AHRQ Patient Safety Network

The Collection > Quality Improvement Strategies

PATIENT SAFETY PRIMERS
Detection of Safety Hazards

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Safety Target

•Device-related Complications (71)

•Diagnostic Errors (74)

•Identification Errors (51)

•Discontinuities, Gaps, and Hand-Off Problems (154)

•Fatigue and Sleep Deprivation (12)

•Medication Safety (407)

•Medical Complications (192)

•Nonsurgical Procedural Complications (40)

•Surgical Complications (196)

•Transfusion Complications (8)

•Psychological and Social Complications (31)

Origin/Sponsor

•Asia (11)

•Australia and New Zealand (32)

•Central and South America (1)

•Europe (145)

•North America (1170)

Resource Types

•Clinical Guideline (7)

•Journal Article (896)

•Legislation/Regulation (36)

•Meeting/Conference (13)

•Newsletter/Journal (4)

•Newspaper/Magazine Article (170)

•Press Release/Announcement (13)

•Special or Theme Issue (43)

•Tools/Toolkit (26)

•Web Resource (45)

•Grant (4)

Error Types

•Epidemiology of Errors and Adverse Events (199)

•Active Errors (183)

•Latent Errors (76)

•Near Miss (17)

Approach to Improving Safety
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Quality Improvement Strategies

•Audit and Feedback (185)

•Benchmarking (116)

•Continuous Quality Improvement (33)

•Critical Pathways (60)

•Practice Guidelines (273)

•Reminders (44)

•Patient Self-Management (84)

•Six Sigma (13)

Clinical Areas

•Allied Health Services (5)

Target Audience

•Health Care Providers (919)

•Health Care Executives and Administrators (1155)

•Non-Health Care Professionals (430)

•Patients (99)

Setting of Care

•Hospitals (816)

•Psychiatric Facilities (7)

•Residential Facilities (23)

•Ambulatory Care (121)

•Outpatient Surgery (26)

•Patient Transport (10)

1 - 20 of 1400

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NEWSPAPER/MAGAZINE ARTICLE

Safety in ASCs: putting patients first.

Dix K. Today's Surgicenter. December 1, 2006.

COMMENTARY

Patient safety in the office-based setting.

Horton JB, Reece EM, Broughton G 2nd, Janis JE, Thornton JF, Rohrich RJ. Plast Reconstr Surg. 2006;117:61e-80e.

NEWSPAPER/MAGAZINE ARTICLE

Surgical errors: new products, protocols help slash the risks.

Williamson JE. Healthcare Purchasing News. January 2006;30:22-25.

COMMENTARY

Right? Left? Neither!

Howell EA, Chassin MR. AHRQ WebM&M [serial online]. May 2006.

SPECIAL OR THEME ISSUE

Patient Safety and the Invitational Conference on Contemporary Surgical Quality, Safety and Transparency.

Amer Surg. 2006;72:985-1149

COMMENTARY

The perianesthesia nurse's role in the prevention of opioid-related sentinel events.

Pasero C. J Perianesth Nurs. 2013;28:31-37.

BOOK/REPORT

Improving America's Hospitals: The Joint Commission's Report on Quality and Safety 2008.

Oakbrook Terrace, IL: The Joint Commission; November 2008.

NEWSPAPER/MAGAZINE ARTICLE

What pilots can teach hospitals about patient safety.

Murphy K. New York Times. October 31, 2006:F5.

SPECIAL OR THEME ISSUE

Patient Safety.

Plastic Surg Nurs. 2006;26:111-170.

SPECIAL OR THEME ISSUE

Quality of Anesthesia Care.

Neuman MD, Martinez EA, eds. Anesthesiol Clin. 2011;29:1-178.

ORGANIZATIONAL POLICY/GUIDELINES

AORN Guidance Statement: Safe Medication Practices in Perioperative Settings Across the Life Span.

AORN J. 2006;84:276-278, 280-283.

COMMENTARY

A comprehensive collaborative patient safety residency curriculum to address the ACGME core competencies.

Singh R, Naughton B, Taylor JS, et al. Med Educ. 2005;39:1195-1204.

BOOK/REPORT

Inspiring Ideas and Celebrating Successes: A Guidebook to Leading Patient Safety Practices in Ontario Hospitals.

OHA Patient Safety Support Service. Toronto, Ontario, Canada: Ontario Hospital Association; 2006.

STUDY

A facilitated survey instrument captures significantly more anesthesia events than does traditional voluntary event reporting.

Oken A, Rasmussen MD, Slagle JM, et al. Anesthesiology. 2007;107:909-922.

REVIEW

Coordinating care across diseases, settings, and clinicians: a key role for the generalist in practice.

Stille CJ, Jerant A, Bell D, Meltzer D, Elmore JG. Ann Intern Med. 2005;142:700-708.

COMMENTARY

The Wild West: Patient Safety in Office-Based Anesthesia

Kaushal R, Upadhyayula S, Gaba DM, Leape LL. AHRQ WebM&M [serial online]. May 2006.

AUDIOVISUAL

Chasing Zero: Winning the War on Healthcare Harm.

Austin, TX: Texas Medical Institute for Technology and the Quaid Foundation; 2010.

STUDY

The effect of executive walk rounds on nurse safety climate attitudes: a randomized trial of clinical units.

Thomas EJ, Sexton JB, Neilands TB, Frankel A, Helmreich RL. BMC Health Serv Res. 2005;5:28.

STUDY

Adopting National Quality Forum medication safe practices: progress and barriers to hospital implementation.

Rask K, Culler S, Scott T, et al. J Hosp Med. 2007;2:212-218.

STUDY

Challenges in posthospital care: nurses as coaches for medication management.

Costa LL, Poe SS, Lee MC. J Nurs Care Qual. 2011;26:243-251.

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