U.S. Department of Health & Human Services
PATIENT SAFETY PRIMERS
2014 ANNUAL PERSPECTIVES
Device-related Complications (9)
Diagnostic Errors (4)
Identification Errors (4)
Discontinuities, Gaps, and Hand-Off Problems (15)
Fatigue and Sleep Deprivation (7)
Medication Safety (34)
Medical Complications (26)
Nonsurgical Procedural Complications (2)
Surgical Complications (19)
Transfusion Complications (1)
Psychological and Social Complications (8)
Australia and New Zealand (4)
Central and South America (1)
North America (161)
Journal Article (95)
Newspaper/Magazine Article (54)
Press Release/Announcement (4)
Special or Theme Issue (1)
Web Resource (2)
Epidemiology of Errors and Adverse Events (24)
Active Errors (10)
Latent Errors (15)
Near Miss (1)
Approach to Improving Safety
Health Care Providers (94)
Health Care Executives and Administrators (129)
Non-Health Care Professionals (141)
Setting of Care
Psychiatric Facilities (2)
Residential Facilities (10)
Ambulatory Care (21)
Outpatient Surgery (6)
Patient Transport (1)
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"Health courts" and accountability for patient safety.
Mello MM, Studdert DM, Kachalia AB, Brennan TA. Milbank Q. 2006;84:459-492.
The evolution of the apology.
Newfield JS. Home Health Care Manage Pract. 2007;19:137-139.
Report: hospital errors cost 18 lives.
Rojas-Burke J. Oregonian. January 30, 2007:B01.
Our broken health care system and how to fix it: an essay on health law and policy.
Jost TS. Wake Forest Law Rev. 2006;41:537-618.
Constitutional arguments in favor of modifying the HCQIA to allow the dissemination of physician information to healthcare consumers.
Chernitsky LA. Wash Lee Law Rev. Spring 2006;63:737-776.
Preventing fatal errors.
Bailey B, Sevrens Lyons J. The Mercury News. November 27, 2005.
Hospitals save money, but safety is questioned.
Klein A. The Washington Post. December 11, 2005:A01.
Collegiality vs. Competence
Sagin T. AHRQ WebM&M [serial online]. March 2006.
Evaluation of the implementation of the alert issued by the UK National Patient Safety Agency on the storage and handling of potassium chloride concentrate solution.
Lankshear AJ, Sheldon TA, Lowson KV, Watt IS, Wright J. Qual Saf Health Care. 2005;14:196-201.
M.R.I.'s strong magnets cited in accidents.
McNeil DG Jr. New York Times. August 19, 2005;National Desk section:1.
Errors with concentrated epinephrine in otolaryngology.
Shah RK, Hoy E, Roberson DW, Nielsen D. Laryngoscope. 2008;118:1928-1930.
To Err Is Human — To Delay Is Deadly.
Jewell K, McGiffert L. Austin, TX: Consumers Union; 2009.
Medication safety technologies: what is and is not working.
Bates DW, Wachter RM, Vanderveen T. Patient Saf Qual Healthc. July/August 2009;6:22-27.
The challenges to transparency in reporting medical errors.
Paterick ZR, Paterick BB, Waterhouse BE, Paterick TE. J Patient Saf. 2009;5:205-209.
Opportunities and Recommendations for State–Federal Coordination to Improve Health System Performance: A Focus on Patient Safety.
Buxbaum J. Portland, ME: National Academy for State Health Policy; January 2010.
Medical error reduction and tort reform through private contractually-based quality medicine societies.
MacCourt D, Bernstein J. Am J Law Med. 2009;35:505-561.
Transparency and public reporting are essential for a safe health care system.
Leape LL. Perspect Health Reform. New York, NY: The Commonwealth Fund; March 17, 2010.
CMS changes in reimbursement for HAIs: setting a research agenda.
Stone PW, Glied SA, McNair PD, et al. Med Care. 2010;48:433-439.
Resident Duty Hours: Enhancing Sleep, Supervision, and Safety.
Ulmer C, Wolman DM, Johns MME, eds. Committee on Optimizing Graduate Medical Trainee (Resident) Hours and Work Schedule to Improve Patient Safety, Institute of Medicine. Washington, DC: The National Academies Press; 2008. ISBN: 9780309127721.
Revisiting duty-hour limits — IOM recommendations for patient safety and resident education.
Iglehart JK. N Engl J Med. 2008;359:2633-2635.
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