AHRQ Patient Safety Network

The Collection > Cognitive Errors ("Mistakes")

Glossary >
Mistakes: In some contexts, Read Full Glossary Entry >

Narrow By

clear selections

Safety Target

•Device-related Complications (7)

•Diagnostic Errors (106)

•Identification Errors (10)

•Discontinuities, Gaps, and Hand-Off Problems (31)

•Fatigue and Sleep Deprivation (2)

•Medication Safety (61)

•Medical Complications (7)

•Nonsurgical Procedural Complications (4)

•Surgical Complications (26)

•Transfusion Complications (1)

•Psychological and Social Complications (10)

Origin/Sponsor

•Asia (4)

•Australia and New Zealand (5)

Resource Types

•Clinical Guideline (1)

•Journal Article (153)

•Legislation/Regulation (1)

•Newspaper/Magazine Article (42)

•Press Release/Announcement (3)

•Special or Theme Issue (3)

•Web Resource (1)

Error Types
< All

Cognitive Errors ("Mistakes")

Approach to Improving Safety

•Quality Improvement Strategies (47)

•Legal and Policy Approaches (28)

•Error Reporting and Analysis (67)

•Communication Improvement (55)

•Human Factors Engineering (38)

•Teamwork (10)

•Specialization of Care (9)

•Logistical Approaches (13)

•Culture of Safety (11)

•Technologic Approaches (33)

•Education and Training (60)

Clinical Areas

•Allied Health Services (1)

Target Audience

•Health Care Providers (169)

•Health Care Executives and Administrators (93)

•Non-Health Care Professionals (59)

•Patients (36)

Setting of Care

•Hospitals (123)

•Psychiatric Facilities (2)

•Residential Facilities (1)

•Ambulatory Care (32)

•Outpatient Surgery (2)

1 - 20 of 220

Show ExcerptDon't Show Excerpt

dropdown

COMMENTARY

Pregnant with Danger.

Pearlman MD, Desmond JS. WebM&M [serial online]. May 2005.

STUDY

Discovering healthcare cognition: the use of cognitive artifacts to reveal cognitive work.

Nemeth C, O’Connor M, Klock PA, Cook R. Org Stud. 2006;27:1011-1035.

COMMENTARY

Not again!

Berwick DM. BMJ. 2001;322:247-248.

COMMENTARY

Deciphering the Code

Goldstein MK. AHRQ WebM&M [serial online]. Febuary 2006.

STUDY

Medical error identification, disclosure, and reporting: do emergency medicine provider groups differ?

Hobgood C, Weiner B, Tamayo-Sarver JH. Acad Emerg Med. 2006;13:443-451.

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

Medication prescribing errors involving the route of administration.

Lesar TS. Hosp Pharm. 2006;41:1053-1066.

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.

NEWSPAPER/MAGAZINE ARTICLE

The antidote to medical errors.

Price M. Monitor. January 2010;41:50.

STUDY

Postoperative video debriefing reduces technical errors in laparoscopic surgery.

Hamad GG, Brown MT, Clavijo-Alvarez JA. Am J Surg. 2007;194:110-114.

STUDY

Surgical skill is predicted by the ability to detect errors.

Bann S, Khan M, Datta V, Darzi A. Am J Surg. 2005;189:412-415.

NEWSPAPER/MAGAZINE ARTICLE

Nurse error spotlights drug's danger.

Greene L. St. Petersburg Times. June 15, 2006:A1.

COMMENTARY

Suicidal Man with Gun.

Simon RI. AHRQ WebM&M [serial online]. May 2003.

COMMENTARY

Unreported errors in the intensive care unit: a case study of the way we work.

Henneman EA. Crit Care Nurse. 2007;27:27-34.

NEWSPAPER/MAGAZINE ARTICLE

Paralyzed by mistakes: preventing errors with neuromuscular blocking agents.

ISMP Medication Safety Alert! Acute Care Edition. September 22, 2005;10:1-3.

ORGANIZATIONAL POLICY/GUIDELINES

Preventing vincristine administration errors.

The Joint Commission. Sentinel Event Alert. July 14, 2005;(34):1-3.

STUDY

Diagnostic pitfalls in paediatric ischaemic stroke.

Braun KP, Kappelle LJ, Kirkham FJ, Deveber G. Dev Med Child Neurol. 2006;48:985-990.

STUDY

Missed and delayed diagnoses in the emergency department: a study of closed malpractice claims from 4 liability insurers.

Kachalia A, Gandhi TK, Puopolo AL, et al. Ann Emerg Med. Ann Emerg Med. 2007;49:196-205.

NEWSPAPER/MAGAZINE ARTICLE

Our long journey towards a safety-minded just culture. Part II: where we're going.

ISMP Medication Safety Alert! Acute Care Edition. September 21, 2006;11:1-2.

1 2 3 4 5 6 7 8 9 10 11 Next >