U.S. Department of Health & Human Services
PATIENT SAFETY PRIMERS
2014 ANNUAL PERSPECTIVES
Device-related Complications (9)
Diagnostic Errors (13)
Identification Errors (16)
Discontinuities, Gaps, and Hand-Off Problems (64)
Fatigue and Sleep Deprivation (7)
Medication Safety (62)
Medical Complications (55)
Nonsurgical Procedural Complications (12)
Surgical Complications (142)
Psychological and Social Complications (43)
Australia and New Zealand (16)
North America (429)
Journal Article (419)
Newspaper/Magazine Article (46)
Special or Theme Issue (28)
Web Resource (10)
Epidemiology of Errors and Adverse Events (56)
Active Errors (54)
Latent Errors (39)
Near Miss (3)
Approach to Improving Safety
Teamwork Training (119)
Allied Health Services (2)
Health Care Providers (404)
Health Care Executives and Administrators (448)
Non-Health Care Professionals (286)
Setting of Care
Psychiatric Facilities (2)
Residential Facilities (5)
Ambulatory Care (32)
Outpatient Surgery (4)
Patient Transport (6)
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Collaboration between pharmacists, physicians and nurse practitioners: a qualitative investigation of working relationships in the inpatient medical setting.
Makowsky MJ, Schindel TJ, Rosenthal M, Campbell K, Tsuyuki RT, Madill HM. J Interprof Care. 2009;23:169-84.
The Team Checkup Tool: evaluating QI team activities and giving feedback to senior leaders.
Lubomski LH, Marsteller JA, Hsu YJ, et al. Jt Comm J Qual Patient Saf. 2008;34:619-623.
Medication Safety Self Assessment for Automated Dispensing Cabinets.
Horsham, PA: Institute for Safe Medication Practices; 2009.
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.
Tennessee Center for Patient Safety.
Structured interdisciplinary rounds in a medical teaching unit: improving patient safety.
O’Leary KJ, Buck R, Fligiel HM, et al. Arch Intern Med. 2011;171:678-684.
Learning accountability for patient outcomes.
Pronovost PJ. JAMA. 2010;304:204-205.
Interdisciplinary teamwork in hospitals: a review and practical recommendations for improvement.
O'Leary KJ, Sehgal NL, Terrell G, Williams MV; High Performance Teams and the Hospital of the Future Project Team. J Hosp Med. 2012;7:48-54.
Operating room briefings: working on the same page.
Makary MA, Holzmueller CG, Thompson D, et al. Jt Comm J Qual Patient Saf. 2006;32:351-355.
A new frontier in patient safety.
McCannon J, Berwick DM. JAMA
BOOSTing Care Transitions Resource Room.
Project BOOST (Better Outcomes for Older adults through Safe Transitions), Society of Hospital Medicine.
The power of collaboration with patient safety programs: building safe passage for patients, nurses, and clinical staff.
Kerfoot KM, Rapala K, Ebright P, Rogers SM. J Nurs Adm. 2006;36:582-588.
How-to Guide: Multidisciplinary Rounds.
Cambridge, MA: Institute for Healthcare Improvement; February 2010.
Practically speaking: rethinking hand hygiene improvement programs in health care settings.
Son C, Chuck T, Childers T, et al. Am J Infect Control. 2011;39:716-724.
Health Care Leader Action Guide to Reduce Avoidable Readmissions.
Osei-Anto A, Joshi M, Audet AJ, Berman A, Jencks SF. New York, NY: The Commonwealth Fund, The John Hartford Foundation, Health Research and Educational Trust; January 25, 2010.
View the world through a different lens: shadowing another provider.
Thompson DA, Holzmueller CG, Lubomski L, Pronovost PJ. Jt Comm J Qual Patient Saf. 2008;34:614-618.
'You talking to me?' Docs and feedback.
Diamond F. Manag Care. July 2013;22:30-32.
Professionalism: a necessary ingredient in a culture of safety.
DuPree E, Anderson R, McEvoy MD, Brodman M. Jt Comm J Qual Patient Saf. 2011;37:447-455.
Integrating CUSP and TRIP to improve patient safety.
Romig M, Goeschel C, Pronovost P, Berenholtz SM. Hosp Pract (Minneap). 2010;38:114-121.
Development of a checklist for documenting team and collaborative behaviors during multidisciplinary bedside rounds.
Henneman EA, Kleppel R, Hinchey KT. J Nurs Adm. 2013;43:280-285.
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