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- Patient Safety Primers 1
- Perspectives on Safety 1
- Review 1
- Study 17
- Slideset 1
- Book/Report 19
- Legislation/Regulation 1
- Newspaper/Magazine Article 101
- Newsletter/Journal 1
- Special or Theme Issue 1
- Toolkit 2
- Web Resource 19
- Meeting/Conference 2
- Communication Improvement 27
- Culture of Safety 5
- Education and Training 26
Error Reporting and Analysis
- Error Reporting 45
- Human Factors Engineering 17
- Legal and Policy Approaches 47
- Logistical Approaches 8
- Policies and Operations 1
- Quality Improvement Strategies 27
- Research Directions 1
- Specialization of Care 2
- Teamwork 1
- Technologic Approaches 13
- Alert fatigue 2
- Device-related Complications 6
- Diagnostic Errors 9
- Discontinuities, Gaps, and Hand-Off Problems 6
- Drug shortages 1
- Failure to rescue 1
- Fatigue and Sleep Deprivation 5
- Identification Errors 5
- Delirium 1
- Medication Safety 18
- Nonsurgical Procedural Complications 2
- Overtreatment 1
- Psychological and Social Complications 13
- Surgical Complications 23
- Transfusion Complications 2
- Internal Medicine 47
- Nursing 2
- Palliative Care 1
- Pharmacy 3
- Family Members and Caregivers 17
- Health Care Executives and Administrators 49
Health Care Providers
- Nurses 6
- Physicians 12
Non-Health Care Professionals
- Media 3
- Australia and New Zealand 3
- Europe 15
- Canada 6
United States of America
United States Federal Government
- Department of Health and Human Services (HHS) 8
- United States Federal Government 10
Search results for "Hospitals"
Consumer Reports. July 29, 2015.
Ungar L. USA Today. February 1, 2015.
Appleby J, Lucas E. Kaiser Health News. August 14, 2019.
Colino S. Fam Circle. August 2019;132:66,69.
Patients and families can play a role in ensuring care is effective and safe. This news article recommends ways for patients to reduce risk of errors during a hospitalization, including using a patient portal to identify mistakes, asking questions, bringing an advocate, and working with hospitalists as key care partners.
Appleby J, Lucas E. Kaiser Health News. June 21, 2019.
Ross C. STAT. May 13, 2019.
Nuisance alarms, interruptions, and insufficient staff availability can hinder effective monitoring and response to acute patient deterioration. This news article reports on how hospital logistics centers are working toward utilizing artificial intelligence to improve clinician response to alarms by proactively identifying hospitalized patients at the highest risk for heart failure to trigger emergency response teams when their condition rapidly declines.
Lives Lost, Lives Saved: An Updated Comparative Analysis of Avoidable Deaths at Hospitals Graded by The Leapfrog Group.
Austin M, Derk J. Baltimore, MD: Armstrong Institute for Patient Safety and Quality, and Johns Hopkins Medicine; May 2019.
Measures help track gaps in process and evidence of safety improvements. This white paper examines the performance of hospitals receiving Hospital Safety Grades and the relationship between high-level recognition and preventable harm. The report estimates that a substantial number of lives could have been saved if performance metrics had been met, but concludes that even high-performing hospitals exhibit areas in need of improvement.
CDC Vital Signs. May 7, 2019.
Maternal morbidity and mortality is a worldwide patient safety problem. This analysis describes the prevalence of pregnancy-related death and areas of concern during pregnancy, at delivery, and up to a year postpartum. It reports that 60% of these deaths are preventable and provides suggestions for families, clinicians, and systems to reduce risks.
Frakt A. New York Times. April 29, 2019.
Health care providers are a known source of potentially harmful bacteria due to their perpetual interaction with germs during practice. This newspaper article reports on how clinician attire, stethoscopes, and technology can be contaminated with bacteria. Hand sanitizer placement, sleeve length, and laundering behaviors can reduce transmission of pathogens.
Rau J. Kaiser Health News. March 1, 2019.
Financial incentives may encourage adoption of practice improvements that enhance safety. This news article reports on the increase in United States hospitals that have had Medicare payments withheld due to high rates of hospital-acquired conditions. The article is accompanied by a state-level tally of individual hospitals penalized.
Journal Article > Study
Making infection prevention and control everyone's business? Hospital staff views on patient involvement.
Sutton E, Brewster L, Tarrant C. Health Expect. 2019 Feb 17; [Epub ahead of print].
Interviews with frontline hospital staff and executive leaders revealed that they were generally supportive of engaging families and patients to promote infection prevention in the clinical setting when using a collaborative approach. Staff identified certain challenges including concerns related to the extent of responsibility patients and families should bear with regard to infection prevention as well as risks to infection control posed by patients themselves.
Patient Safety Primers
Anyone can find it challenging to understand medical terms, and millions of Americans have trouble understanding and acting upon health information. The mismatch between individuals' health literacy skills and the complexity of health information and health care tasks involved in managing health has implications on patient safety.
Watts E, Rayman G. Diabetes UK. London, UK; 2018.
Chronic disease management can add complexity to inpatient care regimens. Researchers worked with patients, system leaders, and clinicians to examine areas of risk for hospitalized patients with diabetes and determine solutions such as specialized teams, clinical leadership, and improved use of technology. A WebM&M commentary illustrated safety challenges associated with providing care for hospitalized patients with diabetes.
Journal Article > Commentary
Leistikow I, Huisman F. J Patient Saf Risk Manag. 2018;23:139-141.
Eldred SM. Health Shots. National Public Radio. August 15, 2018.
Using professional interpreters can avert risks of miscommunication due to language barriers between patients and clinicians. This news article discusses how lack of qualified medical interpreters, use of ad hoc interpreters, and poor patient understanding of instructions can contribute to adverse events. A WebM&M commentary explored patient safety issues associated with patient–clinician language differences.
Young A, Kelly J, Schnaars C, Ungar L. USA Today.
Hoffman RM, Mirarchi FL. PA-PSRS Patient Saf Advis. June 2018;15.
Patient harm associated with advance directive interpretation errors is rare, but these mistakes can have negative psychological consequences for care teams, patients, and families. Discussing research exploring factors that contribute to these misunderstandings, this article recommends actions to help patients articulate end-of-life care preferences and ensure those instructions are accurately shared with their families and the clinical teams acting on their behalf.
Mukherjee S. New York Times Magazine. May 9, 2018.
Checklists can coordinate action and communication to augment safety, but human and system factors may hinder their effectiveness. This magazine article reports on how the checklist phenomenon evolved into a global patient safety effort and spotlights the impact of human behavior on reliable implementation of checklist programs in different care environments.
Journal Article > Study
Mixed-methods evaluation of real-time safety reporting by hospitalized patients and their care partners: the MySafeCare application.
Collins SA, Couture B, Smith AD, et al. J Patient Saf. 2018 Apr 27; [Epub ahead of print].
Detecting adverse events in the health care setting remains an ongoing challenge. Engaging patients and their family members may help to escalate safety issues not identified by other means. In this mixed-methods study, investigators analyzed the types of issues patients and their care partners reported in real time through a web-based electronic application implemented on three hospital units. After implementation of the tool, event reporting by patients to the Patient Family Relations Department declined, suggesting that patients preferred to report concerns anonymously through the application. The authors conclude that additional research is needed to understand how these types of applications could be integrated into patient safety programs. A past PSNet perspective highlighted how patient-facing technologies can empower patients.
Crouch M. Reader's Digest. April 2018.
Involving patients in their care can help improve safety. This magazine article provides 34 tips from leading patient safety experts to assist patients in this role. Tactics include considering a second opinion, bringing an up-to-date medication list, and repeating information back to providers to reduce misunderstandings.