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61. A System to Describe and Reduce Medical Errors in Primary Care (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol1/Advances-Kaprielian_9.pdf
    January 01, 2007 - Errors in prescribing medication. 2. … Errors related to filing systems. 4. Errors in dispensing medications. 5. … Errors in responding to abnormal laboratory test results.8 Studies have found that most errors in … The most common issues were errors in reporting results to providers and errors in responding to results … A preliminary taxonomy of medical errors in family practice.

62. Final Progress Report: Show Your Work: Do Prescription Annotations Impact Near-miss Medication Errors? (pdf file)
    www.ahrq.gov/sites/default/files/2024-01/johnson-baughman-report.pdf
    January 01, 2024 - Final Progress Report: Show Your Work: Do Prescription Annotations Impact Near-miss Medication Errors … Show Your Work: Do Prescription Annotations Impact Near-miss Medication Errors? Kevin B. … Those errors include cognitive errors (wrong medication, no medication for an appropriate indication … , wrong patient); prescribing errors (wrong formulation, wrong dose, wrong route, wrong frequency, errors … Committee on Identifying and Preventing Medication Errors. Preventing medication errors.

63. References | Agency for Healthcare Research and Quality
    www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-current-state-references.html
    January 01, 2024 - Types and origins of diagnostic errors in primary care settings. … A critical appraisal of AHRQ’’s ““diagnostic errors”“ report. … Finding diagnostic errors in children admitted to the PICU. … Strategies to reduce diagnostic errors: a systematic review. … Reducing diagnostic errors in primary care.

64. Introduction | Agency for Healthcare Research and Quality
    www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-patient-role1.html
    September 01, 2024 - And they are the ones who must live with the results of diagnostic errors. … they can have both a broader and a more specific point of view on what is needed to reduce diagnostic errors … Identification and characterization of diagnostic errors have predominantly used a variety of sources … Emerging techniques. to identify and mitigate diagnostic errors using triggers in the medical record. … As noted in a recent AHRQ report, studies show that diagnostic errors result from a confluence of factors

65. Final Progress Report: Automated Lab Test Followup To Reduce Medical Errors (pdf file)
    www.ahrq.gov/sites/default/files/2025-03/greenes-report.pdf
    January 01, 2025 - Automated Lab Test Follow-up to Reduce Medical Errors Principal Investigator: David S. … Application of medical errors theory to the problem of late-arriving laboratory data: Medical errors … theory distinguishes between latent errors and active errors. … of active errors by individual workers. … Although the active errors are most visible to outside observers, it is really the latent errors that

66. Final Progress Report: Automated Image Analysis for the Prevention of Radiotherapy Delivery Errors (pdf file)
    www.ahrq.gov/sites/default/files/2024-11/lamb-report.pdf
    January 01, 2024 - Final Progress Report: Automated Image Analysis for the Prevention of Radiotherapy Delivery Errors … Final Report: Automated Image Analysis for the Prevention of Radiotherapy Delivery Errors … Of a total of 5 errors identified, 2 were previously unreported. … exist that limit reporting of known errors. … Thus, if treatment errors are detected after a single fraction, more significant systematic errors can

67. Patient Safety | Agency for Healthcare Research and Quality
    www.ahrq.gov/ncepcr/reports/2024-annual-report/recent-grants-patient-safety.html
    May 01, 2024 - Teams Prioritize and Manage Vulnerable Patients S2: Using EHR-Based Simulations to Reduce Diagnostic Errors … References Patient safety aims to prevent and reduce the potential risks, errors, and … provision of health care. 55 Threats to patient safety in primary care settings include diagnostic errors … or delays; medication errors, including inappropriate or overprescribing; breakdowns in communication … grants funded in FYs 2021 and 2022 look at issues of patient safety, including reducing diagnostic errors

68. Establishing a Culture of Patient Safety Through a Low-tech Approach to Reducing Medication Errors (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol3/Shaha.pdf
    May 01, 2004 - Why medication errors? … : • Interception of prescribing errors improved 30.9 percent … • Prescribing errors themselves were reduced by 31.6 percent. … Relationship between medication errors and adverse drug events. … Draft guidelines for preventing medication errors in pediatrics.

69. References | Agency for Healthcare Research and Quality
    www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-pediatric-safety-refs.html
    August 01, 2023 - Errors of diagnosis in pediatric practice: a multisite survey. Pediatrics . … Overcoming Diagnostic Errors in Medical Practice. J Pediatr . … The potential for errors in children with special health care needs. … Medication errors in the homes of children with chronic conditions. … Diagnostic Errors and Diagnostic Calibration. JAMA .

70. Conclusion | Agency for Healthcare Research and Quality
    www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-older-adults4.html
    September 01, 2024 - Despite increased attention to the burden and causes of diagnostic errors among older adults, implementation … and testing of interventions to reduce diagnostic errors has been lagging. … geriatrics for healthcare professionals and researchers, funding research that focuses on diagnostic errors

71. Preventing Medication Errors Among Children With Chronic Conditions in Outpatient and Home Settings | Agency for Healthcare Research and Quality
    www.ahrq.gov/funding/grantee-profiles/grtprofile-walsh.html
    October 01, 2023 - Grantee Profile Preventing Medication Errors Among Children With Chronic Conditions in Outpatient … Walsh is working to prevent medication errors and adverse drug events among children, particularly those … Medication errors that occur outside the hospital can be lethal for children with chronic conditions, … Children with cancer are at particularly high risk for errors due to weight-based dosing calculations … With a continued focus on reducing medication errors in children with chronic conditions, Dr.

72. Conclusion | Agency for Healthcare Research and Quality
    www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-dx-stewardship9.html
    August 01, 2024 - Diagnostic stewardship represents a partnership between clinicians and diagnostic testing experts to reduce errors … be important to connect the intermediate outcomes of diagnostic stewardship, such as fewer ordering errors … and improved communication between clinicians and laboratory personnel, to reductions in diagnostic errors

73. Diagnostic Safety as a Challenge for Healthcare Leadership | Agency for Healthcare Research and Quality
    www.ahrq.gov/diagnostic-safety/resources/issue-briefs/leadership-1.html
    June 01, 2021 - This care includes addressing both established and emerging safety concerns, such as diagnostic errors … Errors involve common conditions and nearly half of them have potential for patient harm. … The nature and magnitude of diagnostic errors and their tangible associated costs are drawing the attention … healthcare-associated infections, or HAIs), 3 in addition to the moral imperative for preventing diagnostic errors … with effort, effective strategies, and input from others. 7 Confronting the challenge of diagnostic errors

74. Special Considerations for Measurement of Diagnostic Safety | Agency for Healthcare Research and Quality
    www.ahrq.gov/diagnostic-safety/resources/issue-briefs/state-of-science-2.html
    June 01, 2020 - Overcoming Barriers and Taking Next Steps Conclusion References Defining Diagnostic Errors … Advancing the science of measurement of diagnostic errors in healthcare: the Safer Dx framework. … Valid and reliable measurement of diagnostic errors results in collective mindfulness, organizational … The Safer Dx framework underscores that diagnostic errors can emerge across multiple episodes of care … Unknown scope and frequency of errors.

75. AHRQ Expands Its Repertoire to Eliminate Diagnostic Errors | Agency for Healthcare Research and Quality
    www.ahrq.gov/news/blog/ahrqviews/eliminate-diagnostic-errors.html
    August 01, 2022 - AHRQ Views: Blog posts from AHRQ leaders AHRQ Expands Its Repertoire to Eliminate Diagnostic Errors … However, reliable estimates indicate that diagnostic errors nevertheless remain far too common. … An estimated 250,000 diagnostic errors occur annually in U.S. hospitals. … Regardless of the setting, diagnostic errors can derail proper care and may lead to severe injury or … Measure Dx – is an essential addition to the inventory of resources that can help prevent diagnostic errors

76. Final Progress Report: Pediatric Medication Safety: Analyses from the MEDMARX Medication Error Reporting System (pdf file)
    www.ahrq.gov/sites/default/files/2024-01/bundy-report.pdf
    January 01, 2024 - errors that are harmful. … , not in all errors that occurred. … Outpatient errors involved significantly more dispensing errors (p < 0.001) and more errors due to … Family notification of medication errors was reported in only 12% of errors. … errors; most of these errors involved patients <6 months of age.

77. Patient Experience as a Source for Understanding the Origins, Impact, and Remediation of Diagnostic Errors, Volume 1: Why Patient Narratives Matter (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/topics/dxsafety-patient-experience-vol1.pdf
    July 01, 2023 - Patient Experience as a Source for Understanding the Origins, Impact, and Remediation of Diagnostic Errors … Patient Experience as a Source for Understanding the Origins, Impact, and Remediation of Diagnostic Errors … Patient Experience as a Source for Understanding the Origins, Impact, and Remediation of Diagnostic Errors … Types and origins of diagnostic errors in primary care settings. … Americans’ Experiences With Medical Errors and Views on Patient Safety.

78. Physician-Reported Adverse Events and Medical Errors in Obstetrics and Gynecology (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol1/Advances-November_45.pdf
    January 01, 2007 - Physician-Reported Adverse Events and Medical Errors in Obstetrics and Gynecology Physician-Reported … Adverse Events and Medical Errors in Obstetrics and Gynecology Martin November, MD, MBA; Lucy Chie … They are intimately aware of impediments to care or errors in management. … Although serious AEs are infrequently related to medical errors, relatively little is known about errors … Detection of errors by attending physicians on a general medicine service.

79. Advances in Patient Safety | Agency for Healthcare Research and Quality
    www.ahrq.gov/patient-safety/reports/advances/index.html
    July 01, 2022 - Implementation describes what federally funded programs have accomplished in understanding medical errors … Joel Bartfield An Analysis of Nurses' Cognitive Work: A New Perspective for Understanding Medical Errors … Moores Quantitative and Qualitative Analysis of Medication Errors: The New York Experience (   PDF … Wasserman, Lynne Uhring Identification, Classification, and Frequency of Medical Errors in Outpatient … Moran Identifying, Understanding, and Communicating Medical Device Use Errors: Observations from an

80. Quality and Safety Review System (QSRS) | Agency for Healthcare Research and Quality
    www.ahrq.gov/patient-safety/quality-measures/qsrs/index.html
    July 01, 2025 - QSRS) Retrospectively Reviewing Inpatient Health Records To Identify Adverse Events Medical errors … The extent of medical errors in U.S. hospitals was revealed in 2000 when the Institute of Medicine (now … published To Err Is Human , estimating that up to 98,000 deaths occurred each year due to medical errors