U.S. Department of Health & Human Services
PATIENT SAFETY PRIMERS
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Adverse Events in Hospitals: Overview of Key Issues.
Levinson DR. Washington, DC: US Department of Health and Human Services, Office of the Inspector General; December 2008. Report No. OEI-06-07-00470.
Patient Safety Authority Annual Reports.
Harrisburg, PA: Patient Safety Authority; April 2014.
Hospital Reporting Program.
Portland, OR: Oregon Patient Safety Commission.
The partnership with patients: a call to action for leaders.
Denham CR. J Patient Saf. 2011;7:113-121.
Hospital patient safety grades may misrepresent hospital performance.
Hwang W, Derk J, LaClair M, Paz H. J Hosp Med. 2014;9:111-115.
Assessing the state of safe medication practices using the ISMP Medication Safety Self Assessment for Hospitals: 2000 and 2011.
Vaida AJ, Lamis RL, Smetzer JL, Kenward K, Cohen MR. Jt Comm J Qual Patient Saf. 2014;40:51-67.
The next organizational challenge: finding and addressing diagnostic error.
Graber ML, Trowbridge R, Myers JS, Umscheid CA, Strull W, Kanter MH. Jt Comm J Qual Patient Saf. 2014;40:102-110.
Variability in the measurement of hospital-wide mortality rates.
Shahian DM, Wolf RE, Iezzoni LI, Kirle L, Normand SL. N Engl J Med. 2010;363:2530-2539.
Common formats for patient safety data collection and event reporting.
Federal Register. Rockville, MD: Agency for Healthcare Research and Quality. February 18, 2014;79:9214-9215.
Variation in Patient Safety Outcomes and the Importance of Being Informed.
Golden, CO: Healthgrades; 2013.
Assessing and improving quality and safety.
Zeis M. HealthLeaders Media. July/August 2013;16:26-28.
"That was a close call": endorsing a broad definition of near misses in health care.
Marks CM, Kasda E, Paine L, Wu AW. Jt Comm J Qual Patient Saf. 2013;39:475-479.
Slow progress on meeting hospital safety standards: learning from the Leapfrog Group's efforts.
Moran J, Scanlon D. Health Aff (Millwood). 2013;32:27-35.
Inpatient fall prevention programs as a patient safety strategy: a systematic review.
Miake-Lye IM, Hempel S, Ganz DA, Shekelle PG. Ann Intern Med. 2013;158(5 Pt 2):390-396.
National Healthcare Safety Network.
Centers for Disease Control and Prevention.
Influence of state laws mandating reporting of healthcare-associated infections: the case of central line–associated bloodstream infections.
Pakyz AL, Edmond MB. Infect Control Hosp Epidemiol. 2013;34:780-784.
Financial incentives to promote health care quality: the hospital acquired conditions nonpayment policy.
Kavanagh KT. Soc Work Public Health. 2011;26:524-541.
Few Adverse Events in Hospitals Were Reported to State Adverse Event Reporting Systems.
Wright S. Washington, DC: US Department of Health and Human Services, Office of the Inspector General; July 2012. Report No. OEI-06-09-00092.
Adverse Events in Hospitals: Care Study of Incidence Among Medicare Beneficiaries in Two Selected Counties.
Levinson DR. Washington, DC: US Department of Health and Human Services, Office of the Inspector General; December 2008. Report No. OEI-06-08-00220.
NY Medicaid ups the ante: by refusing to pay for 14 'never events,' the nation's biggest Medicaid program could propel other states into action.
DerGurahian J. Mod Healthc. June 16, 2008;38:6.
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