Patient safety event reporting in a large radiology department.

Stacy R Schultz; Robert E. Watson; Sherrie L. Prescott; Karl N. Krecke; Kenneth T. Aakre; Mohammad N Islam; Anthony W Stanson

Commentary

Patient safety event reporting in a large radiology department.

September 21, 2011

Schultz SR, Watson RE, Prescott SL, et al. American Journal of Roentgenology. 2011;197(3).

View more articles from the same authors.

This commentary describes how one hospital radiology department implemented a Web-based reporting system for adverse events.

Available at

Free full text

PubMed citation

Related Resources From the Same Author(s)

Designing a safer radiology department.

March 29, 2012

Quality initiatives: developing a radiology quality and safety program: a primer.

August 26, 2009

The use of human factors methods to identify and mitigate safety issues in radiation therapy.

December 22, 2010

Normal neurologic and developmental outcome after an accidental intravenous infusion of expressed breast milk in a neonate.

January 25, 2006

Assessment of quality of data provided on Pap test requisitions: implications for quality of care and patient safety.

August 12, 2009

March 6, 2005

Alternative medications for medications in the Use of High-Risk Medications in the Elderly and Potentially Harmful Drug–Disease Interactions in the Elderly quality measures.

November 18, 2015

Quality and safety in surgery: challenges and opportunities.

September 8, 2021

Diagnosing sepsis is subjective and highly variable: a survey of intensivists using case vignettes.

May 11, 2016

Identification of patient safety threats in a post-intensive care clinic.

May 31, 2023

Medication safety at the interface: evaluating risks associated with discharge prescriptions from mental health hospitals.

January 20, 2016

Evaluation of reasons why surgical residents exceeded 2011 duty hour requirements when offered flexibility.

June 20, 2018

Key considerations in ensuring a safe regional telehealth care model: a systematic review.

May 26, 2021

Nil per os orders for imaging: a teachable moment.

September 27, 2017

What is new in paediatric medication safety?

September 12, 2018

Surgical team behaviors and patient outcomes.

October 1, 2008

Reducing cognitive errors in dermatology: can anything be done?

November 6, 2013

Association between hospital safety culture and surgical outcomes in a statewide surgical quality improvement collaborative.

May 15, 2019

Risk of adverse drug events in neonates treated with opioids and the effect of a bar-code–assisted medication administration system.

January 26, 2011

10 years in, why time out still matters.

June 11, 2014

The 2011 duty-hour requirements—a survey of residency program directors.

February 27, 2013

Validating domains of patient contextual factors essential to preventing contextual errors: a qualitative study conducted at Chicago area Veterans Health Administration sites.

April 19, 2017

Clinicians' perceptions of medication errors with opioids in cancer and palliative care services: a priority setting report.

May 30, 2018

Minimising medication errors in children.

February 25, 2009

Mortality rate after nonelective hospital admission.

June 1, 2011

Impact of computerized physician order entry alerts on prescribing in older patients.

March 25, 2015

Learning in action: developing safety improvement capabilities through action learning.

September 25, 2013

Evaluation of contextual influences on the medication administration practice of paediatric nurses.

May 13, 2009

Association of the 2011 ACGME resident duty hour reform with postoperative patient outcomes in surgical specialties.

August 12, 2015

Error rating tool to identify and analyse technical errors and events in laparoscopic surgery.

September 11, 2013

Unexpected increased mortality after implementation of a commercially sold computerized physician order entry system.

December 14, 2005

Wrong-site surgery.

December 13, 2017

A comprehensive estimation of the costs of 30-day postoperative complications using actual costs from multiple, diverse hospitals.

October 14, 2020

Electronic health records and adverse drug events after patient transfer.

December 8, 2010

Perceptions of medical errors in cancer care: an analysis of how the news media describe sentinel events.

October 16, 2013

Adverse events: root causes and latent factors.

February 15, 2012

Developing and pilot testing practical measures of preanalytic surgical specimen identification defects.

March 27, 2013

Characterising the complexity of medication safety using a human factors approach: an observational study in two intensive care units.

November 6, 2013

Moving beyond readmission penalties: creating an ideal process to improve transitional care.

January 16, 2013

The CARE approach to reducing diagnostic errors.

March 22, 2017

Association of the 2011 ACGME resident duty hour reform with general surgery patient outcomes and with resident examination performance.

January 14, 2015

Effectiveness of a barcode medication administration system in reducing preventable adverse drug events in a neonatal intensive care unit: a prospective cohort study.

November 12, 2008

Quality and variability of patient directions in electronic prescriptions in the ambulatory care setting.

April 18, 2018

Prevalence, nature and predictors of omitted medication doses in mental health hospitals: a multi-centre study.

March 11, 2020

Foundations for teaching surgeons to address the contributions of systems to operating room team conflict.

August 28, 2013

Michigan Health & Hospital Association Keystone Obstetrics: a statewide collaborative for perinatal patient safety in Michigan.

January 30, 2005

Information transfer at hospital discharge: a systematic review.

April 15, 2020

Association of surgical resident wellness with medical errors and patient outcomes.

May 6, 2020

Detection of potential look-alike/sound-alike medication errors using Veterans Affairs administrative databases.

November 28, 2018

Hospitalization-associated disability: "She was probably able to ambulate, but I'm not sure."

November 16, 2011

Deferral of care for serious non-COVID-19 conditions: a hidden harm of COVID-19.

November 18, 2020

Medication safety in two intensive care units of a community teaching hospital after electronic health record implementation: sociotechnical and human factors engineering considerations.

March 15, 2017

Time motion study in a pediatric emergency department before and after computer physician order entry.

December 10, 2008

A case for improving measurement of intraoperative iatrogenic injuries.

July 23, 2014

Parent preferences for medical error disclosure: a qualitative study.

February 1, 2017

The impact of dedicated medication nurses on the medication administration error rate: a randomized controlled trial.

March 27, 2005

Sustaining reductions in central line-associated bloodstream infections in Michigan intensive care units: a 10-year analysis.

July 13, 2016

CE: nursing's evolving role in patient safety.

March 15, 2017

EU to tackle issue of patient safety.

April 27, 2005

Patient safety climate (PSC) perceptions of frontline staff in acute care hospitals: examining the role of ease of reporting, unit norms of openness, and participative leadership.

February 26, 2014

Production pressure and its relationship to safety: a systematic review and future directions.

January 18, 2023

Effect of day of the week on short- and long-term mortality after emergency general surgery.

April 5, 2017

Approval and perceived impact of duty hour regulations: survey of pediatric program directors.

October 23, 2013

The effects of work-hour limitations on resident well-being, patient care, and education in an internal medicine residency program.

January 4, 2006

What are covering doctors told about their patients? Analysis of sign-out among internal medicine house staff.

August 19, 2009

Dissecting communication barriers in healthcare: a path to enhancing communication resiliency, reliability, and patient safety.

November 28, 2018

Recommendations from the British Committee for Standards in Haematology and National Patient Safety Agency.

December 13, 2006

Geometric probability distribution for modeling of error risk during prescription dispensing.

June 14, 2006

Change‐of‐shift nursing handoff interruptions: implications for evidence‐based practice.

November 6, 2019

Prospective pilot intervention study to prevent medication errors in drugs administered to children by mouth or gastric tube: a programme for nurses, physicians and parents.

May 19, 2010

Patient safety and quality improvement education: a cross-sectional study of medical students' preferences and attitudes.

April 24, 2013

Antibiotic-resistant infection treatment costs have doubled since 2002, now exceeding $2 billion annually.

April 4, 2018

Briefings, checklists, geese, and surgical safety.

January 13, 2010

Is the future of medical diagnosis in computer algorithms?

May 29, 2019

The collapse of sensemaking in organizations: the Mann Gulch disaster.

March 6, 2005

Organizational culture as a source of high reliability.

March 6, 2005

Evaluation of the association between Hospital Survey on Patient Safety Culture (HSOPS) measures and catheter-associated infections: results of two national collaboratives.

June 22, 2016

Medical students raising concerns.

October 12, 2016

Teaching medical error apologies: development of a multi-component intervention.

July 6, 2011

Pediatric adverse drug events in the outpatient setting: an 11-year national analysis.

October 14, 2009

Adverse drug events in the outpatient setting: an 11-year national analysis.

July 28, 2010

Analysis of prescribers' notes in electronic prescriptions in ambulatory practice.

March 23, 2016

Checking it twice: an evaluation of checklists for detecting medication errors at the bedside using a chemotherapy model.

September 8, 2010

Financial incentives to reduce hospital-acquired infections under alternative payment arrangements.

March 28, 2018

Improving medication management for patients: the effect of a pharmacist on post-admission ward rounds.

June 29, 2005

A hospital is not just a factory, but a complex adaptive system—implications for perioperative care.

August 2, 2017

Discrimination, abuse, harassment, and burnout in surgical residency training.

November 20, 2019

Views of children, parents, and health-care providers on pediatric disclosure of medical errors.

April 11, 2018

How to develop an effective obstetric checklist.

September 28, 2011

Impact of hospital accreditation on quality improvement in healthcare: a systematic review.

January 17, 2024

Impact of the 2011 ACGME resident duty hour reform on hospital patient experience and processes-of-care.

February 24, 2016

Journal Article

Study

Implementation of a medication reconciliation risk stratification tool integrated within an electronic health record: a case series of three academic medical centers.

March 29, 2023

Effect of pharmacists on medication errors in an emergency department.

February 27, 2008

Concept analysis: wrong-site surgery.

June 17, 2015

Counting for patient safety.

September 6, 2006

Impact of introducing an electronic physiological surveillance system on hospital mortality.

October 15, 2014

Can we rely on patients' reports of adverse events?

June 22, 2011

Reducing iatrogenic risks: ICU–acquired delirium and weakness—crossing the quality chasm.

November 24, 2010

Variability in the measurement of hospital-wide mortality rates.

March 19, 2014

Learning from malpractice claims about negligent, adverse events in primary care in the United States.

March 6, 2005

Related Resources

Patient Safety Innovations

Ambulatory Safety Nets to Reduce Missed and Delayed Diagnoses of Cancer

July 31, 2023

Patient Safety Innovations

Remote Response Team and Customized Alert Settings Help Improve Management of Sepsis

May 31, 2023

Reducing errors resulting from commonly missed chest radiography findings.

May 31, 2023

Annual Perspective

Improving Diagnostic Safety and Quality

April 26, 2023

Interview

In Conversation with... Susan McGrath, PhD and George Blike, MD about Surveillance Monitoring

April 26, 2023

Perspective

Surveillance Monitoring to Improve Patient Safety in Acute Hospital Care Units

April 26, 2023

Perspectives on Safety

Annual Perspective

Technology as a Tool for Improving Patient Safety

March 29, 2023

Interview

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

November 16, 2022

An evolution of reporting: identifying the missing link.

August 10, 2022

Error and cognitive bias in diagnostic radiology.

April 13, 2022

Leveraging a safety event management system to improve organizational learning and safety culture.

March 30, 2022

Harnessing event report data to identify diagnostic error during the COVID-19 pandemic.

December 15, 2021

Incident reporting systems: what will it take to make them less frustrating and achieve anything useful?

December 1, 2021

Use of artificial intelligence for image analysis in breast cancer screening programmes: systematic review of test accuracy.

November 17, 2021

Machine learning is booming in medicine. It’s also facing a credibility crisis.

June 16, 2021

AI for radiographic COVID-19 detection selects shortcuts over signal.

June 16, 2021

Wrong-patient ordering errors in peripartum mother-newborn pairs: a unique patient-safety challenge in obstetrics.

September 23, 2020

Role of artificial intelligence in patient safety outcomes: systematic literature review.

August 26, 2020

Changes in cancer detection and false-positive recall in mammography using artificial intelligence: a retrospective, multireader study.

March 4, 2020

Unscheduled radiologic examination orders in the electronic health record: a novel resource for targeting ambulatory diagnostic errors in radiology.

February 12, 2020

International evaluation of an AI system for breast cancer screening.

January 29, 2020

Integrating adverse event reporting into a free-text mobile application used in daily workflow increases adverse event reporting by physicians.

January 8, 2020

Perceptual and interpretive error in diagnostic radiology—causes and potential solutions.

September 4, 2019

From box ticking to the black box: the evolution of operating room safety.

September 4, 2019

End-to-end lung cancer screening with three-dimensional deep learning on low-dose chest computed tomography.

June 5, 2019

Machine learning in medicine.

April 10, 2019

Error and Uncertainty in Diagnostic Radiology.

March 20, 2019

Usability testing of a mobile app to report medication errors anonymously: mixed-methods approach.

January 16, 2019

Dissecting communication barriers in healthcare: a path to enhancing communication resiliency, reliability, and patient safety.

November 28, 2018

Two decades since To Err Is Human: an assessment of progress and emerging priorities in patient safety.

November 7, 2018

See More About The Topic

General Hospitals

Health Care Providers

Quality and Safety Professionals

Information Professionals

Radiology

Patient safety event reporting in a large radiology department.

Implementation of a medication reconciliation risk stratification tool integrated within an electronic health record: a case series of three academic medical centers.

Ambulatory Safety Nets to Reduce Missed and Delayed Diagnoses of Cancer

Remote Response Team and Customized Alert Settings Help Improve Management of Sepsis

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

Patient safety event reporting in a large radiology department.

Implementation of a medication reconciliation risk stratification tool integrated within an electronic health record: a case series of three academic medical centers.

Ambulatory Safety Nets to Reduce Missed and Delayed Diagnoses of Cancer

Remote Response Team and Customized Alert Settings Help Improve Management of Sepsis

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