Follow-up study of medication errors reported to the Vaccine Adverse Event Reporting System (VAERS).

Oversedation of a patient with obstructive sleep apnea prior to imaging.

Blay E Jr, Barnard C, Bilimoria KY. JAMA. 2018;319:495-496.

Anesthesia adverse events voluntarily reported in the Veterans Health Administration and lessons learned.

Neily J, Silla ES, Sum-Ping SJT, et al. Anesth Analg. 2018;126:471-477.

Comparison of medication safety systems in critical access hospitals: combined analysis of two studies.

Cochran GL, Barrett RS, Horn SD. Am J Health Syst Pharm. 2016;73:1167-1173.

Emotional harm from disrespect: the neglected preventable harm.

Sokol-Hessner L, Folcarelli PH, Sands KEF. BMJ Qual Saf. 2015;24:550-553.

A safe practice standard for barcode technology.

Leung AA, Denham CR, Gandhi TK, et al. J Patient Saf. 2015;11:89-99.

Root cause analysis to support infection control in healthcare premises.

Venier AG. J Hosp Infect. 2015;89:331-334.

Root cause analysis of ambulatory adverse drug events that present to the emergency department.

Gertler SA, Coralic Z, López A, Stein JC, Sarkar U. J Patient Saf. 2016;12:119-124

Health care failure mode and effect analysis to reduce NICU line–associated bloodstream infections.

Chandonnet CJ, Kahlon PS, Rachh P, et al. Pediatrics. 2013;131:e1961-e1969.

The 'second victims' of medication errors begin to gain support.

Blum K. Pharmacy Practice News. November 16, 2011.

Key performance outcomes of patient safety curricula: root cause analysis, failure mode and effects analysis, and structured communications skills.

Fassett WE. Am J Pharm Educ. 2011;75:164.

Multimodal system designed to reduce errors in recording and administration of drugs in anaesthesia: prospective randomised clinical evaluation.

Merry AF, Webster CS, Hannam J, et al. BMJ. 2011;343:d5543.

Scanner beep only means the barcode has been scanned.

ISMP Medication Safety Alert! Acute Care Edition. June 30, 2011;16:1-2.

ASHP statement on bar-code verification during inventory, preparation, and dispensing of medications.

Am J Health Syst Pharm. 2011;68:442-445.

Utilising improvement science methods to optimise medication reconciliation.

White CM, Schoettker PJ, Conway PH, et al. BMJ Qual Saf. 2011;20:372-380.

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

Morriss FH, Jr, Abramowitz PW, Nelson SP, Milavetz G, Michael SL, Gordon SN. Am J Health Syst Pharm. 2011;68:57-62.

Wrong-site and wrong-patient procedures in the Universal Protocol era: analysis of a prospective database of physician self-reported occurrences.

Stahel PF, Sabel AL, Victoroff MS, et al. Arch Surg. 2010;145:978-984.

What’s past is prologue: organizational learning from a serious patient injury.

Tamuz M, Franchois KE, Thomas EJ. Safety Sci. 2011;49:75-82.

Building patient safety skills: common pitfalls when conducting a root cause analysis.

ISMP Medication Safety Alert! Acute Care Edition. April 22, 2010;15:1-4.

Random safety auditing, root cause analysis, failure mode and effects analysis.

Ursprung R, Gray J. Clin Perinatol. 2010;37:141-165.

Fellowships and Mentorships Program.

Horsham, PA. Institute for Safe Medication Practices.