Perspectives on Safety
Narrow Results Clear All
- Communication Improvement 45
- Culture of Safety 49
Education and Training
- Students 2
- Error Reporting and Analysis 66
- Human Factors Engineering 27
Legal and Policy Approaches
- Regulation 14
- Logistical Approaches 19
- Policies and Operations 2
- Quality Improvement Strategies 85
- Research Directions 1
- Specialization of Care 5
- Teamwork 17
- Clinical Information Systems 21
- Transparency and Accountability 2
- Alert fatigue 2
- Device-related Complications 5
- Diagnostic Errors 14
- Discontinuities, Gaps, and Hand-Off Problems 16
- Fatigue and Sleep Deprivation 10
- Identification Errors 2
- Delirium 1
- Medication Errors/Preventable Adverse Drug Events 11
- Nonsurgical Procedural Complications 6
- Psychological and Social Complications 19
- Second victims 1
- Surgical Complications 14
- Gynecology 53
- Surgery 12
- Nursing 11
- Pharmacy 7
- Family Members and Caregivers 4
- Health Care Executives and Administrators
Health Care Providers
- Nurses 7
- Physicians 20
Non-Health Care Professionals
- Educators 23
- Media 1
- Patients 3
Aviation and Patient Safety, January 2006
Jack Barker, PhD, is Vice President of Research and Development for Mach One Leadership and a commercial pilot for a major airline. Dr. Barker began his career in the Air Force and proceeded to get his doctorate in cognitive psychology. His research has centered on high-performance teams, crew resource management (CRM), and training. He has trained hundreds of commercial airline pilots, as well as pilots and others working for NASA in the Space Shuttle program and Mars mission. His company, like several others, works with health care providers and organizations in an effort to translate aviation safety principles to health care.
The Law and Patient Safety, December 2005
Dr. Brennan is a Professor of Medicine at Harvard Medical School and Professor of Law and Public Health at the Harvard School of Public Health. As the lead investigator of the groundbreaking study that assessed the prevalence of adverse events in hospitalized patients, Dr. Brennan has contributed dramatically to our understanding of the epidemiology of medical errors. More recently, he has emerged as one of the world's most thoughtful and influential analysts of the complex interplay among medicine, ethics, law, and public health.
Patient Safety Initiatives, September 2005
Dr. Carolyn Clancy has been the Director of the Agency for Healthcare Research and Quality (AHRQ) since 2003. Prior to becoming AHRQ Director, she led the Agency's Center for Outcomes and Effectiveness Research. A general internist and health services researcher, she has published widely in the peer reviewed literature on a variety of topics, ranging from quality improvement to primary care. She is a member of the Institute of Medicine and a Master of the American College of Physicians.
with commentary by Robert M. Wachter, MD, Patient Safety Initiatives, September 2005
Translational research is all the rage in biomedicine. In its purest form, the concept refers to the translation of basic research discoveries into clinical applications, followed by patient-oriented studies to demonstrate benefit.(1) Increasingly, it also...
with commentary by Linda H. Aiken, PhD, RN , Nursing and Patient Safety , July-August 2005
The goal set by the Institute of Medicine (IOM) in 1999 to reduce medical errors by half within 5 years has not been achieved. Opinion polls of consumers and health professionals show that concerns about patient safety remain high. Yet only 16% of hospital...
Nursing and Patient Safety , July-August 2005
Barbara A. Blakeney, MS, RN, is President of the 150,000-member American Nurses Association (ANA). A nurse practitioner and expert in public health practice, policy, and primary care, Ms. Blakeney is on leave from the Boston Public Health Commission, where she has been director of health care services for the homeless. She is the recipient of numerous awards and has been named to Modern Healthcare Magazine's list of the 100 most influential people in health care for the past 3 years.
with commentary by Kaveh G. Shojania, MD, Research in Patient Safety , June 2005
Five years ago, a widely publicized randomized trial reported a 90% reduction in the incidence of contrast dye-induced renal failure when patients were pretreated with acetylcysteine, an agent previously used to treat acetaminophen overdoses and bronchitis...
Research in Patient Safety , June 2005
Peter J. Pronovost, MD, PhD, is Medical Director of the Johns Hopkins Center for Innovation in Quality Patient Care. A practicing anesthesiologist and critical care physician, he has appointments in both The Johns Hopkins University School of Medicine and its Bloomberg School of Public Health. Dr. Pronovost's research, which has focused on how to improve patient safety and quality in the ICU setting, has been characterized by a blend of methodologic sophistication and practical attention to the details of making change happen and making it stick. His many contributions include studies of the value of intensivists, of the use of daily goal cards on safety and communication, of an executive adopt-a-unit strategy, and of a comprehensive unit-based safety program. For this work, much of which has been supported by AHRQ, he was awarded the John M. Eisenberg Award in Research Achievement in 2004.
Organizational Change in the Face of Highly Public Errors—I. The Dana-Farber Cancer Institute Experience
with commentary by James B. Conway; Saul N. Weingart, MD, PhD, Errors in the Media and Organizational Change, May 2005
A decade ago, two tragic medical errors rocked one of the world’s great cancer hospitals, Dana-Farber Cancer Institute (DFCI) in Boston, to its core. The errors led to considerable soul searching and, ultimately, a major change in institutional practices a...
with commentary by Karen Frush, MD, Errors in the Media and Organizational Change, May 2005
In February 2003, 17-year-old Jessica Santillan died at Duke University Medical Center due to a mismatched heart-lung transplantation. As with the Dana-Farber experience, the death made headlines around the world and devastated the leaders and providers at...