U.S. Department of Health & Human Services
PATIENT SAFETY PRIMERS
2014 ANNUAL PERSPECTIVES
Handoffs and Transitions
Safety and Medical Education
Device-related Complications (164)
Diagnostic Errors (134)
Identification Errors (70)
Discontinuities, Gaps, and Hand-Off Problems (447)
Fatigue and Sleep Deprivation (127)
Medication Safety (861)
Medical Complications (487)
Nonsurgical Procedural Complications (72)
Surgical Complications (340)
Transfusion Complications (17)
Psychological and Social Complications (172)
Australia and New Zealand (80)
Central and South America (4)
North America (3184)
Clinical Guideline (3)
Journal Article (2631)
Newspaper/Magazine Article (521)
Press Release/Announcement (15)
Special or Theme Issue (48)
Web Resource (87)
Epidemiology of Errors and Adverse Events (986)
Active Errors (595)
Latent Errors (590)
Near Miss (51)
Approach to Improving Safety
Quality Improvement Strategies (883)
Legal and Policy Approaches (408)
Error Reporting and Analysis (1053)
Communication Improvement (788)
Human Factors Engineering (409)
Specialization of Care (278)
Logistical Approaches (318)
Culture of Safety (653)
Technologic Approaches (567)
Education and Training (797)
Allied Health Services (6)
Health Care Providers (2173)
Health Care Executives and Administrators (3062)
Non-Health Care Professionals (1688)
Setting of Care
General Hospitals (657)
Children’s Hospitals (86)
Specialty Hospitals (25)
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Creating a culture of safety.
Bush H. Trustee Magazine. July 2013.
Communication-and-resolution programs: the challenges and lessons learned from six early adopters.
Mello MM, Boothman RC, McDonald T, et al. Health Aff (Millwood). 2014;33:20-29.
Duty-hour limits and patient care and resident outcomes: can high-quality studies offer insight into complex relationships?
Philibert I, Nasca T, Brigham T, Shapiro J. Annu Rev Med. 2013;64:467-483.
Minnesota Hospital Association Statewide Project: SAFE from FALLS.
Apold J, Quigley PA. J Nurs Care Qual. 2012;27:299-306.
The impossible workload for doctors in training.
Chen PW. New York Times. April 18, 2013.
Creating a culture of safety in the emergency department: the value of teamwork training.
Jones F, Podila P, Powers C. J Nurs Adm. 2013;43:194-200.
Duty hour reform in a shifting medical landscape.
Jena AB, Prasad V. J Gen Intern Med. 2013;28:1238-1240.
Surgical training, duty-hour restrictions, and implications for meeting the Accreditation Council for Graduate Medical Education core competencies: views of surgical interns compared with program directors.
Antiel RM, Van Arendonk KJ, Reed DA, et al. Arch Surg. 2012;147:536-541.
Tennessee Center for Patient Safety.
Patient safety in the era of the 80-hour workweek.
Shelton J, Kummerow K, Phillips S, et al. J Surg Educ. 2014;71:551-559.
The silent treatment: 'just be quiet about it'.
Smerd J. Workforce Management. November 19, 2007;1, 16-20.
"Second victim" casualties and how physician leaders can help.
MacLeod L. Physician Exec. Jan-Feb 2014;40:8-12.
Instituting a culture of professionalism: the establishment of a Center for Professionalism and Peer Support.
Shapiro J, Whittemore A, Tsen LC. Jt Comm J Qual Patient Saf. 2014;40:168-177.
Resident Duty Hours: Enhancing Sleep, Supervision, and Safety.
Ulmer C, Wolman DM, Johns MME, eds. Committee on Optimizing Graduate Medical Trainee (Resident) Hours and Work Schedule to Improve Patient Safety, Institute of Medicine. Washington, DC: The National Academies Press; 2008. ISBN: 9780309127721.
The new recommendations on duty hours from the ACGME Task Force.
Nasca TJ, Day SH, Amis ES Jr; for ACGME Duty Hours Task Force. N Engl J Med. 2010;363:e3.
SPECIAL OR THEME ISSUE
Front-Line Ownership: Generating a Cure Mindset for Patient Safety.
Kitts J, ed. Healthcare Papers. 2013;13:1-82.
Effect of the 2011 vs 2003 duty hour regulation-compliant models on sleep duration, trainee education, and continuity of patient care among internal medicine house staff: a randomized trial.
Desai SV, Feldman L, Brown L, et al. JAMA Intern Med. 2013;173:649-655.
Using crew resource management and a 'read-and-do checklist' to reduce failure-to-rescue events on a step-down unit.
Young-Xu Y, Fore AM, Metcalf A, Payne K, Neily J, Sculli GL. Am J Nurs. 2013;113:51-57.
Improving safety culture on adult medical units through multidisciplinary teamwork and communication interventions: the TOPS Project.
Blegen MA, Sehgal NL, Alldredge BK, Gearhart S, Auerbach AD, Wachter RM. Qual Saf Health Care. 2010;19:346-350.
The response of the APPD, CoPS and AAP to the Institute of Medicine report on resident duty hours.
Guralnick S, Rushton J, Bale JF Jr, Norwood V, Trimm F, Schumacher D. Pediatrics. 2010;125:786-790.
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