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PATIENT SAFETY PRIMERS
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Safety Target
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Device-related Complications (148)
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Diagnostic Errors (279)
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Identification Errors (116)
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Discontinuities, Gaps, and Hand-Off Problems (389)
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Fatigue and Sleep Deprivation (106)
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Medication Safety (1024)
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Nonsurgical Procedural Complications (96)
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Epidemiology of Errors and Adverse Events (888)
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Approach to Improving Safety
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Target Audience
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Health Care Providers (2707)
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Non-Health Care Professionals (1310)
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Patients (206)
Setting of Care
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Hospitals (2161)
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Outpatient Surgery (32)
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Patient Transport (22)
1 - 20
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STUDY
Outside case review of surgical pathology for referred patients: the impact on patient care.
Swapp RE, Aubry MC, Salomão DR, Cheville JC. Arch Pathol Lab Med. 2013;137:233-240.
STUDY
Direct reporting of laboratory test results to patients by mail to enhance patient safety.
Sung S, Forman-Hoffman V, Wilson MC, Cram P. J Gen Intern Med. 2006;21:1075-78.
STUDY
Clinical impact and frequency of anatomic pathology errors in cancer diagnoses.
Raab SS, Grzybicki DM, Janosky JE, et al. Cancer. 2005;104:2205-2213.
STUDY
Identification errors involving clinical laboratories: a College of American Pathologists Q-Probes study of patient and specimen identification errors at 120 institutions.
Valenstein PN, Raab SS, Walsh MK. Arch Pathol Lab Med. 2006;130:1106-1113.
ORGANIZATIONAL POLICY/GUIDELINES
Recommendations for quality assurance and improvement in surgical and autopsy pathology.
Association of Directors of Anatomic and Surgical Pathology. Hum Pathol. 2006;37:985-988.
STUDY
Causes of errors in the electrocardiographic diagnosis of atrial fibrillation by physicians.
Davidenko JM, Snyder LS. J Electrocardiol. 2007;40:450-457.
BOOK/REPORT
Why Current Breast Pathology Practices Must Be Evaluated.
Dallas, TX: Susan G. Komen Breast Cancer Foundation; June 2006.
REVIEW
Quality in cancer diagnosis.
Raab SS, Grzybicki DM. CA Cancer J Clin. 2010;60:139-165.
STUDY
Cognitive errors and logistical breakdowns contributing to missed and delayed diagnoses of breast and colorectal cancers: a process analysis of closed malpractice claims.
Poon EG, Kachalia A, Puopolo AL, Gandhi TK, Studdert DM. J Gen Intern Med. 2012;27:1416-1423.
STUDY
Overestimation of clinical diagnostic performance caused by low necropsy rates.
Shojania KG, Burton EC, McDonald KM, Goldman L. Qual Saf Health Care. 2005;14:408-413.
STUDY
Effectiveness of a community collaborative for eliminating the use of high-risk abbreviations written by physicians.
Leonhardt KK, Botticelli J. J Patient Saf. 2006;2:147-153.
NEWSPAPER/MAGAZINE ARTICLE
Medical simulations identify potential problems before they can pose a real threat.
Kleefeld E. Wisconsin Technology Network. June 15, 2005.
STUDY
Preventable morbidity at a mature trauma center.
Teixeira PGR, Inaba K, Salim A, et al. Arch Surg. 2009;144:536-541.
STUDY
Comparison and interpretation of urinalysis performed by a nephrologist versus a hospital-based clinical laboratory.
Tsai JJ, Yeun JY, Kumar VA, Don BR. Am J Kidney Dis. 2005;46:820-829.
STUDY
Patient safety in the clinical laboratory: a longitudinal analysis of specimen identification errors.
Wagar EA, Tamashiro L, Yasin B, Hilborne L, Bruckner DA. Arch Pathol Lab Med. 2006;130:1662-1668.
STUDY
"It's not our ass": medical resident sense-making regarding lawsuits.
Noland C, Carl WJ. Health Commun. 2006;20:81-89.
STUDY
CT for suspected appendicitis in children: an analysis of diagnostic errors.
Taylor GA, Callahan MJ, Rodriguez D, Smink DS. Pediatr Radiol. 2006;36:331-337.
SPECIAL OR THEME ISSUE
Special Section—Association of Directors of Anatomic and Surgical Pathology Symposium.
Arch Pathol Lab Med. 2006;130:602-649.
STUDY
Missed diagnoses by urologists resulting in malpractice payment.
Badger WJ, Moran ME, Abraham C, Yarlagadda B, Perrotti M. J Urol. 2007;178;2537-2539.
STUDY
Burnout and satisfaction with work-life balance among US physicians relative to the general US population.
Shanafelt TD, Boone S, Tan L, et al. Arch Intern Med. 2012;172:1377-1385.
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