Patient Safety Primers
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Clinical Decision Support Systems

Clinical decision support systems provide information or recommendations to help clinicians make safe and evidence-based decisions. The use and sophistication of these systems have grown markedly over the past decade, due to widespread implementation of electronic health records and advances in clinical informatics.

  Patient Safety Primers

Maternal Safety

Pregnancy, childbirth, and the postpartum year present a complex set of patient safety challenges. Numerous maternal safety initiatives aim to prevent errors and harm, while enhancing readiness to address maternal complications.

  Patient Safety Primers

Burnout

Burnout among health care professionals is highly prevalent. Current work focuses on understanding burnout and clinician well-being as system-level concerns that can influence safety, quality, and organizational performance.

  Patient Safety Primers

Opioid Safety

Over the past decade, the opioid epidemic has taken the lives of tens of thousands of patients. Much of the epidemic can be ascribed to inappropriate prescribing of opioids, despite knowledge of the safety risks they pose. Current efforts to improve opioid safety have primarily focused on reducing opioid prescribing.

  Patient Safety Primers

Medication Administration Errors

Medication administration errors are a persistent safety problem. Increasing the safety of medication administration requires a multifaceted system-level approach that spans all phases of primary, specialty, inpatient, and community-based care.

  Patient Safety Primers

Surgical Site Infections

Infections after surgery are common and frequently lead to hospital readmission and other adverse consequences for patients. Recent programs, including several led by the Agency for Healthcare Research and Quality, have demonstrated how hospitals can successfully prevent these infections.

  Patient Safety Primers

Individual Clinician Performance Issues

Most safety improvement efforts justifiably emphasize system performance. A clinician's individual skill level is an important component of the care delivery system that can influence patient safety—both independently and in conjunction with other system components. Emerging evidence examines assessment, monitoring, and improvement of clinicians' competence as a means of addressing this unique component and ensuring patient safety.

  Patient Safety Primers

Electronic Health Records

The widespread implementation of electronic health records has caused a sea change in health care and in medical practice. The digitization of health care data has had some positive effects on patient safety, but it has also created new patient safety concerns.

  Patient Safety Primers

Patient Safety 101

This Primer provides an overview of the history and current status of the patient safety field and key definitions and concepts. It links to other Patient Safety Primers that discuss the concepts in more detail.

  Patient Safety Primers