Health information technology (HIT) has had a profound impact on health care delivery and patient safety, but unintended consequences remain a concern. Findings from semi-structured interviews with medical and IT professionals indicate differing perspectives on the underlying causes of medical errors. While IT experts consider technology to be the source of most errors, clinicians attribute errors to person, process, and contextual factors. 

Unreliable test result management systems and failure to follow-up on abnormal test results are common issues in ambulatory care. Using a modified failure mode and effect analysis methodology, this study sought to prospectively identify safety hazards in the laboratory testing process in primary care clinics.

Standardized patients and simulated error scenarios were used to teach family medicine residents about error detection, error disclosure, and root cause analysis.

The authors describe a survey instrument based on failure mode and effects analysis used to assess perceptions of medical error frequency and impact.

This case study illustrates how therapeutic duplication can lead to harm and provides several strategies to minimize its occurrence.

The authors describe a curriculum implemented at a university-based family medicine residency program that was successfully integrated into the residents' daily work.

The authors describe a systems engineering model of analysis and synthesis for understanding error in ambulatory care settings.