A modified critical-incident analysis technique was used in a retrospective examination of the characteristics of human error and equipment failure in anesthetic ...

Most quality improvement or change management interventions are currently designed intuitively and their results are often disappointing. While improving the effectiveness of interventions requires ...

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A wide variety of research studies suggest that breakdowns in the diagnostic process result in a staggering toll of harm and patient deaths. These include autopsy studies, case reviews, surveys of ...

The clinical microsystem puts medical error and harm reduction into the broader context of safety and quality of care by providing a framework to assess and evaluate ...

To date, improvement in health care has relied mainly on a “top down” programme by programme approach to service change and development. This has spawned a multitude of different and often impressive ...

Correspondence to Professor Bryony Dean Franklin, Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust/UCL School of Pharmacy ...

Background Early detection of subtle changes in a patient's condition is critical to patient safety, but is difficult to achieve, even with electronic medical records. Objectives To identify at-risk ...

1 Department of Pediatrics and Children’s Research Institute, Medical College of Wisconsin in Milwaukee, WI, USA 2 Department of Family and Community Medicine, Medical College of Wisconsin in ...

Quality indicators have been developed throughout Europe primarily for use in hospitals, but also increasingly for primary care. Both development and application are important but there has been less ...

Background Speaking up is important for patient safety, but healthcare professionals often hesitate to voice their concerns. Direct supervisors have an important role in influencing speaking up.

In 2009, the National Patient Safety Foundation’s Lucian Leape Institute (LLI) published a paper identifying five areas of healthcare that require system-level attention and action to advance patient ...