Narrow Results Clear All
- Communication Improvement 22
- Culture of Safety 7
- Education and Training 7
- Error Reporting and Analysis 26
- Human Factors Engineering 17
- Legal and Policy Approaches 10
- Logistical Approaches 9
- Quality Improvement Strategies 24
- Specialization of Care 3
- Teamwork 5
- Clinical Information Systems 9
- Device-related Complications 4
- Diagnostic Errors 3
- Discontinuities, Gaps, and Hand-Off Problems 6
- Drug shortages 2
- Fatigue and Sleep Deprivation 2
- Identification Errors 2
- Medical Complications 6
- Medication Errors/Preventable Adverse Drug Events 19
- MRI safety 1
- Nonsurgical Procedural Complications 3
- Surgical Complications 8
- Allied Health Services 1
- Internal Medicine 16
- Surgery 8
- Nursing 2
- Pharmacy 13
- Family Members and Caregivers 1
Health Care Executives and Administrators
- Risk Managers
Health Care Providers
- Nurses 15
- Pharmacists 11
- Physicians 23
- Non-Health Care Professionals 27
- Patients 10
Search results for "Risk Managers"
- Newspaper/Magazine Article
- Risk Managers
Hertz BT. Med Econ. 2015;92:40-44.
Communication and response strategies have been shown to improve how organizations, clinicians, and patients and their families recover from adverse incidents. This news article discusses apology laws which protect certain statements regarding disclosure from being admissible in court and highlights how sensitivity to patients and transparent communication about the failure can be beneficial for both clinicians and patients after a medical error.
Fibuch E, Ahmed A. Physician Exec. Jul-Aug 2014;40:28-32.
Failure mode and effects analysis (FMEA) has been recommended as a method to detect safety hazards and proactively address system flaws. This article reviews the initial purpose of FMEA, provides a breakdown of the process, describes a scoring tool applying Six Sigma designations to determine probability of failure, and discusses how FMEA is used in health care settings.
Beaulieu-Volk D. Med Econ. 2014;91:52-55.
Apology laws have been explored as a tactic to encourage conversations between patients and clinicians involved in errors, and many states have instituted laws that protect certain statements regarding disclosure from being used in court. This article describes efforts to improve error disclosure and transparency, such as policies to disclose, apologize, and offer compensation to patients who experience adverse events.
Joint Commission: The Source. September 2005;3:3-4,11.
This article provides tips for implementing a program to proactively assess risk in hospitals.
Butler M. J AHIMA. March 2015;86:18-23.
Although health information technology presents opportunities to improve patient safety, it can also introduce risks. This commentary discusses how insufficient interoperability, data integrity, training, and protection against copy-and-paste errors can hinder optimal use of electronic health record systems.
Dubeck D. PA-PSRS Patient Saf Advis. September 2014;11:93-101.
Research has documented a substantial learning curve for surgeons as they develop skills to use robotic technologies. Drawing from data submitted to the Pennsylvania Patient Safety Authority, this article analyzes the 722 safety events involving robotic-assisted surgery reported since 2005—approximately 75% of these incidents did not result in harm but 10 patient deaths were recorded—and discusses the challenges introduced as robotic-assisted surgery becomes accepted as standard surgical practice.
Community-based health coaches and care coordinators reduce readmissions using information technology to identify and support at-risk Medicare patients after discharge.
Agency for Healthcare Research and Quality. Health Care Innovations Exchange. July 30, 2014.
This article describes an intervention that trained health coaches to use mobile technology to assess the health status of recently discharged Medicare patients, first during an in-home visit 48 hours after leaving the hospital and then with weekly phone calls over a 3-week period. The program resulted in decreased readmission rates and significant cost savings.
Betbeze P. HealthLeaders Media. May 2, 2014.
Latino RJ. Patient Saf Qual Healthc. September/October 2013;10:32-34,36-37.
This article relates how root cause analysis, typically used after an adverse event, can be utilized as a proactive risk assessment tool to enhance reliability.
Galli BJ, Riebling N, Paraso C, Lehmann G, Yule M. Patient Saf Qual Healthc. July/August 2013;10:36-41.
Talsma J. Drug Topics. June 15, 2013.
Discussing the current state of and efforts to address drug shortages, this news article notes a reduction in chemotherapy delays and reveals persistent barriers to improvement.
Fatal PCA adverse events continue to happen...better patient monitoring is essential to prevent harm.
ISMP Medication Safety Alert! Acute Care Edition. May 30, 2013;18:1-3.
Jain M. Washington Post. May 27, 2013.
Murray C, Rycek W, Johnson D, Sifuentes-Tovar F. Pharm Purch Prod. January 2013;10:12.
This magazine article details how one academic medical center used a collaborative approach and implemented policies and procedures to address perioperative drug shortages.
Joint Commission: The Source. September 2012;10:1-19.
Gallegos A. American Medical News. May 21, 2012.
Welch J. Patient Saf Qual Healthc. May/June 2012;9:26-29,32-33.
ISMP Medication Safety Alert! Acute Care Edition. September 22, 2011;16:1-3.
This newsletter article reveals system failures that contribute to continued drug name confusion, even after authorities have been notified of the problem.
ISMP Medication Safety Alert! Acute Care Edition. August 11, 2011;16:1-3.
This article discusses incidents involving misadministration of IV insulin and makes recommendations to improve safety in delivering this high-alert medication.
ISMP Canada Safety Bulletin. July 31, 2011;11:1-2.
This announcement reports on mistaken intravenous administration of breast milk and provides recommendations to prevent parenteral administration of enteral nutrition.