdiagnosis is more common than drug errors or wrong-site surgery. Boodman SG. Washington Post. May 6, 2013.
Leapfrog hospital safety scores 'depressing.' Clark C. HealthLeaders Media. May 9, 2013.
MEETING/CONFERENCE
 6th International Conference: Diagnostic Error in Medicine. Society to Improve Diagnosis in Medicine. September 22–25, 2013; Northwestern University Feinberg School of Medicine, Chicago, IL.
Mistake Proofing Healthcare Workshop. Virginia Mason Institute. June 19–20, 2013; Virginia Mason Institute, Seattle, WA.

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Also of Note...
Ideas to Innovation: Stimulating Collaborations in the Application of Resilience Engineering to Healthcare. Medstar Healthcare and University-Industry Demonstration Partnership. June 13–14, 2013; Keck Center of the National Academies, Washington, DC.
2013 SEIPS Short Course on Human Factors Engineering and Patient Safety Extended Part I: Human Factors and Sociotechnical Systems Engineering. Center for Quality and Productivity Improvement. July 15–18, 2013; The Lowell Center, University of Wisconsin-Extension, Madison, WI.
An Introduction to AHRQ PSNet
Robert M. Wachter, MD
Editor, AHRQ PSNet
Patient Safety Primers
Patient Safety Primers icon
Learn about key concepts in patient safety with our primers

• Never Events

• Medication Reconciliation

• Handoffs and Signouts

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Did You Know?
Many patients did not understand changes to their medications.