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digital.ahrq.gov/sites/default/files/docs/citation/r01hs024713-adelman-final-report-2023.pdf
January 01, 2023 - Since all patients are at risk for an order error, all patients for whom at least 1 order was placed … the
order session, rather than each order, represents an independent opportunity for a wrong-patient error … For all analyses, the effect was estimated
using odds ratio (OR), standard error (SE), and Wald test … The impact of
computerized physician order entry on medication error prevention.
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digital.ahrq.gov/ahrq-funded-projects/health-information-technology-and-improving-medication-use/annual-summary/2011
January 01, 2011 - Relatively low error rates were found, both during implementation and during sustained use among practices
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digital.ahrq.gov/research-method/delphi-method
January 01, 2023 - Delphi Method
Preventing Perioperative Medication Errors and Adverse Drug Events Through the Use of Clinical Decision Support - Final Report
Citation
Nanji K. Preventing Perioperative Medication Errors and Adverse Drug Events Through the Use of Clinical Decision Support - Fina…
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digital.ahrq.gov/research-method/chart-review
January 01, 2023 - Chart Review
The impact of electronic communication of medication discontinuation (CancelRx) on medication safety: A pilot study.
Citation
Pitts SI, Yang Y, Woodroof T, Mollenkopf NL, Wang NY, Thomas BA, Chen AR. The impact of electronic communication of medication discontinua…
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digital.ahrq.gov/health-it-tools-and-resources/workflow-assessment-health-it-toolkit/experience-research/steele-aw-et
January 01, 2023 - Steele AW et al. 2005 "The effect of automated alerts on provider ordering behavior in an outpatient setting."
Reference
Steele AW, Eisert S, Witter J, et al. The effect of automated alerts on provider ordering behavior in an outpatient setting. PLoS Med 2005;2(9):864-870.
[Link]
Abstract
"B…
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digital.ahrq.gov/ahrq-funded-projects/advancing-health-information-exchange-hie-during-inter-hospital-transfer-iht
January 01, 2024 - Advancing Health Information Exchange During Inter-Hospital Transfer to Improve Patient Outcomes
Project Description
Publications
Research Story
An enhanced health information exchange platform that improves workflow, interoperability, and visualization of data for …
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digital.ahrq.gov/ahrq-funded-projects/health-information-technology-and-improving-medication-use
January 01, 2023 - safety threats early after transitioning to a new e-Prescribing system, and leads to sustained low error … Record , Electronic Prescribing , Health Information Exchange , Voice Recognition
Medical error … Medical error: a 60-year-old man with delayed care for a renal mass.
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digital.ahrq.gov/principal-investigator/pitts-samantha
July 24, 2024 - Pitts, Samantha
Medication Without Harm - How Digital Healthcare Tools Can Support Providers and Improve Patient Safety
Event Date
July 24, 2024 - 2:30pm
- July 24, 2024 - 4:00pm
Medication errors are a leading cause of injury and avoidable harm in healthcare, with an…
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digital.ahrq.gov/2018-year-review/research-spotlights/improving-ehr-design-increases-patient-safety-especially-children
January 01, 2018 - Improving EHR Design Increases Patient Safety—Especially for Children
Poor EHR design can harm patients.
Dr. Raj Ratwani and his research team identified pervasive problems with EHR systems that regularly lead to patient safety errors and other issues, regardless of vendor. “If we don’t focus on EHR technolog…
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digital.ahrq.gov/health-it-tools-and-resources/workflow-assessment-health-it-toolkit/experience/zind-b-2009-response
January 01, 2009 - There is not enough flexibility with suspensions and so sometimes the prescription is in error.
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digital.ahrq.gov/sites/default/files/docs/publication/Parisetal_HFES2008.pdf
January 01, 2008 - research
team reviewed all medication safety events to adjudicate the
occurrence of a medication error … Pharmacist clarification of
an ordering error and pharmacist consults on the dose to be
administered
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digital.ahrq.gov/2018-year-review/research-summary/supports-clinicians-work
January 01, 2018 - Design is the study of human behavior, the environment, and technology with the goals of reducing human error
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digital.ahrq.gov/ahrq-funded-projects/opportunistic-decision-making-information-needs-and-workflow-emergency-care/annual-summary/2012
January 01, 2012 - decisionmaking in the ED and develop interventions to reduce cognitive burden, improve communication, and reduce error
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digital.ahrq.gov/sites/default/files/docs/citation/r01hs023694-schiff-final-report-2018.pdf
January 01, 2018 - test the hypothesis that this new system will demonstrate
significant improvements in ordering speed, error … Medication
Safety)1,2 and the other by the National Patient Safety Foundation (MedMarx CPOE Medical Error … For example, to attempt to
provoke a common LASA error-mixing hydroxyzine and hydralazine, one test … Usability Metrics/Analysis
We recorded the medications ordered with each task and calculated an error … vendor 2 were classified as
inappropriate for the patient and indication. <1% of orders had an LASA error
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digital.ahrq.gov/decisionmaker-brief-computerized-provider-order-entry-cpoe
January 01, 2023 - This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: https://digital.ahrq.gov/contact-us . Let us know th…
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digital.ahrq.gov/sites/default/files/docs/publication/r01hs015054-keenan-final-report-2008.pdf
January 01, 2008 - A safety survey was instituted at the go-live as a means of anonymously
monitoring error rates in our … Respondents were allowed
to pick more than one of the error categories but only one response was allowed … Additionally, if an error option was checked,
the RN could provide more details by selecting “willing … Though there were no significant differences in error rates
across time, the trend was downward.1.688% … Though reported error rates were very
small and not significantly different over time and across units
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digital.ahrq.gov/sites/default/files/docs/publication/r18hs017029-kaushal-final-report-2011.pdf
January 01, 2011 - This included review of error definitions and
review of test and actual cases. … Methodology
included error classifications and identification of ADE trigger drugs. … Excluding the most common type of error, inappropriate
abbreviation errors, we found that error rates
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digital.ahrq.gov/sites/default/files/docs/citation/r21hs022670-patel-final-report-2019.pdf
January 01, 2019 - Team communication also allowed for
any error checks, making sure safety was not compromised. … There is less chance of an error
being caught, given that there are no team safety checks, which may … technology in the ED to increase efficiency without compromising safety (within a
given margin of error … How can we offset this issue of “error check”? … ISMMS’ team-based model of error detection and
correction may outweigh the capacity for recovery of
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digital.ahrq.gov/sites/default/files/docs/page/johnson-success-story.pdf
June 16, 2021 - STEPStools not only reduces the margin of error for
dosing, its drop-down dosage menus can save provid
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digital.ahrq.gov/sites/default/files/docs/survey/rwhc-thqit-readiness-assessment.pdf
June 16, 2021 - percent of correctly processed claims, the percent of
prescriptions written by physicians containing an error … clinical staff-
hospital administration)
More tightly link physicians to community
Risk management (error