50 Years of Inquiries in the National Health Service.

Special or Theme Issue

50 Years of Inquiries in the National Health Service.

July 24, 2019

Polit Q. 2019;90:177-342.

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The National Health Service strategy of publishing their inquiries into systematic poor care in the health service is a model of transparency. Articles in this special issue summarize this legacy and the learning that has been realized by the process. The authors discuss high-profile inquiries, quality of the investigations, and the need for the work to result in sustainable change.

Table of contents

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Patient Safety Papers 3.

April 23, 2008

Patient Safety Papers 5.

November 10, 2010

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Patient Safety Papers.

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November 21, 2018

The Francis Report: One Year On.

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Patient Safety Papers.

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Educating for Safety.

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Safety in Numbers: Evidence-based Development of a Medicine Management Learning Tool.

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The English Patient Safety Programme.

February 10, 2010

Resident Projects for Improvement.

June 19, 2013

Overview of the Environmental Scan of Primary Care-Based Effort To Reduce Readmissions.

March 27, 2019

Patient Safety.

August 19, 2020

Patient Safety: Research into Practice.

September 13, 2006

Understanding the knowledge gaps in whistleblowing and speaking up in health care: narrative reviews of the research literature and formal inquiries, a legal analysis and stakeholder interviews.

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2012 User Comparative Database Report: Medical Office Survey on Patient Safety Culture.

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Special Issue on Medication Safety.

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Health Information Technology in the United States: The Information Base for Progress.

October 25, 2006

Medical misdiagnoses put pressure on patients to stay engaged.

September 21, 2016

Simulation in Maternal Fetal Medicine.

June 26, 2013

Investigating the Prevalence and Causes of Prescribing Errors in General Practice: The PRACtICe Study.

May 16, 2012

Safety by Design.

December 20, 2006

2017 John M. Eisenberg Patient Safety and Quality Awards.

July 18, 2018

Patient safety for global health - developing safe, effective and accessible technologies.

September 1, 2010

Quality and Safety Between Ward and Board: a Biography of Artefacts Study.

August 29, 2018

2009 John M. Eisenberg Patient Safety and Quality Awards.

November 25, 2009

Toward a High Performance Health System: Public-Private Efforts to Make Health Care Safer and More Effective.

October 19, 2005

Patient Safety and Adverse Events.

September 23, 2009

Utilizing a Systems and Design Thinking Approach for Improving Well-Being Within Health Professional Education and Health Care.

January 16, 2019

Evaluation of postoperative handover using a tool to assess information transfer and teamwork.

May 4, 2011

Special Issue on Resilience Engineering and High Reliability Organizations.

August 7, 2019

The Commonwealth Fund Quality Improvement Colloquium: Patient Safety Five Years After To Err Is Human.

March 27, 2005

Special Section on Human Factors and Ergonomics in the Operating Room: Contributions That Advance Surgical Practice.

June 19, 2019

The Science of Teamwork.

June 20, 2018

Systems Approach in Healthcare.

October 31, 2018

The Sociology of Healthcare Safety and Quality.

February 17, 2016

Making Healthcare Safer III.

March 18, 2020

Biomedical Complexity and Error.

July 13, 2011

Best Care at Lower Cost: The Path to Continuously Learning Health Care in America.

September 19, 2012

Burnout and Resilience and Quality and Safety Programs in Obstetrics and Gynecology.

August 21, 2019

Critical Thinking.

June 1, 2011

Assessing the effectiveness of quality improvement strategies in Europe: the MARQuIS project.

March 11, 2009

LINNEAUS Collaboration on Patient Safety in Primary Care.

September 23, 2015

Patient Safety.

February 15, 2012

Safety in Anaesthesia.

June 15, 2011

Patient Safety in Obstetrics and Gynecology.

May 29, 2019

New Approaches to Researching Patient Safety.

January 6, 2010

With Safety in Mind: Mental Health Services and Patient Safety.

September 6, 2006

WebM&M Cases

Dying in the Hospital With Advanced Dementia

December 1, 2017

Enhancing Surgical Systems.

October 15, 2008

Teamwork in Healthcare.

September 23, 2015

Special Issue on Patient Safety.

July 30, 2014

Preventable morbidity at a mature trauma center.

June 24, 2009

Unintended Consequences: New Problems and New Solutions.

December 7, 2016

The 2015 John M. Eisenberg Patient Safety and Quality Awards.

May 25, 2016

Have we gone too far in translating ideas from aviation to patient safety?

February 9, 2011

Interprofessional Approaches to Patient Safety.

October 11, 2006

Hospital Survey on Patient Safety Culture: 2018 User Database Report.

April 4, 2018

Supplemental Issue: Quality and Safety Education for Nurses (QSEN) program.

September 6, 2017

Hospital Survey on Patient Safety Culture: 2010 User Comparative Database Report.

May 19, 2010

Hospital Survey on Patient Safety Culture: 2011 User Comparative Database Report.

April 6, 2011

Nursing Home Survey on Patient Safety Culture: 2011 User Comparative Database Report.

September 14, 2011

Hospital Survey on Patient Safety Culture: 2009 Comparative Database Report.

June 10, 2009

Hospital Survey on Patient Safety Culture: 2008 Comparative Database Report.

April 16, 2008

Patient Safety: Committing to Learn and Acting to Improve.

January 15, 2014

Patient Safety in Pediatric Emergency Medicine.

January 3, 2007

Resident Duty Hours Across Borders: An International Perspective.

January 21, 2015

Health and Social Care Ergonomics: Patient Safety in Practice.

January 17, 2018

COVID-19: The Diagnostic Challenge.

November 25, 2020

AMIA Annual Symposium Proceedings: 2011.

January 25, 2012

Deprescribing Guidelines: Special Section on Symposium Results.

June 26, 2019

Risk, Safety and Reliability Special Issue.

May 20, 2009

The Essential Guide for Patient Safety Officers, Second Edition.

September 22, 2010

Opioid Stewardship.

April 25, 2018

Magnet in Support of Patient Safety.

November 26, 2014

Patient Safety.

December 12, 2007

Community Pharmacy Survey on Patient Safety Culture: 2019 User Comparative Database Report.

April 17, 2019

Salzburg Global Seminar Session 565—Better Health Care: How Do We Learn About Improvement?

May 16, 2018

Patient Safety in Ambulatory Settings.

November 2, 2016

Stories from the sharp end: case studies in safety improvement.

March 29, 2006

Complications and Errors in Periodontal and Implant Therapy.

September 13, 2023

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February 20, 2019

Quality and Safety.

July 29, 2015

Focus On: Health Care Policy and Quality.

December 6, 2017

Still Crossing The Quality Chasm.

April 20, 2011

Partnering with pediatric patients and families in high reliability to identify and reduce preventable safety events.

September 26, 2018

Patient Safety.

December 13, 2006

A system-based approach to managing patient safety in ambulatory care (and beyond).

January 10, 2018

Human Factors in Anaesthesia and Critical Care.

July 14, 2010

Evidence Brief: Implementation of High Reliability Organization Principles.

July 24, 2019

To Do No Harm: Ensuring Patient Safety in Health Care Organizations.

August 24, 2005

Iatrogenesis in Pediatrics.

September 20, 2017

Related Resources

On Patient Safety.

January 13, 2024

Complaints to the Parliamentary and Health Service Ombudsman.

October 23, 2023

Disclosing medical errors: prioritising the needs of patients and families.

July 5, 2023

Comparing perspectives on organisational silence: an analysis of the Gosport inquiry.

May 17, 2023

Annual Perspective

Improving Diagnostic Safety and Quality

April 26, 2023

Creating a stronger culture of safety within US community pharmacies.

April 12, 2023

Care Delivery within Community Mental Health Teams.

April 5, 2023

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April 5, 2023

Crisis in the Lakeshore Hospital ER.

March 8, 2023

Access to Clinical Information at the Bedside.

March 1, 2023

Medical error and vulnerable communities.

November 16, 2022

'Reading the Signals' : Maternity and Neonatal Services in East Kent – the Report of the Independent Investigation.

November 16, 2022

Veterans Health Administration response to the COVID-19 crisis: surveillance to action.

October 26, 2022

Patient safety and legal regulations: a total-scale analysis of the scientific literature.

October 19, 2022

Solutions from Professional Regulation and Beyond.

October 5, 2022

Charlie Bourg was on the lookout for veterans harmed by a new VA computer system. He didn’t expect to be one of them.

September 21, 2022

Inequity and Iatrogenic Harm.

August 31, 2022

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Criminal liability for nursing and medical harm.

August 3, 2022

The evidence base for US Joint Commission hospital accreditation standards: cross sectional study.

July 13, 2022

An Investigation into the Death of Baby J at University Hospitals Bristol and Weston NHS Foundation Trust.

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Opioids in the United Kingdom: safety and surveillance during COVID-19.

July 7, 2021

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June 30, 2021

How U.S. teams advanced communication and resolution program adoption at local, state and national levels.

January 13, 2021

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Artificial Intelligence in Health Care: Benefits and Challenges of Technologies to Augment Patient Care.

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Older Adults and COVID-19: Implications for Aging Policy and Practice.

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February 19, 2020

Report of the Independent Inquiry into the Issues Raised by Paterson.

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Whistleblowing over patient safety and care quality: a review of the literature.

November 13, 2019

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Epidemiology of Errors and Adverse Events

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Error Reporting and Analysis

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