PATIENT SAFETY PRIMERS
Diagnostic Errors (4)
Discontinuities, Gaps, and Hand-Off Problems (4)
Medication Safety (8)
Medical Complications (2)
Psychological and Social Complications (1)
North America (19)
Journal Article (17)
Newspaper/Magazine Article (5)
Epidemiology of Errors and Adverse Events (6)
Active Errors (5)
Latent Errors (2)
Near Miss (2)
Approach to Improving Safety
Quality Improvement Strategies (7)
Legal and Policy Approaches (3)
Error Reporting and Analysis (10)
Communication Improvement (3)
Human Factors Engineering (1)
Specialization of Care (2)
Logistical Approaches (2)
Culture of Safety (4)
Technologic Approaches (1)
Education and Training (2)
Health Care Providers (21)
Health Care Executives and Administrators (19)
Non-Health Care Professionals (4)
Setting of Care
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Approved: no new National Patient Safety Goals, only minor revisions for 2011.
Jt Comm Perspect. August 2010;30:6-7.
Approved: 2010 National Patient Safety Goals.
Jt Comm Perspect. October 2009;29:1, 20-31.
Improving Communication During Transitions of Care.
Oakbrook Terrace, IL: Joint Commission Resources; 2010. ISBN: 9781599404097.
Patient Safety: Supporting a Culture of Continuous Quality Improvement in Hospitals and Other Health Care Organizations.
Testimony before the Permanent Subcommittee on Investigations of the Senate Committee of Governmental Affairs, 108th Cong, 1st Sess (June 11, 2003) (statement of Carolyn M. Clancy, MD).
Safety in Doses.
London, UK: National Patient Safety Agency; 2009. ISBN: 9781906624088.
Hospital infections hard to gauge.
Hamill SD. Pittsburgh Post-Gazette. April 18, 2010:A1.
Using root cause analysis to reduce falls with injury in the psychiatric unit.
Lee A, Mills PD, Watts BV. Gen Hosp Psychiatry. 2012;34:304-311.
Prohibition of Excessive Overtime for Nurses Act.
The General Assembly of Pennsylvania. HB957 (2005).
Medication safety in a psychiatric hospital.
Rothschild JM, Mann K, Keohane CA, et al. Gen Hosp Psychiatry. 2007;29:156-162.
Diagnostic errors and temporal stability in bipolar disorder.
López J, Baca E, Botillo C, et al. Actas Esp Psiquiatr. 2008;36:205-209.
Medication errors in mental healthcare: a systematic review.
Maidment ID, Lelliott P, Paton C. Qual Saf Health Care. 2006;15:409-413.
Learning from the best.
Grantham D. Behav Healthc. April 2010;30:22-24.
Code Blue—Where To?
Adams BD. AHRQ WebM&M [serial online]. October 2007.
Toward understanding errors in inpatient psychiatry: a qualitative inquiry.
Cullen SW, Nath SB, Marcus SC. Psychiatr Q. 2010;81:197-205.
Identifying and reducing medication errors in psychiatry: creating a culture of safety through the use of an adverse event reporting mechanism.
Jayaram G, Doyle D, Steinwachs D, Samuels J. J Psychiatr Pract. 2011;17:81–88.
Global priorities for patient safety research.
Bates DW, Larizgoitia I, Prasopa-Plaizier N, Jha AK; Research Priority Setting Working Group of the WHO World Alliance for Patient Safety. BMJ. 2009;338:b1775.
Hospital mistakes kept secret.
Judd A. The Atlanta Journal-Constitution. November 20, 2011.
When “Psychiatric” Symptoms are Not.
Goldberg RJ. AHRQ WebM&M [serial online]. February 2003.
Patient safety in psychiatric inpatient care: a literature review.
Kanerva A, Lammintakanen J, Kivinen T. J Psychiatr Ment Health Nurs. 2012 Jul 8; [Epub ahead of print].
Supporting a psychiatric hospital culture of safety.
Mahoney JS, Ellis TE, Garland G, Palyo N, Greene PK. J Am Psychiatr Nurses Assoc. 2012;18:299-306.
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