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COMMENTARY
Failure to Report
Spath PL. AHRQ WebM&M [serial online]. March 2007.
STUDY
Error tracking in a clinical biochemistry laboratory.
Szecsi PB, Ødum L. Clin Chem Lab Med. 2009;47:1253-1257.
COMMENTARY
ISMP medication error report analysis.
Cohen MR. Hosp Pharm. 2006;41:405-406.
STUDY
Identifying causes of adverse events detected by an automated trigger tool through in-depth analysis.
Muething SE, Conway PH, Kloppenborg E, et al. Qual Saf Health Care. 2010;19:435-439.
COMMENTARY
Check the Wristband.
Rosenthal MM. AHRQ WebM&M [serial online]. July 2003.
FACT SHEET/FAQS
Eliminating Serious, Preventable, and Costly Medical Errors - Never Events.
Baltimore, MD: Centers for Medicare & Medicaid Services (CMS) Office of Public Affairs; May 18, 2006.
STUDY
Time-dependent drug–drug interaction alerts in care provider order entry: software may inhibit medication error reductions.
van der Sijs H, Lammers L, van den Tweel A, et al. J Am Med Inform Assoc. 2009;16:864-868.
STUDY
Nature, causes and consequences of unintended events in surgical units.
van Wagtendonk I, Smits M, Merten H, Heetveld MJ, Wagner C. Br J Surg. 2010;97:1730-1740.
BOOK/REPORT
Patient Safety Authority Annual Reports.
Harrisburg, PA: Patient Safety Authority; April 2014.
STUDY
Reducing warfarin medication interactions: an interrupted time series evaluation.
Feldstein AC, Smith DH, Perrin N, et al. Arch Intern Med. 2006;166:1009-1015.
COMMENTARY
Missed Appendicitis.
Adams JG. AHRQ WebM&M [serial online]. June 2003.
STUDY
Critical incidents related to cardiac arrests reported to the Danish Patient Safety Database.
Andersen PO, Maaløe R, Andersen HB. Resuscitation. 2010;81:312-316.
COMMENTARY
Flying Object Hits MRI.
Gosbee J, Gosbee LL. AHRQ WebM&M [serial online]. February 2003.
STUDY
An intervention to decrease patient identification band errors in a children's hospital.
Hain PD, Joers B, Rush M, et al. Qual Saf Health Care. 2010;19:244-247.
COMMENTARY
Organizational Change in the Face of Highly Public Errors—I. The Dana-Farber Cancer Institute Experience
Conway JB, Weingart SN. AHRQ WebM&M [serial online]. May 2005.
COMMENTARY
Do Not Disturb!
Duffy FD, Cassel CK. AHRQ WebM&M [serial online]. October 2007.
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