AHRQ Patient Safety Network

The Collection > United States of America

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Safety Target

•Device-related Complications (148)

•Diagnostic Errors (117)

•Identification Errors (74)

•Discontinuities, Gaps, and Hand-Off Problems (400)

•Fatigue and Sleep Deprivation (92)

•Medication Safety (894)

•Medical Complications (434)

•Nonsurgical Procedural Complications (62)

•Surgical Complications (259)

•Transfusion Complications (17)

•Psychological and Social Complications (129)

Origin/Sponsor
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United States of America

•United States Federal Government (283)

•State Governments and Agencies (48)

Resource Types

•Clinical Guideline (5)

•Journal Article (2187)

•Legislation/Regulation (61)

•Meeting/Conference (36)

•Newsletter/Journal (7)

•Newspaper/Magazine Article (549)

•Press Release/Announcement (22)

•Special or Theme Issue (57)

•Tools/Toolkit (68)

•Web Resource (94)

•Grant (11)

Error Types

•Epidemiology of Errors and Adverse Events (568)

•Active Errors (377)

•Latent Errors (314)

•Near Miss (48)

Approach to Improving Safety

•Quality Improvement Strategies (903)

•Legal and Policy Approaches (574)

•Error Reporting and Analysis (985)

•Communication Improvement (768)

•Human Factors Engineering (374)

•Teamwork (274)

•Specialization of Care (246)

•Logistical Approaches (287)

•Culture of Safety (762)

•Technologic Approaches (608)

•Education and Training (652)

Clinical Areas

•Allied Health Services (10)

Target Audience

•Health Care Providers (2156)

•Health Care Executives and Administrators (2717)

•Non-Health Care Professionals (1453)

•Patients (374)

Setting of Care

•Hospitals (2387)

•Psychiatric Facilities (12)

•Residential Facilities (66)

•Ambulatory Care (302)

•Outpatient Surgery (33)

•Patient Transport (13)

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COMMENTARY

Medicare nonpayment, hospital falls, and unintended consequences.

Inouye SK, Brown CJ, Tinetti ME. N Engl J Med. 2009;360:2390-2393.

REVIEW

Negligence, genuine error, and litigation.

Sohn DH. Int J Gen Med. 2013;6:49-56.

AUDIOVISUAL

Chasing Zero: Winning the War on Healthcare Harm.

Austin, TX: Texas Medical Institute for Technology and the Quaid Foundation; 2010.

NEWSPAPER/MAGAZINE ARTICLE

Making hospitals accountable.

Peters PG Jr. Regulation. Summer 2009;32:30-36.

BOOK/REPORT

Tennessee Center for Patient Safety Annual Report 2010.

Nashville, TN: Tennessee Center for Patient Safety; August 2011.

STUDY

Hospital governance and the quality of care.

Jha AK, Epstein AM. Health Aff (Millwood). 2010;29:182-187.

COMMENTARY

The Henry Ford Health System No Harm Campaign: a comprehensive model to reduce harm and save lives.

Conway WA, Hawkins S, Jordan J, Voutt-Goos MJ. Jt Comm J Qual Patient Saf. 2012;38:318-327.

COMMENTARY

Duty hour reform in a shifting medical landscape.

Jena AB, Prasad V. J Gen Intern Med. 2013 Apr 9; [Epub ahead of print].

BOOK/REPORT

Patient Safety Authority Annual Reports.

Harrisburg, PA: Patient Safety Authority; April 2012.

BOOK/REPORT classic

Adverse Events in Hospitals: National Incidence Among Medicare Beneficiaries.

Levinson DR. Washington, DC: US Department of Health and Human Services, Office of the Inspector General; November 2010. Report No. OEI-06-09-00090.

BOOK/REPORT

Pulse Report 2009: Safety Culture: Staff Perspectives on American Health Care.

South Bend, IN: Press Ganey Associates, Inc: 2009.

BOOK/REPORT

Improving America's Hospitals: The Joint Commission's Annual Report on Quality and Safety 2012.

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

NEWSPAPER/MAGAZINE ARTICLE

When errors occur.

Wetzel TG. Hosp Health Netw. October 2010.

NEWSPAPER/MAGAZINE ARTICLE

Raising the index of suspicion: red flags that represent credible threats to patient safety.

ISMP Medication Safety Alert! Acute Care Edition. July 26, 2012;17:1-3.

STUDY

The effect of health information technology on quality in U.S. hospitals.

McCullough JS, Casey M, Moscovice I, Prasad S. Health Aff (Millwood). 2010;29:647-654.

STUDY

The $17.1 billion problem: the annual cost of measurable medical errors.

Van Den Bos J, Rustagi K, Gray T, Halford M, Ziemkiewicz E, Shreve J. Health Aff (Millwood). 2011;30:596-603.

COMMENTARY

Frontline hospital workers and the worker safety/patient safety nexus.

Sokas R, Braun B, Chenven L, et al. Jt Comm J Qual Patient Saf. 2013;39:185-192.

NEWSPAPER/MAGAZINE ARTICLE

Patient safety front and center.

Terry K. Hosp Health Netw. July 2011;85:38-40, 42.

SPECIAL OR THEME ISSUE

Front-Line Ownership: Generating a Cure Mindset for Patient Safety.

Kitts J, ed. Healthcare Papers. 2013;13:1-82.

BOOK/REPORT

Leadership in Healthcare Organizations: A Guide to Joint Commission Leadership Standards.

Schyve PM. San Diego, CA: Governance Institute; 2009.

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