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- Communication Improvement 1
- Education and Training 1
- Error Reporting and Analysis
- Human Factors Engineering 2
- Logistical Approaches 2
- Quality Improvement Strategies 2
- Technologic Approaches 1
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- Facility and Group Administrators
- Failure Mode Effects Analysis
- Health Care Executives and Administrators
Journal Article > Review
Duwe B, Fuchs BD, Hansen-Flaschen J. Crit Care Clin. 2005;21:21-30, vii.
This article provides background on failure mode and effects analysis (FMEA) and reviews both the positive and negative elements of implementing FMEA as an error prevention approach for intensive care units.
Journal Article > Commentary
Saxena S, Kempf R, Wilcox S, et al. Jt Comm J Qual Patient Saf. 2005;31:495-506.
The authors applied failure mode effects and criticality analysis to improve laboratory value notification processes with non-emergent areas of care in a teaching hospital.
Inspiring Ideas and Celebrating Successes: A Guidebook to Leading Patient Safety Practices in Ontario Hospitals.
OHA Patient Safety Support Service. Toronto, Ontario, Canada: Ontario Hospital Association; 2006.
This report shares successful patient safety strategies employed in Ontario hospitals to address medication safety, patient incident management, infection issues, and administrative process improvements.
Journal Article > Study
van Beuzekom M, Akerboom SP, Boer F. Qual Saf Health Care. 2007;16:45-50.
The authors describe an instrument for identifying failures in the intensive care unit (ICU) and operating room to help organizations gain insight into system failures in those high-risk environments.
Grout JR. Rockville, MD: Agency for Healthcare Research and Quality; May 2007. AHRQ Publication No. 07-P0020.
In this report, the author draws from multidisciplinary sources to share examples of practical process and design changes that can mitigate human error in health care.