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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/35409/psn-pdf
    September 11, 2009 - The Perruche case and the issue of compensation for the consequences of medical error. … The Perruche case and the issue of compensation for the consequences of medical error. … presents a high-profile French diagnostic error case and draws parallels from its resolution to the … U.S. debate on "just" compensation for patients and families affected by medical error. … psnet.ahrq.gov//#error

  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/36412/psn-pdf
    December 22, 2010 - Ambiguities of chronic illness management and challenges to the medical error paradigm. … Ambiguities of chronic illness management and challenges to the medical error paradigm. … https://psnet.ahrq.gov/issue/ambiguities-chronic-illness-management-and-challenges-medical-error- paradigm … The authors studied provider understanding of error in two diabetes clinics and found that medical … error vocabularies used in acute illness care are mismatched when used regarding chronic illness.

  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/35504/psn-pdf
    February 22, 2010 - Dispensing error rate in a highly automated mail-service pharmacy practice. … Dispensing error rate in a highly automated mail-service pharmacy practice. … authors found an error rate of less than 1 error per 1,000 prescriptions dispensed though a mail- service … pharmacy and conclude that the highly automated process contributed to the low rate of error. … https://psnet.ahrq.gov/issue/dispensing-error-rate-highly-automated-mail-service-pharmacy-practice

  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45595/psn-pdf
    April 19, 2017 - Estimating deaths due to medical error: the ongoing controversy and why it matters. … Estimating deaths due to medical error: the ongoing controversy and why it matters. … https://psnet.ahrq.gov/issue/estimating-deaths-due-medical-error-ongoing-controversy-and-why-it-matters … A recent article asserted that medical error is the third leading cause of death in the United States … The authors note that this estimate was generated by simply combining medical error rates from prior

  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/39863/psn-pdf
    January 04, 2011 - Improving the quality of drug error reporting. January 4, 2011 Armitage G, Newell R, Wright J. … Improving the quality of drug error reporting. … The authors make suggestions, based on error theory, to improve reporting systems to enhance the ease … of reporting and the quality of error reports. … https://psnet.ahrq.gov/issue/human-error

  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/34649/psn-pdf
    June 11, 2014 - On error management: lessons from aviation. June 11, 2014 Helmreich RL. … On error management: lessons from aviation. BMJ . 2000;320(7237):781-785. … https://psnet.ahrq.gov/issue/error-management-lessons-aviation In this perspective, the author draws … Helmreich provides background on the methods and use of error data in aviation, and how those processes … importance of reliable data on error, both of which are necessary if providers are to systematically

  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41704/psn-pdf
    September 26, 2012 - The role of surgeon error in withdrawal of postoperative life support. … The role of surgeon error in withdrawal of postoperative life support. … https://psnet.ahrq.gov/issue/role-surgeon-error-withdrawal-postoperative-life-support Through the use … https://psnet.ahrq.gov/issue/role-surgeon-error-withdrawal-postoperative-life-support https://psnet.ahrq.gov … /issue/nature-human-error-implications-surgical-practice https://psnet.ahrq.gov/issue/nature-human-error-implications-surgical-practice

  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44143/psn-pdf
    April 15, 2016 - "First, know thyself": cognition and error in medicine. … "First, know thyself": cognition and error in medicine. … https://psnet.ahrq.gov/issue/first-know-thyself-cognition-and-error-medicine Cognition has been recognized … as a human factor that can contribute to medical error. … https://psnet.ahrq.gov/issue/first-know-thyself-cognition-and-error-medicine https://psnet.ahrq.gov/issue

  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/40129/psn-pdf
    January 12, 2011 - Medical error disclosure training: evidence for values- based ethical environments. … Medical Error Disclosure Training: Evidence for Values-Based Ethical Environments. … https://psnet.ahrq.gov/issue/medical-error-disclosure-training-evidence-values-based-ethical-environments … inhibit clinicians from disclosing medical errors to patients, ranging from inadequate training in error … Based on survey data, the authors argue that formal error disclosure training programs for staff not

  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/34789/psn-pdf
    December 23, 2008 - Medication error prevention by pharmacists. … Medication error prevention by pharmacists. Am J Hosp Pharm. 1988;45(9):1902-3. … https://psnet.ahrq.gov/issue/medication-error-prevention-pharmacists This study investigated the impact … Physicians confirmed an error in more than 90% of orders questioned by pharmacists. … https://psnet.ahrq.gov/issue/medication-error-prevention-pharmacists

  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44262/psn-pdf
    November 17, 2016 - The challenges in defining and measuring diagnostic error. November 17, 2016 Zwaan L, Singh H. … The challenges in defining and measuring diagnostic error. … https://psnet.ahrq.gov/issue/challenges-defining-and-measuring-diagnostic-error Although diagnostic … error is gaining attention, there is still lack of agreement on how to define and measure it. … https://psnet.ahrq.gov/issue/challenges-defining-and-measuring-diagnostic-error https://psnet.ahrq.gov

  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/35797/psn-pdf
    May 24, 2010 - Medical error identification, disclosure, and reporting: do emergency medicine provider groups differ … Medical error identification, disclosure, and reporting: do emergency medicine provider groups differ … https://psnet.ahrq.gov/issue/medical-error-identification-disclosure-and-reporting-do-emergency-medicine … investigators had physicians, nurses, and emergency medical technicians review 10 vignettes illustrating error … They found variances between the three groups in identification of error and the likelihood of disclosure

  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41279/psn-pdf
    September 19, 2016 - Medical error, incident investigation and the second victim: doing better but feeling worse? … Medical error, incident investigation and the second victim: doing better but feeling worse? … https://psnet.ahrq.gov/issue/medical-error-incident-investigation-and-second-victim-doing-better-feeling … physicians-in-training and provides tactics to improve support for clinicians affected by medical error … https://psnet.ahrq.gov/issue/medical-error-second-victim

  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/36362/psn-pdf
    October 27, 2010 - Effectiveness of Toyota process redesign in reducing thyroid gland fine-needle aspiration error. … Effectiveness of Toyota process redesign in reducing thyroid gland fine-needle aspiration error. … psnet.ahrq.gov/issue/effectiveness-toyota-process-redesign-reducing-thyroid-gland-fine-needle- aspiration-error … The authors compared the frequency of diagnostic error for a thyroid aspiration service before and … after applying error reduction strategies.

  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/36738/psn-pdf
    August 02, 2011 - Barriers and motivators for making error reports from family medicine offices: a report from the American … Barriers and motivators for making error reports from family medicine offices: a report from the American … https://psnet.ahrq.gov/issue/barriers-and-motivators-making-error-reports-family-medicine-offices-report … - american-academy While incident reporting is an accepted method of error detection in the inpatient … , researchers conducted focus groups with physicians, nurses, and office staff around the issue of error

  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47311/psn-pdf
    October 10, 2018 - Cognitive error in an academic emergency department. … Cognitive error in an academic emergency department. … https://psnet.ahrq.gov/issue/cognitive-error-academic-emergency-department In 2015, the National Academy … of Medicine called for renewed focus on reducing diagnostic error. … https://psnet.ahrq.gov/issue/cognitive-error-academic-emergency-department https://psnet.ahrq.gov/issue

  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44900/psn-pdf
    April 22, 2016 - When a surgical colleague makes an error. April 22, 2016 Antiel RM, Blinman TA, Rentea RM, et al. … When a Surgical Colleague Makes an Error. … https://psnet.ahrq.gov/issue/when-surgical-colleague-makes-error Physicians have become more comfortable … recognizing and disclosing errors to patients in the past few decades, but speaking up about a peer's error … https://psnet.ahrq.gov/web-mm/duty-disclose-someone-elses-error

  18. Drug related admissions to a cardiology department; frequency and avoidability. | PSNet

    psnet.ahrq.gov/issue/drug-related-admissions-cardiology-department-frequency-and-avoidability
    August 20, 2018 - June 16, 2019 ISMP medication error report analysis. … June 16, 2019 ISMP medication error report analysis. … June 16, 2019 ISMP medication error report analysis. … June 16, 2019 ISMP medication error report analysis. … June 16, 2019 ISMP medication error report analysis.

  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46330/psn-pdf
    September 24, 2017 - Systemic error in radiology. September 24, 2017 Waite S, Scott JM, Legasto A, et al. … Systemic Error in Radiology. AJR Am J Roentgenol. 2017;209(3):629- 639. doi:10.2214/AJR.16.17719. … https://psnet.ahrq.gov/issue/systemic-error-radiology Radiology interpretation errors can contribute … to diagnostic error. … fool-me-twice-delayed-diagnoses-radiology-emphasis-perpetuated-errors https://psnet.ahrq.gov/issue/understanding-and-confronting-our-mistakes-epidemiology-error-radiology-and-strategies-error

  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41392/psn-pdf
    July 02, 2014 - Exploring error in team-based acute care scenarios: an observational study from the United Kingdom. … Exploring error in team-based acute care scenarios: an observational study from the United kingdom. … https://psnet.ahrq.gov/issue/exploring-error-team-based-acute-care-scenarios-observational-study-united … - kingdom This study used an error-modeling system initially devised by Dr. … https://psnet.ahrq.gov/issue/human-error
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