AHRQ Patient Safety Network

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PATIENT SAFETY PRIMERS
The Role of the Patient in Safety

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Safety Target

•Device-related Complications (6)

•Diagnostic Errors (34)

•Identification Errors (21)

•Discontinuities, Gaps, and Hand-Off Problems (91)

•Fatigue and Sleep Deprivation (4)

•Medication Safety (126)

•Medical Complications (32)

•Nonsurgical Procedural Complications (5)

•Surgical Complications (35)

•Transfusion Complications (1)

•Psychological and Social Complications (52)

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•Australia and New Zealand (14)

•North America (409)

Resource Types

•Audiovisual (10)

•Book/Report (44)

•Journal Article (303)

•Legislation/Regulation (6)

•Meeting/Conference (3)

•Newspaper/Magazine Article (91)

•Press Release/Announcement (1)

•Special or Theme Issue (6)

•Tools/Toolkit (13)

•Web Resource (11)

Error Types

•Epidemiology of Errors and Adverse Events (64)

•Active Errors (92)

•Latent Errors (34)

•Near Miss (10)

Approach to Improving Safety
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Provider-Patient Communication

•Informed Consent (19)

•Health Literacy Improvement (57)

Clinical Areas

•Allied Health Services (1)

•Medicine (302)

•Nursing (20)

•Pharmacy (51)

Target Audience

•Health Care Providers (390)

•Health Care Executives and Administrators (288)

•Non-Health Care Professionals (133)

•Patients (124)

Setting of Care

•Hospitals (225)

•Psychiatric Facilities (1)

•Residential Facilities (5)

•Ambulatory Care (99)

•Outpatient Surgery (5)

1 - 20 of 492

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STUDY

Last orders: follow-up of tests ordered on the day of hospital discharge.

Ong MS, Magrabi F, Jones G, Coiera E. Arch Intern Med. 2012;172:1347-1349.

COMMENTARY

Improving heparin safety: a multidisciplinary invited conference.

Peterson C, Ham CW, Vanderveen T. Hosp Pharm. 2008;43:491-497.

STUDY

Determining a patient's comfort in inquiring about healthcare providers' hand-washing behavior.

Clare CA, Afzal O, Knapp K, Viola D. J Patient Saf. 2013;9:68-74.

STUDY

classic

The care transitions intervention: translating from efficacy to effectiveness.

Voss R, Gardner R, Baier R, Butterfield K, Lehrman S, Gravenstein S. Arch Intern Med. 2011;171:1232-1237.

STUDY

Hospital discharge documentation and risk of rehospitalisation.

Hansen LO, Strater A, Smith L, et al. BMJ Qual Saf. 2011;20:773-778.

STUDY

Language barriers and understanding of hospital discharge instructions.

Karliner LS, Auerbach A, Nápoles A, Schillinger D, Nickleach D, Pérez-Stable EJ. Med Care. 2012;50:283-289.

STUDY

A reengineered hospital discharge program to decrease rehospitalization: a randomized trial.

Jack BW, Chetty VK, Anthony D, et al. Ann Intern Med. 2009;150:178-187.

COMMENTARY

Missed Appendicitis.

Adams JG. AHRQ WebM&M [serial online]. June 2003.

STUDY

Hospitalized patients' understanding of their plan of care.

O'Leary KJ, Kulkarni N, Landler MP, et al. Mayo Clin Proc. 2010;85:47-52.

NEWSPAPER/MAGAZINE ARTICLE

Patients taking their own medications while in the hospital.

PA-PSRS Patient Saf Advis. June 2012;9:50-57.

NEWSPAPER/MAGAZINE ARTICLE

Hospitals boost patients' power as advisers.

Landro L. Wall Street Journal. August 8, 2007:D1.

STUDY

Reduction in pediatric identification band errors: a quality collaborative.

Phillips SC, Saysana M, Worley S, Hain PD. Pediatrics. 2012;129:e1587-e1593.

BOOK/REPORT

Achieving an Exceptional Patient and Family Experience of Inpatient Hospital Care.

Balik B, Conway J, Zipperer L, Watson J. Cambridge, MA: Institute for Healthcare Improvement; 2011.

STUDY

Older veterans and emergency department discharge information.

Hastings S, Stechuchak K, Oddone E, et al. BMJ Qual Saf. 2012;21:835-842.

COMMENTARY

Apology for errors: whose responsibility?

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

STUDY

The effects of emergency department staff rounding on patient safety and satisfaction.

Meade CM, Kennedy J, Kaplan J. J Emerg Med. 2010;38:666-674.

BOOK/REPORT

Health Care Leader Action Guide to Reduce Avoidable Readmissions.

Osei-Anto A, Joshi M, Audet AJ, Berman A, Jencks SF. New York, NY: The Commonwealth Fund, The John Hartford Foundation, Health Research and Educational Trust; January 25, 2010.

STUDY

Effects of an educational patient safety campaign on patients' safety behaviours and adverse events.

Schwappach DLB, Frank O, Buschmann U, Babst R. J Eval Clin Pract. 2013;19:285-291.

BOOK/REPORT

Patient-Centered Care Improvement Guide.

Frampton S, Guastello S, Brady C, et al. Derby, CT: Planetree; Camden, ME: Picker Institute; 2008.

STUDY

The management of test results in primary care: does an electronic medical record make a difference?

Elder NC, McEwen TR, Flach J, Gallimore J, Pallerla H. Fam Med. 2010;42:327-333.

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