AHRQ Patient Safety Network

The Collection > Quality Improvement Strategies

PATIENT SAFETY PRIMERS
Detection of Safety Hazards

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Safety Target

•Device-related Complications (56)

•Diagnostic Errors (44)

•Identification Errors (28)

•Discontinuities, Gaps, and Hand-Off Problems (81)

•Fatigue and Sleep Deprivation (6)

•Medication Safety (257)

•Medical Complications (163)

•Nonsurgical Procedural Complications (24)

•Surgical Complications (103)

•Transfusion Complications (9)

•Psychological and Social Complications (20)

Origin/Sponsor

•Africa (1)

•Asia (7)

•Australia and New Zealand (8)

•Central and South America (1)

Resource Types

•Clinical Guideline (2)

•Journal Article (620)

•Legislation/Regulation (22)

•Meeting/Conference (11)

•Newsletter/Journal (3)

•Newspaper/Magazine Article (160)

•Press Release/Announcement (4)

•Special or Theme Issue (35)

•Tools/Toolkit (19)

•Web Resource (49)

•Grant (5)

Error Types

•Epidemiology of Errors and Adverse Events (135)

•Active Errors (92)

•Latent Errors (53)

•Near Miss (11)

Approach to Improving Safety
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Quality Improvement Strategies

•Audit and Feedback (94)

•Benchmarking (113)

•Continuous Quality Improvement (23)

•Critical Pathways (25)

•Practice Guidelines (128)

•Reminders (20)

•Patient Self-Management (43)

•Six Sigma (8)

Clinical Areas

•Allied Health Services (5)

•Medicine (609)

•Nursing (62)

•Pharmacy (81)

Target Audience

•Health Care Providers (649)

•Health Care Executives and Administrators (943)

•Non-Health Care Professionals (365)

•Patients (92)

Setting of Care

•Hospitals (704)

•Psychiatric Facilities (6)

•Residential Facilities (16)

•Ambulatory Care (68)

•Outpatient Surgery (15)

•Patient Transport (4)

1 - 20 of 1081

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BOOK/REPORT

Seven Leadership Leverage Points for Organization-Level Improvement in Health Care.

Reinertsen JL, Bisognano M, Pugh MD. 2nd ed. Cambridge, MA: Institute for Healthcare Improvement; 2008.

NEWSPAPER/MAGAZINE ARTICLE

Engaging as partners in patient safety: the experience of librarians.

Zipperer L, Sykes J. Patient Saf Qual Healthc. March/April 2009;6:28-30,32-33.

NEWSPAPER/MAGAZINE ARTICLE

10 years, 5 voices, 1 challenge.

Larkin H. Hosp Health Netw. October 21, 2009.

COMMENTARY

North Mississippi Medical Center: a focus on quality, safety, and financial critical success factors.

Murphree J, Englert J, Koch K, Davis KM, Heer J. Jt Comm J Qual Patient Saf. 2005;31:545-553.

BOOK/REPORT

Meeting the Joint Commission's 2013 National Patient Safety Goals.

Oakbrook Terrace, IL: The Joint Commission; September 2012. ISBN: 9781599407555.

TOOLKIT

Leading a Strategic Planning Effort.

Pathways for Medication Safety Tool #1. Chicago, IL: American Hospital Association; 2003.

MULTI-USE WEBSITE

Texas Center for Quality & Patient Safety.

Texas Hospital Association.

REVIEW

Responsibility for quality improvement and patient safety: hospital board and medical staff leadership challenges.

Goeschel CA, Wachter RM, Pronovost PJ. Chest. 2010;138:171-178.

COMMENTARY

Patient safety rounds: description of an inexpensive but important strategy to improve the safety culture.

Campbell DA Jr, Thompson M. Am J Med Qual. 2007;22:26-33.

STUDY

Examination of how a survey can spur culture changes using a quality improvement approach: a region-wide approach to determining a patient safety culture.

Pringle J, Weber RJ, Rice K, Kirisci L, Sirio C. Am J Med Qual. 2009; 24:374-384.

COMMENTARY

Toward improving patient safety through voluntary peer-to-peer assessment.

Hudson DW, Holzmueller CG, Pronovost PJ, et al. Am J Med Qual. 2012;27:201-220.

NEWSPAPER/MAGAZINE ARTICLE

'Never' land.

Carpenter D. Hosp Health Netw. November 2007;81:34-38.

NEWSPAPER/MAGAZINE ARTICLE

How safe do patients feel?

Wolosin R, Vercler L, Matthews J. Patient Safety & Quality Healthcare. November/December 2005;2:40-44.

NEWSPAPER/MAGAZINE ARTICLE

Leading a culture of safety.

Sandrick K. Trustee. July/August 2009;62:6-10.

NEWSPAPER/MAGAZINE ARTICLE

Hospitals move to cut dangerous lab errors.

Landro L. Wall Street Journal (Eastern edition). June 14, 2006:D1. [Reprinted on Post-gazette.com].

STUDY

Engagement of leadership in quality improvement initiatives: executive quality improvement survey results.

Vaughn T, Koepke M, Kroch E, Lehrman W, Sinha S, Levey S. J Patient Saf. 2006;2:2-9.

NEWSPAPER/MAGAZINE ARTICLE

100K Lives falling short.

Robeznieks A. Modern Healthc. March 20, 2006;36:12.

STUDY

Exploring strategies for reducing hospital errors.

McFadden KL, Stock GN, Gowen CR III. J Healthc Manag. 2006;51:123-136.

NEWSPAPER/MAGAZINE ARTICLE

Hospitals tie CEO bonuses to safety.

Rowland C. Boston Globe. May 5, 2007:1A.

STUDY

Healthcare climate: a framework for measuring and improving patient safety.

Zohar D, Livne Y, Tenne-Gazit O, Admi H, Donchin Y. Crit Care Med. Crit Care Med. 2007;35:1312-1317.

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