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| Audiovisual Presentation |
When things go wrong.
Institute for Healthcare Improvement. Campaign Live. August 18, 2008. |
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| Commentary |
ISMP medication error report analysis.
Cohen MR. Hosp Pharm. 2008;43:696–698. |
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Learning from adverse events and near misses.
Greenberg CC. J Gastrointest Surg. 2008 Sep 17; [Epub ahead of print]. |
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| Study |
Adverse events during hospitalization: results of a patient survey.
Fowler FJ, Epstein A, Weingart SN, et al. Jt Comm J Qual Patient Saf. 2008;34:583-590. |
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Decreased bile duct injury rate during laparoscopic cholecystectomy in the era of the 80-hour resident workweek.
Yaghoubian A, Saltmarsh G, Rosing DK, et al. Arch Surg. 2008;143:847-851. |
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Early readmissions to the department of medicine as a screening tool for monitoring quality of care problems.
Balla U, Malnick S, Schattner A. Medicine (Baltimore). 2008;87:294-300. |
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Epidemiology of adverse events in air medical transport.
Macdonald RD, Banks BA, Morrison M. Acad Emerg Med. 2008 Sep 8; [Epub ahead of print]. |
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Frequency of and risk factors for preventable medication-related hospital admissions in the Netherlands.
Leendertse AJ, Egberts ACG, Stoker LJ, van den Bemt PMLA, for the HARM Study Group. Arch Intern Med. 2008;168:1890-1896. |
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Handoffs causing patient harm: a survey of medical and surgical house staff.
Kitch BT, Cooper JB, Zapol WM, et al. Jt Comm J Qual Patient Saf. 2008;34:563-570. |
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Patient reported receipt of medication instructions for warfarin is associated with reduced risk of serious bleeding events.
Metlay JP, Hennessy S, Localio AR, et al. J Gen Intern Med. 2008;23:1589-1594. |
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Quality of clinical aspects of call handling at Dutch out of hours centres: cross sectional national study.
Derkx HP, Rethans JE, Muijtjens AM, et al. BMJ. 2008;337:a1264. |
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Severity of medication administration errors detected by a bar-code medication administration system.
Sakowski J, Newman JM, Dozier K. Am J Health Syst Pharm. 2008;65:1661-1666. |
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Surgical team behaviors and patient outcomes.
Mazzocco K, Petitti DB, Fong KT, et al. Am J Surg. 2008 Sep 11; [Epub ahead of print]. |
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| Organizational Policy/Guidelines |
Preventing errors relating to commonly used anticoagulants.
Sentinel Event Alert. September 24, 2008;41:1-3. |
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| Newspaper/Magazine Article |
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| Newspaper/Magazine Article |
"E-mergency" management: a model plan for continuing patient care during computer/communication system failures.
Turner N. Jt Comm Perspect Patient Saf. 2008;8:5-8. |
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Effective use of medication-related decision support in CPOE.
Metzger JB, Welebob E, Turisco F, Classen DC. Patient Saf Qual Healthc. 2008;5:16-24. |
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No more blame & shame: developing event-reporting systems may go a long way to reducing patient care errors in EMS.
Rajasekaran K, Fairbanks RJ, Shah MN. EMS Magazine. September 2008. |
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Patient safety records: silent witness.
Gould M. Health Service Journal. September 15, 2008. |
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Sponges, surgical instruments miscounted in 13% of surgeries.
O'Reilly KB. American Medical News. September 22, 2008. |
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Why doctors make mistakes.
Groopman J. AARP Magazine. September/October 2008. |
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