The health factory.

Newspaper/Magazine Article

The health factory.

August 31, 2005

Spear SJ.

View more articles from the same authors.

In this editorial, the author suggests that health care organizations approach error the way other industries do, by constantly evaluating and solving problems, rather than working around them.

Free full text

Related Resources From the Same Author(s)

Discharge missteps can send seniors back to hospital.

March 3, 2010

A Randomized Field Study of a Leadership WalkRounds-Based Intervention.

September 5, 2012

Operational failures and interruptions in hospital nursing.

June 14, 2006

Driving improvement in patient care: lessons from Toyota.

March 6, 2005

Why accountability sharing in health care organizational cultures means patients are probably safer.

September 23, 2020

Selling soap.

October 4, 2006

Teaching Clinical Reasoning.

August 26, 2015

Clinical reasoning in the wild: premature closure during the COVID-19 pandemic.

August 19, 2020

Speaking Up Constructively: Managerial Practices that Elicit Solutions from Front-Line Employees.

March 9, 2011

Intraoperative adverse events and related postoperative complications in spine surgery: implications for enhancing patient safety founded on evidence-based protocols.

June 21, 2006

Exploring system features of primary care practices that promote better providers' clinical work satisfaction: a qualitative comparative analysis.

May 18, 2022

Quality Improvement in Neurosurgery.

April 15, 2015

Assessing and monitoring override medications in automated dispensing devices.

May 31, 2006

The role of automation in complex system failures.

May 11, 2005

Listening for What Matters: Avoiding Contextual Errors in Health Care.

March 9, 2016

Clinical reasoning assessment methods: a scoping review and practical guidance.

June 26, 2019

Declaring uncertainty: using quality improvement methods to change the conversation of diagnosis.

March 17, 2021

Untangling infusion confusion: a comparative evaluation of interventions in a simulated intensive care setting.

September 18, 2019

Agreement between patient-reported symptoms and their documentation in the medical record.

August 27, 2008

How house officers cope with their mistakes.

March 6, 2005

The Medical Apology: Making It Right When Things Go Wrong.

April 18, 2012

Association of measured quality with financial health among U.S. hospitals.

May 4, 2022

Formalizing the hidden curriculum of performance enhancing errors.

March 22, 2023

Medication histories in critically ill patients completed by pharmacy personnel.

August 7, 2019

Surgical fire in the United States: 2000-2020.

March 15, 2023

Strategies to reduce errors associated with 2-component vaccines.

December 2, 2020

Association of measured quality and future financial performance among hospitals performing cardiac surgery.

December 7, 2022

Conversations on diagnostic uncertainty and its management among pediatric acute care physicians.

April 27, 2022

Experiences of transgender people reviewing their electronic health records, a qualitative study.

June 29, 2022

How accurately do older adult emergency department patients recall their medications?

August 12, 2020

Physician reporting of clinically significant events through a computerized patient sign-out system.

September 14, 2011

Strategies for improving the value of the radiology report: a retrospective analysis of errors in formally over-read studies.

June 21, 2017

An international perspective on definitions and terminology used to describe serious reportable patient safety incidents: a systematic review.

December 8, 2021

Electronic approaches to making sense of the text in the adverse event reporting system.

September 7, 2016

Patient feedback for safety improvement in primary care: results from a feasibility study.

July 29, 2020

A retrospective audit of postoperative days alive and out of hospital, including before and after implementation of the WHO surgical safety checklist.

February 2, 2022

Anatomic pathology databases and patient safety.

October 19, 2005

Patient Safety.

October 4, 2006

Clarifying radiology's role in safety events: a 5-year retrospective common cause analysis of safety events at a pediatric hospital.

September 2, 2020

Association between Leapfrog safe practices score and hospital mortality in major surgery.

November 30, 2011

Outcomes and patient safety in overlapping vs. nonoverlapping total joint arthroplasty: a systematic review and meta-analysis.

January 19, 2022

Rapid response systems as a patient safety strategy: a systematic review.

March 20, 2013

Quality and Safety in Medicine.

December 9, 2009

Human Factors and Ergonomics in Healthcare Delivery: A Special Issue on Health Information Technology and Medication Administration Safety.

September 7, 2011

College of American Pathologists Special Topic Symposium on Error in Pathology and Laboratory Medicine—Practical Lessons for the Pathologist.

October 19, 2005

Complications.

January 24, 2018

Patient Safety: An Old and New Issue.

August 22, 2007

Simulation in Anaesthesia and Surgery.

May 13, 2015

Improving Pediatric Surgery Quality and Outcomes in the 21st Century.

January 13, 2016

Human Factors in Anaesthesia and Critical Care.

July 14, 2010

Patient Safety.

February 15, 2012

Special Issue: Progress at the Intersection of Patient Safety and Medical Liability.

December 14, 2016

Clinical Handover: Critical Communications.

June 10, 2009

Symposium on Simulation Science in Health and Medicine.

November 24, 2010

Safety by Design.

December 20, 2006

From Science to Implementation: AHRQ's Program to Prevent HAIs—Results and Lessons.

November 5, 2014

Situativity: A Family of Social Cognitive Theories for Clinical Reasoning and Error.

August 26, 2020

Special Issue: Patient Safety.

June 7, 2006

Patient Safety.

January 28, 2015

The Patient Safety in Surgery Study.

June 20, 2007

Adverse Events: Expecting too Much of Nurses and too Little of Nursing Research.

May 11, 2011

Innovation in Perioperative Patient Safety.

February 27, 2013

Safety in EMS.

December 21, 2011

Resident Duty Hours Across Borders: An International Perspective.

January 21, 2015

Identification and Prevention of Common Adverse Drug Events in the Intensive Care Unit.

June 16, 2010

Perioperative Safety Culture: Principles, Practices, and Pragmatic Approaches.

November 1, 2023

Making Health Care Safer: A Critical Review of Modern Evidence Supporting Strategies to Improve Patient Safety.

March 6, 2013

The Science of Simulation in Healthcare: Defining and Developing Clinical Expertise.

November 19, 2008

The Science of Teamwork.

June 20, 2018

Health Literacy Research: Current Status and Future Directions.

November 24, 2010

Patient Safety and Adverse Events.

September 23, 2009

Language Barriers in Health Care.

February 6, 2008

Health and Social Care Ergonomics: Patient Safety in Practice.

January 17, 2018

Health Information Technology.

February 4, 2015

Complications and Errors in Periodontal and Implant Therapy.

September 13, 2023

Health Professions Education.

June 12, 2019

Risk Prevention and Surgical Checklists.

November 14, 2012

Patient Safety.

August 19, 2020

National Cancer Institute–American Society of Clinical Oncology Teams in Cancer Care Project.

December 14, 2016

Patient Safety.

November 21, 2018

Improving Usability, Safety and Patient Outcomes With Health Information Technology.

February 27, 2019

Health IT and Clinical Decision Support Systems.

November 12, 2014

Nutrition Support Safety.

February 7, 2024

Related Resources

Impact of short-notice accreditation assessments on hospitals' patient safety and quality culture--a scoping review.

April 24, 2024

Patient Safety Innovations

Suicide Prevention in an Emergency Department Population: ED-SAFE

April 24, 2024

Annual Perspective

Equity in Patient Safety

March 27, 2024

Transforming team performance through reimplementation of the surgical safety checklist.

December 6, 2023

ISMP Cheers Awards.

November 20, 2023

Contextual factors influencing the implementation of a multifaceted intervention to improve teamwork and quality for hospitalized patients: a multi-site qualitative comparative case study.

November 1, 2023

Implementing patient safety and quality improvement in dermatology.

October 4, 2023

Toolkits To Reduce Hypertension in Pregnancy and Obstetric Hemorrhage.

August 16, 2023

Patient Safety Innovations

Ambulatory Safety Nets to Reduce Missed and Delayed Diagnoses of Cancer

July 31, 2023

Issues and complexities in safety culture assessment in healthcare.

July 19, 2023

The Patient Safety Adoption Framework: a practical framework to bridge the know-do gap.

May 31, 2023

Actions to renew focus on safety culture.

May 24, 2023

Annual Perspective

Improving Diagnostic Safety and Quality

April 26, 2023

Tools for establishing a sustainable safety culture within maternity services: a retrospective case study.

April 26, 2023

Controlled substance drug diversion by healthcare workers as a threat to patient safety.

March 14, 2023

A high-reliability organization mindset.

February 22, 2023

National patient safety goal to improve health care equity.

February 8, 2023

Interventions to increase patient safety in long-term care facilities-umbrella review.

January 25, 2023

Sources of nurse-sensitive inpatient safety improvement.

December 21, 2022

Interview

In Conversation with... Ellen Deutsch, MD, MS, FACS, FAAP, FSSH, CPPS

December 14, 2022

Perspective

Resilient Healthcare and the Safety-I and Safety-II Frameworks

December 14, 2022

Perspective

Using Human Factors Engineering and the SEIPS Model to Advance Patient Safety in Care Transitions

November 16, 2022

Interview

In Conversation With... Pascale Carayon, PhD and Nicole Werner, PhD

November 16, 2022

Toward zero harm: Mackenzie Health's journey toward becoming a high reliability organization and eliminating avoidable harm.

November 16, 2022

Improving Quality and Safety in Healthcare.

October 26, 2022

Experience of learning from everyday work in daily safety huddles: a multi-method study.

September 14, 2022

Positive approaches to safety: learning from what we do well.

August 31, 2022

Recognizing Excellence in Diagnosis: Recommended Practices for Hospitals.

August 10, 2022

Distinguishing high-performing from low-performing hospitals for severe maternal morbidity: a focus on quality and equity.

July 6, 2022

Development and validation of a brief culture-of-safety survey.

June 22, 2022

See More About The Topic

Hospitals

Health Care Providers

Health Care Executives and Administrators

Continuous Quality Improvement

Culture of Safety

The health factory.

Suicide Prevention in an Emergency Department Population: ED-SAFE

Ambulatory Safety Nets to Reduce Missed and Delayed Diagnoses of Cancer

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

The health factory.

Suicide Prevention in an Emergency Department Population: ED-SAFE

Ambulatory Safety Nets to Reduce Missed and Delayed Diagnoses of Cancer

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

Submit Your Innovations

Continue as a Guest

Continue Logged In

Submit Your Innovations

Continue as a Guest

Continue logged in

New Users to the PSNet site