Pediatric patient safety events during hospitalization: approaches to accounting for institution-level effects.

Anthony Slonim; James P. Marcin; Wendy Turenne; Matt Hall; Jill G. Joseph

Study

Pediatric patient safety events during hospitalization: approaches to accounting for institution-level effects.

November 28, 2007

Slonim A, Marcin JP, Turenne W, et al. Health Serv Res. 2007;42(6 Pt 1):2275-93; discussion 2294-323.

View more articles from the same authors.

This AHRQ-funded study describes different approaches to analyzing administrative data, along with how these methods affect the interpretation of related findings. The authors use these methods to uncover characteristics associated with the occurrence of patient safety indicators.

PubMed citation

Available at

Free full text

Related Resources From the Same Author(s)

Charges and lengths of stay attributable to adverse patient-care events using pediatric-specific quality indicators: a multicenter study of freestanding children's hospitals.

June 11, 2008

Proactive risk assessment of surgical site infections in ambulatory surgery centers.

June 7, 2017

Quality and safety in the intensive care unit.

August 9, 2006

Assessing teamwork attitudes in healthcare: development of the TeamSTEPPS teamwork attitudes questionnaire.

October 6, 2010

Effect of Patient and Family Centered I-PASS on adverse event rates in hospitalized children with complex chronic conditions.

March 8, 2023

Comparison of quality measures from US hospitals with physician vs nonphysician chief executive officers.

November 2, 2022

March 28, 2018

Five pitfalls in decisions about diagnosis and prescribing.

November 2, 2005

The contribution of nurses to incident disclosure: a narrative review.

August 28, 2013

Medication errors among acutely ill and injured children treated in rural emergency departments.

May 2, 2007

Hand-off Communications.

October 27, 2010

Using Health Care Failure Mode and Effect Analysis: the VA National Center for Patient Safety's prospective risk analysis system.

March 27, 2005

Using a spare medication vial to store multiple medications: a potentially fatal in-home medication error.

March 6, 2019

Telemedicine consultations and medication errors in rural emergency departments.

December 11, 2013

Clinicians in quality improvement: a new career pathway in academic medicine.

February 25, 2009

Using a pediatric trigger tool to estimate total harm burden hospital-acquired conditions represent.

July 11, 2018

Medical team training improves team performance: AOA critical issues.

October 18, 2017

Medical and surgical comanagement after elective hip and knee arthroplasty: a randomized, controlled trial.

March 6, 2005

Telemedicine vs telephone consultations and medication prescribing errors among referring physicians: a cluster randomized crossover trial.

March 13, 2024

Using proactive risk assessment (HFMEA) to improve patient safety and quality associated with intraocular lens selection and implantation in cataract surgery.

September 18, 2019

Disparities in racial, ethnic, and payer groups for pediatric safety events in US hospitals.

February 28, 2024

Pediatric medication administration errors and workflow following implementation of a bar code medication administration system.

August 6, 2014

Characteristics of medical professional liability claims in patients with cardiovascular diseases.

April 21, 2010

Examining variations in prescribing safety in UK general practice: cross sectional study using the Clinical Practice Research Datalink.

November 25, 2015

Inpatient suicide and suicide attempts in Veterans Affairs hospitals.

August 20, 2008

A method for prioritizing interventions following root cause analysis (RCA): lessons from philosophy.

January 14, 2015

Quality improvement in medical education: current state and future directions.

January 18, 2012

Developing surgical and anesthesia resident patient safety competencies through systems-based event analysis. Guide to curricular development and evaluation of longer-term resident perceptions.

October 18, 2023

What evidence supports the use of computerized alerts and prompts to improve clinicians' prescribing behavior?

July 15, 2009

Reducing serious safety events and priority hospital-acquired conditions in a pediatric hospital with the implementation of a patient safety program.

June 6, 2018

Analysis of iatrogenic and in-hospital medication errors reported to United States poison centers: a retrospective observational study.

June 24, 2020

A trigger tool to detect harm in pediatric inpatient settings.

June 3, 2015

A checklist to identify inpatient suicide hazards in Veterans Affairs hospitals.

February 17, 2010

Awareness and use of a cognitive aid for anesthesiology.

September 19, 2007

Elevated mortality among weekend hospital admissions is not associated with adoption of seven day clinical standards.

December 6, 2017

The future of graduate medical education: a systems-based approach to ensure patient safety.

July 22, 2015

Patient Safety.

February 8, 2012

Patient safety: lessons learned.

March 1, 2006

How I minimize mistransfusion risk in my hospital.

July 26, 2006

Patient safety: what is really at issue?

October 26, 2005

Apology and unintended harm in global health.

July 17, 2019

ADVERSE drug events: incidence and risk reduction across the care continuum.

February 10, 2016

The incidence and nature of adverse events during pediatric sedation/anesthesia with propofol for procedures outside the operating room: a report from the Pediatric Sedation Research Consortium.

March 18, 2009

Patient Safety in the Traditional and Evolving Nontraditional Office Setting

October 2, 2019

Hospital staffing and health care–associated infections: a systematic review of the literature.

October 3, 2018

Should electronic differential diagnosis support be used early or late in the diagnostic process? A multicentre experimental study of Isabel.

October 27, 2021

Errors detected in pediatric oral liquid medication doses prepared in an automated workflow management system.

February 28, 2018

Speaking up about safety concerns: multi-setting qualitative study of patients' views and experiences.

December 15, 2010

Interdisciplinary Quality Improvement Conference: using a revised morbidity and mortality format to focus on systems-based patient safety issues in a VA hospital: design and outcomes.

November 12, 2014

Prescription of long-acting opioids and mortality in patients with chronic noncancer pain.

November 30, 2016

Teaching quality improvement and patient safety to trainees: a systematic review.

June 30, 2010

How prevalent are hazardous attitudes among orthopaedic surgeons?

May 27, 2015

An improved patient safety reporting system increases reports of disruptive behavior in the perioperative setting.

February 5, 2020

Usability evaluation of order sets in a computerized provider order entry system.

August 24, 2011

Does user-centred design affect the efficiency, usability and safety of CPOE order sets?

May 4, 2011

Hospital inpatient falls across clinical departments.

September 1, 2021

Office-based anesthesia.

February 10, 2010

When medical care leads to harm—difficulty finding words: a teachable moment.

June 17, 2015

Teams, tribes and patient safety: overcoming barriers to effective teamwork in healthcare.

February 5, 2014

Reporting near-miss events in nursing homes.

April 19, 2006

Medication reconciliation at an academic medical center: implementation of a comprehensive program from admission to discharge.

December 9, 2009

Emergency department discharge prescription interventions by emergency medicine pharmacists.

June 20, 2012

Incorrect surgical procedures within and outside of the operating room.

November 25, 2009

Disclosing medical errors to patients: a challenge for health care professionals and institutions.

October 21, 2009

Risk of misdiagnosis and delayed diagnosis with COVID-19: a syndemic approach.

February 10, 2021

Enhanced morbidity and mortality meeting and patient safety education for specialty trainees.

August 12, 2015

Who is responsible for the safe introduction of new surgical technology? An important legal precedent from the da Vinci Surgical System Trials.

May 10, 2017

Medication administration process assessment: applying lessons learned from commercial aviation.

March 11, 2009

The 100,000 Lives Campaign: crystallizing standards of care for hospitals.

November 23, 2005

Association between measured teamwork and medical errors: an observational study of prehospital care in the USA

December 11, 2019

Professional, structural and organisational interventions in primary care for reducing medication errors.

October 18, 2017

Despite federal legislation, shortages of drugs used in acute care settings remain persistent and prolonged.

May 18, 2016

Sustaining quality improvement and patient safety training in graduate medical education: lessons from social theory.

September 11, 2013

Patients' and physicians' attitudes regarding the disclosure of medical errors.

March 6, 2005

The quality 'journey' at Ascension Health: how we've prevented at least 1,500 avoidable deaths a year—and aim to do even better.

April 27, 2011

When COVID-19 hit, many elderly were left to die.

August 19, 2020

Incidence and nature of adverse events during pediatric sedation/anesthesia for procedures outside the operating room: report from the Pediatric Sedation Research Consortium.

October 18, 2006

Weekly variation in health-care quality by day and time of admission: a nationwide, registry-based, prospective cohort study of acute stroke care.

June 22, 2016

Handoff checklists improve the reliability of patient handoffs in the operating room and postanesthesia care unit.

June 12, 2013

Making the business case for patient safety.

March 6, 2005

Handoffs causing patient harm: a survey of medical and surgical house staff.

October 1, 2008

Effectiveness of interventions designed to promote patient involvement to enhance safety: a systematic review.

June 2, 2010

Clinical pathway adherence and missed diagnostic opportunities among children with musculoskeletal infections.

September 6, 2023

Clinical decision support for atypical orders: detection and warning of atypical medication orders submitted to a computerized provider order entry system.

June 25, 2014

Evaluating implementation of a rapid response team: considering alternative outcome measures.

May 7, 2014

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

Junior doctors and patient safety: evaluating knowledge, attitudes and perception of safety climate.

September 5, 2012

To expand the evidence base about harms from tests and treatments.

September 15, 2021

Validating patient safety in the endoscopy unit using The Joint Commission standards.

July 13, 2011

Root cause analysis and actions for the prevention of medical errors: quality improvement and resident education.

May 17, 2017

State legal restrictions and prescription-opioid use among disabled adults.

July 20, 2016

Journal reporting of medical errors: the wisdom of Solomon, the bravery of Achilles, and the foolishness of Pan.

March 28, 2007

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

December 22, 2010

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

November 28, 2018

Human factors engineering in healthcare systems: the problem of human error and accident management.

January 21, 2009

Uncovering the risks of anticancer therapy through incident report analysis using a newly developed medical oncology incident taxonomy.

December 13, 2023

American College of Surgeons' Committee on Trauma performance improvement and patient safety program: maximal impact in a mature trauma center.

December 14, 2011

Building a Patient Safety Toolkit for use in general practice.

July 20, 2016

Is hand hygiene before putting on nonsterile gloves in the intensive care unit a waste of health care worker time? A randomized controlled trial.

September 4, 2013

Coordinating care across diseases, settings, and clinicians: a key role for the generalist in practice.

May 4, 2005

Related Resources

Disparities in racial, ethnic, and payer groups for pediatric safety events in US hospitals.

February 28, 2024

Pediatric Diagnostic Safety: State of the Science and Future Directions.

September 13, 2023

Patient Safety Innovations

The e-Autopsy/e-Biopsy: A Systematic Chart Review to Increase Safety and Diagnostic Accuracy Innovation

August 30, 2023

Patient Safety Indicators Overview.

August 1, 2023

Classification of health information technology safety events in a pediatric tertiary care hospital.

June 7, 2023

Annual Perspective

Improving Diagnostic Safety and Quality

April 26, 2023

Relationships between pediatric safety indicators across a national sample of pediatric hospitals: dispelling the myth of the "safest" hospital.

June 22, 2022

Patient Safety Innovations

Handshake antimicrobial stewardship as a model to recognize and prevent diagnostic errors

September 29, 2021

Variability in collection and use of race/ethnicity and language data in 93 pediatric hospitals.

October 14, 2020

Patient safety morning report: innovation in teaching core patient safety principles to third-year medical students.

July 10, 2019

Perceptions of pediatric hospital safety culture in the United States: an analysis of the 2016 Hospital Survey on Patient Safety Culture.

April 24, 2019

Priorities for pediatric patient safety research.

February 13, 2019

Surgical safety checklists in children's surgery: surgeons' attitudes and review of the literature.

February 6, 2019

The association of the nurse work environment and patient safety in pediatric acute care.

January 16, 2019

Case-based simulation empowering pediatric residents to communicate about diagnostic uncertainty.

January 16, 2019

Adverse events and patient outcomes among hospitalized children cared for by general pediatricians vs hospitalists.

January 9, 2019

Patient safety after implementation of a coproduced family centered communication programme: multicenter before and after intervention study.

December 19, 2018

Racial, ethnic, and socioeconomic disparities in patient safety events for hospitalized children.

December 19, 2018

Self-reported adherence to high reliability practices among participants in the Children's Hospitals' Solutions for Patient Safety Collaborative.

December 12, 2018

Identifying electronic health record usability and safety challenges in pediatric settings.

November 28, 2018

Epidemiology of and risk factors for harmful anti-infective medication errors in a pediatric hospital.

September 19, 2018

What is new in paediatric medication safety?

September 12, 2018

Pediatric adverse event rates associated with inexperience in teaching hospitals: a multilevel analysis.

March 21, 2018

Effect of a pediatric early warning system on all-cause mortality in hospitalized pediatric patients.

March 7, 2018

Iatrogenesis in Pediatrics.

September 20, 2017

The proportion of errors in medical prescriptions and their executions among hospitalized children before and during accreditation.

September 13, 2017

Nurses' response to parents' 'speaking-up' efforts to ensure their hospitalized child's safety: an attribution theory perspective.

August 30, 2017

Why it is so hard to talk about overuse in pediatrics and why it matters.

August 30, 2017

Deployment of a second victim peer support program: a replication study.

August 16, 2017

Video analysis of factors associated with response time to physiologic monitor alarms in a children's hospital.

April 19, 2017

See More About The Topic

Children's Hospitals

Pediatrics

Epidemiology of Errors and Adverse Events

Error Analysis

Patient Safety Indicators

Pediatric patient safety events during hospitalization: approaches to accounting for institution-level effects.

The e-Autopsy/e-Biopsy: A Systematic Chart Review to Increase Safety and Diagnostic Accuracy Innovation

Handshake antimicrobial stewardship as a model to recognize and prevent diagnostic errors

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

Pediatric patient safety events during hospitalization: approaches to accounting for institution-level effects.

The e-Autopsy/e-Biopsy: A Systematic Chart Review to Increase Safety and Diagnostic Accuracy Innovation

Handshake antimicrobial stewardship as a model to recognize and prevent diagnostic errors

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