Narrow Results Clear All
- Communication Improvement 2
- Culture of Safety 1
- Error Reporting and Analysis
- Human Factors Engineering 1
- Legal and Policy Approaches 2
- Logistical Approaches 1
- Device-related Complications 1
- Identification Errors 1
- Medical Complications 2
- Medication Safety 2
- Surgical Complications 1
Search results for "Health Care Providers"
St. Paul, MN: Minnesota Department of Health; March 2019.
The National Quality Forum has defined 29 never events—patient safety problems that should never occur, such as wrong-site surgery and patient falls. Since 2003, Minnesota hospitals have been required to report such incidents. The 2018 report summarizes information about 384 adverse events that were reported and found pressure ulcers and invasive procedure events increased, while fall-related deaths decreased. Reports from previous years are also available.
Child Health Patient Safety Organization. Washington, DC: Children's Hospital Association; 2017.
Oakbrook Terrace, IL: Joint Commission Resources; 2017. ISBN: 9781599409849.
Root cause analysis has been widely adopted as a strategy to investigate events, despite questions regarding its effectiveness in health care. This book provides information about updated approaches to root cause analysis, including how this strategy enables design of proactive and reactive improvements.
Kelsey R. CRC Press: Boca Raton, FL; 2017. ISBN: 9781498781169.
Preventing Patient Falls: A Systematic Approach From the Joint Commission Center for Transforming Healthcare Project.
Chicago, IL: Health Research & Educational Trust; October 2016.
Falls are a common hazard among both hospitalized and ambulatory patients. This report summarizes the results of a collaborative to identify and address the root causes of falls in hospitals and provides case studies from the participating organizations to illustrate their experiences during the initiative.
Toronto, ON, Canada: Institute for Safe Medication Practices Canada. April 30, 2007.
McKee J, ed. Oakbrook Terrace, IL: Joint Commission Resources; 2005. ISBN: 0866889116.
This book provides information on implementing the Joint Commission on Accreditation of Healthcare Organization's (JCAHO) Sentinel Event Policy in all health care settings. The text includes a sample sentinel event root cause analysis form and a glossary.
Oakbrook Terrace, IL; Joint Commission on Accreditation of Healthcare Organizations; 2006. ISBN: 0866889892.
This book provides a complete overview of the Joint Commission on Accreditation of Healthcare Organization's National Patient Safety Goals and how to apply them in various settings. In addition, it discusses the role that patient safety plays in the accreditation process.
US Government Accountability Office. Washington, DC: US Government Accountability Office; 2004. Publication GAO-05-83.
The Government Accountability Office studied patient safety programs at four Department of Veterans Affairs (VA) health facilities and recommends that the VA emphasize leadership action and open communication to support safety improvement.