U.S. Department of Health & Human Services
PATIENT SAFETY PRIMERS
2014 ANNUAL PERSPECTIVES
Device-related Complications (17)
Identification Errors (2)
Discontinuities, Gaps, and Hand-Off Problems (33)
Medication Safety (379)
Medical Complications (8)
Nonsurgical Procedural Complications (1)
Surgical Complications (3)
Australia and New Zealand (9)
Central and South America (2)
North America (311)
Clinical Guideline (1)
Journal Article (281)
Newspaper/Magazine Article (69)
Press Release/Announcement (2)
Special or Theme Issue (1)
Web Resource (3)
Epidemiology of Errors and Adverse Events (141)
Active Errors (89)
Latent Errors (29)
Near Miss (8)
Approach to Improving Safety
Quality Improvement Strategies (67)
Legal and Policy Approaches (19)
Error Reporting and Analysis (72)
Communication Improvement (88)
Human Factors Engineering (73)
Specialization of Care (91)
Logistical Approaches (22)
Culture of Safety (16)
Technologic Approaches (192)
Education and Training (49)
Health Care Providers (298)
Health Care Executives and Administrators (282)
Non-Health Care Professionals (115)
Setting of Care
Psychiatric Facilities (1)
Ambulatory Care (8)
Outpatient Surgery (2)
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Early cost and safety benefits of an inpatient electronic health record.
Zlabek JA, Wickus JW, Mathiason MA. J Am Med Inform Assoc. 2011;18:169-172.
Errors associated with medications removed from automated dispensing machines using override functions.
Kester K, Baxter J, Freudenthal K. Hosp Pharm. 2006;41:535-537.
For all the right reasons.
Hagland M. Healthc Informatics. 2009;26:40-44.
Effective use of medication-related decision support in CPOE.
Metzger JB, Welebob E, Turisco F, Classen DC. Patient Saf Qual Healthc. Sept/Oct 2008;5:16-24.
Impact of a pharmacist on medication reconciliation on patient admission to a Veterans Affairs Medical Center.
Strunk LB, Matson AW, Steinke D. Hosp Pharm. 2008;43:643-649.
Improvement of medication event interventions through use of an electronic database.
Merandi J, Morvay S, Lewe D, et al. Am J Health Syst Pharm. 2013;70:1708-1714.
The use of a CPOE log for the analysis of physicians' behavior when responding to drug-duplication reminders.
Long A-J, Chang P, Li Y-C, Chiu W-T. Int J Med Inform. 2008;77:499-506.
Effect of bar-code technology on the safety of medication administration.
Poon EG, Keohane CA, Yoon CS, et al. N Engl J Med. 2010;362:1698-1707.
Evaluating the medication process in the context of CPOE use: the significance of working around the system.
Niazkhani Z, Pirnejad H, van der Sijs H, Aarts J. Int J Med Inform. 2011;80:490-506.
Does user-centred design affect the efficiency, usability and safety of CPOE order sets?
Chan J, Shojania KG, Easty AC, Etchells EE. J Am Med Inform Assoc. 2011;18:276-281.
Decrease in hospital-wide mortality rate after implementation of a commercially sold computerized physician order entry system.
Longhurst CA, Parast L, Sandborg CI, et al. Pediatrics. 2010;126:14-21.
Description of inpatient medication management using cognitive work analysis.
Pingenot AA, Shanteau J, Sengstacke DN. Comput Inform Nurs. 2009;27:379-392.
CPOE in Iran—a viable prospect? Physicians' opinions on using CPOE in an Iranian teaching hospital.
Kazemi A, Ellenius J, Tofighi S, Salehi A, Eghbalian F, Fors UG. Int J Med Inform. 2008;78:199-207.
Health literacy and medication understanding among hospitalized adults.
Marvanova M, Roumie CL, Eden SK, Cawthon C, Schnipper JL, Kripalani S. J Hosp Med. 2011;6:488-493.
The unintended consequences of computerized provider order entry: findings from a mixed methods exploration.
Ash JS, Sittig DF, Dykstra R, Campbell E, Guappone K. Int J Med Inform. 2009;78(suppl 1): S69-S76.
Implementing online medication reconciliation at a large academic medical center.
Bails D, Clayton K, Roy K, Cantor MN. Jt Comm J Qual Patient Saf. 2008;34:499-508.
Impact of electronic prescribing in a hospital setting: a process-focused evaluation.
Cunningham TR, Geller ES, Clarke SW. Int J Med Inform. 2008;77:546-554.
Evaluating clinical decision support systems: monitoring CPOE order check override rates in the Department of Veterans Affairs' computerized patient record system.
Lin C-P, Payne TH, Nichol WP, et al. J Am Med Inform Assoc. 2008;15:620-626.
Can an electronic prescribing system detect doctors who are more likely to make a serious prescribing error?
Coleman JJ, Hemming K, Nightingale PG, et al. J R Soc Med. 2011;104:208-218.
Drug-related problems in medical wards with a computerized physician order entry system.
Bedouch P, Allenet B, Grass A, et al. J Clin Pharm Ther. 2009;34:187-195.
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