AHRQ Patient Safety Network

PATIENT SAFETY PRIMERS
Safety Culture

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Safety Culture: High-reliability organizations consistently minimize adverse events despite carrying out intrinsically hazardous work... Read Full Glossary Entry >

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Safety Target

•Device-related Complications (32)

•Diagnostic Errors (18)

•Identification Errors (19)

•Discontinuities, Gaps, and Hand-Off Problems (44)

•Fatigue and Sleep Deprivation (6)

•Medication Safety (144)

•Medical Complications (104)

•Nonsurgical Procedural Complications (23)

•Surgical Complications (103)

•Transfusion Complications (2)

•Psychological and Social Complications (39)

Origin/Sponsor

•Africa (1)

•Asia (10)

•Australia and New Zealand (21)

•Central and South America (3)

Resource Types

•Clinical Guideline (1)

•Journal Article (636)

•Legislation/Regulation (12)

•Meeting/Conference (17)

•Newsletter/Journal (1)

•Newspaper/Magazine Article (98)

•Press Release/Announcement (4)

•Special or Theme Issue (34)

•Tools/Toolkit (17)

•Web Resource (31)

•Grant (4)

Error Types

•Epidemiology of Errors and Adverse Events (106)

•Active Errors (70)

•Latent Errors (68)

•Near Miss (16)

Approach to Improving Safety
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Culture of Safety

•Learning Organization (40)

•Red Rules (3)

•Institutional Patient Safety Plan (19)

•Just Culture (30)

Clinical Areas

•Allied Health Services (4)

•Complementary and Alternative Medicine (1)

Target Audience

•Health Care Providers (593)

•Health Care Executives and Administrators (849)

•Non-Health Care Professionals (446)

•Patients (60)

Setting of Care

•Hospitals (573)

•Psychiatric Facilities (4)

•Residential Facilities (24)

•Ambulatory Care (63)

•Outpatient Surgery (5)

•Patient Transport (7)

1 - 20 of 980

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STUDY

The relationship of self-report of quality to practice size and health information technology.

Gorman PN, O'Malley JP, Fagnan LJ. J Am Board Fam Med. 2012;25:614-624.

STUDY

Stopping the error cascade: a report on ameliorators from the ASIPS collaborative.

Parnes B, Fernald D, Quintela J, et al. Qual Saf Health Care. 2007;16:12-16.

BOOK/REPORT

Safety First: Top of Your Board's Agenda: 100 Day Challenge Survey Report.

The Patients Association. Harrow, Middlesex, UK: The Patients Association; June 2009.

STUDY

Patient safety climate in primary care: age matters.

Holden LM, Watts DD, Hinton WP. J Patient Saf. 2009;5:23-28.

STUDY

Measuring perceptions of safety climate in primary care: a cross-sectional study.

de Wet C, Johnson P, Mash R, McConnachie A, Bowie P. J Eval Clin Pract. 2012;18:135-142.

COMMENTARY

Simple strategies to avoid medication errors.

Jenkins RH, Vaida AJ. Fam Pract Manag. 2007;14:41-47.

STUDY

An inpatient fall prevention initiative in a tertiary care hospital.

Weinberg J, Proske D, Szerszen A, et al. Jt Comm J Qual Patient Saf. 2011;37:317-325.

COMMENTARY

Reducing diagnostic error through medical home-based primary care reform.

Singh H, Graber M. JAMA. 2010;304:463-464.

MEASUREMENT TOOL/INDICATOR

Medical Office Survey on Patient Safety Culture.

Rockville, MD: Agency for Healthcare Research and Quality; November 2010.

TOOLKIT

Seven steps to patient safety in general practice.

National Patient Safety Agency. London, England: NHS; 2009.

STUDY

Organizational culture, team climate and diabetes care in small office-based practices.

Bosch M, Dijkstra R, Wensing M, van der Weijden T, Grol R. BMC Health Serv Res. 2008;8:180.

STUDY

A patient safety objective structured clinical examination.

Singh R, Singh A, Fish R, McLean D, Anderson DR, Singh G. J Patient Saf. 2009;5:55-60.

STUDY

The development and psychometric evaluation of a safety climate measure for primary care.

de Wet C, Spence W, Mash R, Johnson P, Bowie P. Qual Saf Health Care. 2010;19:578-584.

BOOK/REPORT

Improving America's Hospitals: The Joint Commission's Annual Report on Quality and Safety 2012.

Oakbrook Terrace, IL: The Joint Commission; September 2012.

BOOK/REPORT

A Guide to Patient Safety in the Medical Practice.

Vance JE. Chicago, IL: American Medical Association; 2008. ISBN: 9781579476748.

BOOK/REPORT

2012 User Comparative Database Report: Medical Office Survey on Patient Safety Culture.

Sorra J, Famolaro T, Dyer N, Smith S, Liu H, Ragan M. Rockville, MD: Agency for Healthcare Research and Quality; May 2012. AHRQ Publication No. 12-0052.

STUDY

Are health professionals' perceptions of patient safety related to figures on safety incidents?

Martijn L, Harmsen M, Gaal S, Mettes D, van Dulmen S, Wensing M. J Eval Clin Pract. 2012 Jul 29; [Epub ahead of print].

STUDY

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.

STUDY

Improving patient safety using the sterile cockpit principle during medication administration: a collaborative, unit-based project.

Fore AM, Sculli GL, Albee D, Neily J. J Nurs Manag. 2013;21:106-111.

NEWSPAPER/MAGAZINE ARTICLE

Medical errors still claiming many lives.

Weise E. USA Today. May 18, 2005.

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