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Errors in breast imaging: how to reduce errors and promote a safety environment.
July 7, 2021
Sivarajah R, Dinh ML, Chetlen A. J Breast Imaging. 2021;3(2):221-230.
This article describes the Yorkshire contributory factors framework, which identifies factors contributing to safety errors across four hierarchical levels (active errors, situational factors, local working conditions, and latent factors) and two cross-cutting factors (communication systems and safety culture). The authors apply this framework to a case of missed mass on breast imaging and discuss how its use can help health systems effectively learn from error and develop systematic, proactive programs to improve safety and manage safety issues.
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