Narrow Results Clear All
- Communication Improvement 2
- Culture of Safety 1
- Education and Training 3
- Error Reporting and Analysis 4
- Human Factors Engineering 2
- Legal and Policy Approaches 5
- Quality Improvement Strategies 13
- Teamwork 1
- Technologic Approaches 2
- Interruptions and distractions 1
- Medical Complications 2
- Medication Safety 6
- Surgical Complications 3
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Horsham, PA: Institute for Safe Medication Practices; 2019.
Drug dispensing systems have been adopted in hospitals to prevent medication errors, but accidents associated with their use still occur. This report provides comprehensive guidelines on the safe use of automated dispensing cabinets. Recommendations include improvement in areas such as stocking, labeling, and removal of expired medications.
Horsham, PA: Institute for Safe Medication Practices; January 2019.
Inaccurate or incomplete data in electronic health records can limit the effectiveness of health information technology. This guideline focuses on improvements in how medication information is formatted to support safe medication delivery. Recommended approaches include avoidance of error-prone abbreviations, use of Tall Man lettering, and required use of metric measurements to reduce risks in electronic health records, barcoding systems, smart infusion devices, and other information technologies.
Executive Board EB144/29 144th session. Geneva, Switzerland: World Health Organization; December 12, 2018.
This guidance summarizes the current status of global patient safety, highlights World Health Organization efforts to address the problem, and provides direction for WHO leadership and policy makers to achieve improvements in safety. Recommendations include universal health coverage, coordination of efforts, and dissemination of effective practices.
Dallas, TX: Facilities Guidelines Institute; 2018.
These updated guidelines include design changes, such as the adoption of private rooms to reduce medical error, interruptions, and hospital-acquired infections. The 2018 edition was developed as a 3-volume set covering hospitals, outpatient facilities, and residential health, care, and support facilities. Each provides information on design elements that enhance safety. The material also includes risk assessments to identify space concerns that could lead to unsafe conditions.
In: 2018 Comprehensive Accreditation Manual for Hospitals. CAMH. Oakbrook Terrace, IL: Joint Commission; January 2018:PS1-PS50.
This chapter provides information about how organizations can re-design existing programs or launch new initiatives working to meet National Patient Safety Goal and accreditation standards. The material focuses on the importance of integrating safety and quality work with frontline activities, evaluating progress of interventions, and learning from critical events to guide improvements.
Philadelphia, PA: American College of Physicians; 2017.
Patient safety in the ambulatory setting is gaining traction as a focus for research, intervention, and policy. This position paper highlights seven recommendations to address patient safety challenges in the ambulatory environment, including enhancing patient health literacy, utilizing team-based care models, and establishing a national effort to reduce patient harm across all settings of health care.
Horsham, PA: Institute for Safe Medication Practices; May 2017.
Insulin is a widely used medication that can contribute to serious patient harm if used incorrectly. This report provides information about problems associated with insulin use in adults and offers consensus-developed strategies to encourage subcutaneous insulin practices that reduce errors at the prescribing, pharmacy management, administration, and transition phases.
Allegranzi B, Bischoff P, de Jonge S, et al; WHO Guidelines Development Group. Geneva, Switzerland: World Health Organization; 2016. ISBN: 9789241549882.
Efforts to reduce surgical site infections have achieved some success. The World Health Organization has taken a leading role in eliminating health care–associated harms and has compiled guidelines to address factors that contribute to surgical site infections in preoperative, intraoperative, and postoperative care. The document includes recommendations for improvement informed by the latest evidence.
Horsham, PA: Institute for Safe Medication Practices; 2016.
This updated report describes best practices to ensure safety when preparing sterile compounds, including pharmacist verification of orders entered into computerized provider order entry systems. The guidelines emphasize the role of technologies such as barcoding and robotic image recognition as approaches to enhance safety.
London, UK: Royal College of Surgeons of England; 2016.
Rockville, MD: Center for Drug Evaluation and Research, US Food and Drug Administration; April 2016.
NHS England Patient Safety Domain, National Safety Standards for Invasive Procedures Group. London, UK: National Health Service; 2015.
Patients face risks when undergoing invasive procedures. This report provides recommendations developed by multidisciplinary consensus and outlines how organizations can implement the standards to improve safety of invasive procedures.
Horsham, PA: The Institute for Safe Medication Practices; July 2015.
To address the lack of standards on intravenous (IV) push medication administration, this guidance reflects applied expert opinion and current evidence regarding IV push medication administration to support application of best practices to facilitate safe care. To ensure the applicability and use of the recommendations in hospitals, the authors sought broader consensus and review from the field.
London, UK: General Medical Council and the Nursing and Midwifery Council; June 29, 2015.
Open and honest discussion with patients after an error or near miss is key to effective disclosure. This guidance provides recommendations for physicians, nurses, and midwives regarding disclosure practices in the United Kingdom. A set of case studies accompanies the report, which illustrate the professional duty of candor in various practical situations.
Manchester, UK: General Medical Council; January 2012. ISBN: 9780901458568.
This guidance from the United Kingdom outlines how physicians can raise concerns and take appropriate action if they believe a patient's safety is at risk.
Windwick B, Aubin D, Beard P, et al; Disclosure Working Group. Edmonton, AB, Canada: Canadian Patient Safety Institute; 2011. ISBN: 9781926541389.
These national guidelines for Canadian health care providers serve as a tool for developing and implementing disclosure policies, practices, and training methods.
Communication Advisory Committee. Edmonton, AB, Canada: Canadian Patient Safety Institute; 2010. ISBN: 9781926541266
This guideline provides an organizational strategy, flow charts, and a task list to improve internal and external communication following a medical error.
Women's Health Care Physicians; Committee on Patient Safety and Quality Improvement. Washington, DC: American College of Obstetricians and Gynecologists; 2010. ISBN: 9781934946930.
This manual describes various facets of health care quality and tools for quality improvement in obstetric and gynecologic practice.
Health-Care-Associated Infections in Hospitals: Leadership Needed from HHS to Prioritize Prevention Practices and Improve Data on these Infections.
Washington, DC: United States Government Accountability Office; March 31, 2008. Publication GAO-08-283.
This report examines US government standards, procedures, and data collection methods related to health-care-associated infections (HAI) and recommends increased integration across program databases.
Washington, DC: National Quality Forum; January 2006.
In this report, the National Quality Forum presents four consensus standards that support the application of the Joint Commission on Accreditation of Healthcare Organizations' Patient Safety Event Taxonomy—a standardized framework for classifying patient safety data.