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Approach to Improving Safety
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Journal Article > Commentary
Ten years after the IOM report: engaging residents in quality and patient safety by creating a house staff quality council.
Fleischut PM, Evans AS, Nugent WC, et al. Am J Med Qual. 2011;26:89-94.
This commentary describes one hospital's approach to engage residents in improving patient safety.
Newspaper/Magazine Article
Preventing medication errors during codes.
ISMP Medication Safety Alert! Acute Care Edition. February 9, 2011;16:1-3.
This piece discusses medication errors during emergency resuscitations and outlines risk-reduction strategies.
Journal Article > Study
Assessing and improving safety culture throughout an academic medical centre: a prospective cohort study.
Paine LA, Rosenstein BJ, Sexton JB, Kent P, Holzmueller CG, Pronovost PJ. Qual Saf Health Care. 2010;19:547-554.
Strategies that foster a positive safety culture are increasingly supported by emerging relationships between hospital safety culture and adverse events, such as readmissions. Teamwork training, executive walk rounds, and establishing unit-based safety teams are all initiatives associated with improvements in safety culture measurement. This study describes a hospital-wide initiative that significantly improved nearly all safety culture domains in 144 clinical units over a 3-year period. The initiatives implemented included a comprehensive unit-based safety program (CUSP), specific teamwork and communication tools, a series of educational venues, and investments in infrastructure and leadership positions. A past AHRQ WebM&M conversation and perspective discussed important facets of safety culture in health care.
Journal Article > Study
A prospective controlled trial of the effect of a multi-faceted intervention on early recognition and intervention in deteriorating hospital patients.
Mitchell IA, McKay H, Van Leuvan C, et al. Resuscitation. 2010;81:658-666.
An intervention including staff education and implementation of a "track-and-trigger" system improved detection of clinically unstable patients, increased utilization of the rapid response system, and improved some clinical outcomes.
Newspaper/Magazine Article
Beware of basal opioid infusions with PCA therapy.
ISMP Medication Safety Alert! Acute Care Edition. March 12, 2009;14:1-3.
This article provides screening, dosing, and monitoring recommendations for using basal opioid infusions and patient-controlled analgesia (PCA) in patients at risk for developing respiratory depression.
Journal Article > Study
Failure to rescue as a process measure to evaluate fetal safety during labor.
Beaulieu MJ. MCN Am J Matern Child Nurs. 2009;34:18-23.
This study discovers that using selected failure to rescue process measures may help identify areas for improvement in perinatal care.
Book/Report
To Err Is Human—But Don't Expect to Get Paid For It.
ASQ Quarterly Quality Report. Milwaukee, WI: American Society of Quality; October 2008.
This report describes strategies for health care institutions to prevent never events, based on results of a 2008 survey of quality professionals.
Cases & Commentaries
Novel Drug Misuse
- Spotlight Case
- Web M&M
Derek C. Angus, MD, MPH; Eric B. Milbrandt, MD, MPH; July 2004
Following a motor vehicle collision, a patient is mistakenly given drotrecogin alfa (activated) for organ failure not due to sepsis.