AHRQ Patient Safety Network

The Collection > Active Errors

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Safety Target

•Device-related Complications (63)

•Diagnostic Errors (169)

•Identification Errors (87)

•Discontinuities, Gaps, and Hand-Off Problems (130)

•Fatigue and Sleep Deprivation (6)

•Medication Safety (411)

•Medical Complications (86)

•Nonsurgical Procedural Complications (38)

•Surgical Complications (161)

•Transfusion Complications (8)

•Psychological and Social Complications (48)

Origin/Sponsor

•Africa (2)

•Asia (16)

•Australia and New Zealand (24)

•Central and South America (1)

Resource Types

•Clinical Guideline (2)

•Journal Article (676)

•Legislation/Regulation (7)

•Meeting/Conference (3)

•Newspaper/Magazine Article (186)

•Press Release/Announcement (12)

•Special or Theme Issue (6)

•Tools/Toolkit (6)

•Web Resource (11)

•Grant (1)

Error Types
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Active Errors

•Noncognitive Errors ("Slips & Lapses") (119)

•Cognitive Errors ("Mistakes") (161)

Approach to Improving Safety

•Quality Improvement Strategies (251)

•Legal and Policy Approaches (121)

•Error Reporting and Analysis (264)

•Communication Improvement (293)

•Human Factors Engineering (215)

•Teamwork (45)

•Specialization of Care (43)

•Logistical Approaches (56)

•Culture of Safety (74)

•Technologic Approaches (212)

•Education and Training (205)

Clinical Areas

•Allied Health Services (7)

Target Audience

•Health Care Providers (754)

•Health Care Executives and Administrators (647)

•Non-Health Care Professionals (290)

•Patients (139)

Setting of Care

•Hospitals (646)

•Psychiatric Facilities (5)

•Residential Facilities (15)

•Ambulatory Care (129)

•Outpatient Surgery (17)

•Patient Transport (11)

1 - 20 of 963

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COMMENTARY classic

Balancing "no blame" with accountability in patient safety.

Wachter RM, Pronovost PJ. N Engl J Med. 2009;361:1401-1406.

COMMENTARY

In Conversation with...Sorrel King

AHRQ WebM&M [serial online]. March 2007.

COMMENTARY

No Blood, Please.

Liang BA. AHRQ WebM&M [serial online]. May 2004.

COMMENTARY

The Dangerous Detour.

Gibson J, Taylor D. AHRQ WebM&M [serial online]. June 2003.

COMMENTARY

Apology for errors: whose responsibility?

Leape LL. Front Health Serv Manage. 2012;28:3-12.

COMMENTARY

Language Barrier

Flores G. AHRQ WebM&M [serial online]. April 2006.

STUDY

Communication failures in patient sign-out and suggestions for improvement: a critical incident analysis.

Arora V, Johnson J, Lovinger D, Humphrey HJ, Meltzer DO. Qual Saf Health Care. 2005;14:401-407.

COMMENTARY

Urine a Tough Position.

Gandhi TK. AHRQ WebM&M [serial online]. October 2003.

STUDY

Disclosure of hospital adverse events and its association with patients' ratings of the quality of care.

López L, Weissman JS, Schneider EC, Weingart SN, Cohen AP, Epstein AM. Arch Intern Med. 2009;169:1888-1894.

COMMENTARY

Ashamed to admit it: owning up to medical error.

Ofri D. Health Aff (Millwood). 2010;29:1549-1551.

STUDY

The many faces of error disclosure: a common set of elements and a definition.

Fein SP, Hilborne LH, Spiritus EM, et al. J Gen Intern Med. 2007;22:755-761.

NEWSPAPER/MAGAZINE ARTICLE

How to avoid falling victim to a hospital mistake.

Cohen E. Empowered Patient. CNN.com. November 13, 2009.

COMMENTARY

Anatomy of an incident disclosure: the importance of dialogue.

Iedema R, Allen S. Jt Comm J Qual Patient Saf. 2012;38:435-442.

REVIEW

Hospital do-not-resuscitate orders: why they have failed and how to fix them.

Yuen JK, Reid MC, Fetters MD. J Gen Intern Med. 2011;26:791-797.

STUDY

Disclosure-and-resolution programs that include generous compensation offers may prompt a complex patient response.

Murtagh L, Gallagher TH, Andrew P, Mello MM. Health Aff (Millwood). 2012;31:2681-2689.

COMMENTARY

Disclosing harmful pathology errors to patients.

Dintzis SM, Gallagher TH. Am J Clin Pathol. 2009;131:463-465.

COMMENTARY

Development of an expert system for classification of medical errors.

Kopec D, Levy K, Kabir M, Reinharth D, Shagas G. Stud Health Technol Inform. 2005;114:110-116.

STUDY

Paid malpractice claims for adverse events in inpatient and outpatient settings.

Bishop TF, Ryan AK, Casalino LP. JAMA. 2011;305:2427-2431.

STUDY

Ambulance personnel perceptions of near misses and adverse events in pediatric patients.

Cushman JT, Fairbanks RJ, O'Gara KG, et al. Prehosp Emerg Care. 2010;14:477-484.

NEWSPAPER/MAGAZINE ARTICLE

Hospitals tally their avoidable mistakes.

Rein L. Washington Post. July 21, 2009:E1.

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