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21. Defining Diagnostic Error: A Scoping Review to Assess the Impact of the National Academies’ Report Improving Diagnosis in Health Care (pdf file)
    www.healthcare411.ahrq.gov/sites/default/files/wysiwyg/topics/defining-diagnostic-error-a-scoping-review.pdf
    April 27, 2022 - Patient Focus Five studies explored patient reports of diagnostic errors. … Types and origins of diagnostic errors in primary care settings. … Diagnostic error in medicine: analysis of 583 physician-reported errors. … Malpractice claims related to diagnostic errors in the hospital. … Diagnostic errors in medicine: a case of neglect.

22. Diagnostic Safety Centers of Excellence | Agency for Healthcare Research and Quality
    www.healthcare411.ahrq.gov/patient-safety/diagnostic-excellence-grants/index.html
    June 01, 2023 - 01 Project Aims: Develop a multidisciplinary diagnostic excellence center to address diagnostic errors … , accelerate its implementation in a large healthcare system, and evaluate its impact on diagnostic errors … Propose, prioritize, and codesign patient-centered solutions to mitigate diagnostic errors. … Carry out a comprehensive program evaluation, including analysis of rates of diagnostic errors and process … and outpatient) to improve patient/family and clinician communication and experience and to reduce errors

23. Health Care Simulation to Advance Safety | Agency for Healthcare Research and Quality
    www.healthcare411.ahrq.gov/research/findings/factsheets/errors-safety/simulproj15/index.html
    August 01, 2018 - Home Research Research Findings & Reports Fact Sheets Medical Errors … Reports: Patient Safety Evidence-based Practice Center Reports Fact Sheets Medical Errors … https://www.ahrq.gov/research/findings/factsheets/errors-safety/simulproj15/index.html  

24. Diagnostic Errors Are Common in Seriously Ill Hospitalized Adults | Agency for Healthcare Research and Quality
    www.healthcare411.ahrq.gov/news/newsletters/e-newsletter/895.html
    January 01, 2024 - Home News Newsletter AHRQ News Now Diagnostic Errors … Newsroom Blog Newsletter AHRQ News Now Events Diagnostic Errors … Today's Headlines: Diagnostic Errors Are Common in Seriously Ill Hospitalized Adults . … Diagnostic Errors Are Common in Seriously Ill Hospitalized Adults A random sample of patients from … The researchers concluded that three-quarters of these diagnostic errors contributed to temporary or

25. Appendix B: Bringing It To Life - Case Study | Agency for Healthcare Research and Quality
    www.healthcare411.ahrq.gov/health-literacy/professional-training/lepguide/app-b.html
    September 01, 2020 - English proficiency , which is absolutely necessary to adapt current systems to better identify medical errors … This problem highlights the importance addressing root causes to prevent medical errors among LEP patients … This problem highlights the need to address root causes to prevent medical errors among LEP patients … ensure that staff are comfortable identifying issues, and (2) the need to improve reporting of medical errors … communication and LEP patient safety. 64 , 65 While this case may seem extreme, research shows that errors

26. Toolkit for Engaging Patients To Improve Diagnostic Safety  | Agency for Healthcare Research and Quality
    www.healthcare411.ahrq.gov/diagnostic-safety/tools/engaging-patients-improve.html
    July 01, 2022 - Toolkit for Engaging Patients To Improve Diagnostic Safety  Diagnostic errors … Research suggests that 79 percent of diagnostic errors are related to the patient-clinician encounter … and up to 56 percent of these errors are related to miscommunication during the encounter. … , uninterrupted, and in a way that gives clinicians the information they need can reduce diagnostic errors … Organization Toolkit Infographic  (PDF, 743 KB) provides statistics about incidents of diagnostic errors

27. Speaking Plainly: Communicating the Patient’s Role in Health Care Safety (pdf file)
    www.healthcare411.ahrq.gov/downloads/pub/advances/vol4/Miranda.pdf
    July 01, 2004 - Others specified particular actions that patients could take to avoid errors, such as maintaining a … refers to “medical errors.” … Agency for Healthcare Research and Quality: 20 tips to help prevent medical errors. … Preventing medical errors: communicating a role for Medicare beneficiaries. … Prescription errors tied to lack of advice: pharmacists skirting law, Mass. study finds.

28. Improving Patient Safety Systems for Patients With Limited English Proficiency: A Guide for Hospitals (pdf file)
    www.healthcare411.ahrq.gov/sites/default/files/publications/files/lepguide.pdf
    September 01, 2012 - Patient Safety Terminology Medical errors*: Medical errors happen when something that was planned as … Most errors result from problems created by today’s complex health care system, but errors also happen … If anything, errors related to LEP are bundled as being caused by “communication errors,” which does … We identified three common causes of errors (or potential errors) for LEP and culturally diverse patients … Address Root Causes To Prevent Medical Errors Among LEP Patients Background Medical errors among LEP

29. Appendix E | Agency for Healthcare Research and Quality
    www.healthcare411.ahrq.gov/research/findings/final-reports/environmental-scan-programs/envscan-program-ape.html
    April 01, 2018 - Missed or Critical Lab Results 0 413 Fatigue and Sleep Deprivation 13 411 Identification Errors … -- Venous Thrombosis and Thromboembolism 0 414 Medication Safety 126 416  -- Medication Errors … /Preventable Adverse Drug Events 96 420  ---- Administration Errors 14 419  ---- Dispensing … Errors 11 448  ---- Monitoring Errors and Failures 23 417  ---- Ordering/Prescribing Errors … 6 418  ---- Transcription Errors 5 415  -- Side Effects/Adverse Drug Reactions 17 421

30. AHRQ Research Helps Pharmacists in Mentoring Program to Reduce Drug Errors in Emergency Departments | Agency for Healthcare Research and Quality
    www.healthcare411.ahrq.gov/news/newsroom/case-studies/cquips0802.html
    October 01, 2014 - Impact Case Studies AHRQ Research Helps Pharmacists in Mentoring Program to Reduce Drug Errors … Events AHRQ Research Helps Pharmacists in Mentoring Program to Reduce Drug Errors … June 2008 AHRQ-sponsored research on how clinical pharmacy services can reduce medication-related errors … ASHP aims to prevent medication errors, help people make the best use of medicines, and assist pharmacists … Internet Citation: AHRQ Research Helps Pharmacists in Mentoring Program to Reduce Drug Errors

31. Outpatient Medication Errors Prevalent Among Pediatric Leukemia, Lymphoma Patients | Agency for Healthcare Research and Quality
    www.healthcare411.ahrq.gov/news/newsletters/e-newsletter/848.html
    January 01, 2023 - Home News Newsletter AHRQ News Now Outpatient Medication Errors … Today's Headlines: Outpatient Medication Errors Prevalent Among Pediatric Leukemia, Lymphoma Patients … Outpatient Medication Errors Prevalent Among Pediatric Leukemia, Lymphoma Patients An AHRQ-supported … of children with leukemia or lymphoma experienced adverse drug events due to outpatient medication errors … 2023 Page originally created January 2023 Internet Citation: Outpatient Medication Errors

32. Producing Accurate Clinical Quality Reports for Population Health: A Delivery System-Oriented Approach to Report Validation (pdf file)
    www.healthcare411.ahrq.gov/sites/default/files/wysiwyg/evidencenow/tools-and-materials/ehr-reports.pdf
    March 01, 2016 - They found no errors in the report logic. … For validation purposes it is useful to categorize clinical quality report errors into “inclusion errors … Other inclusion errors can be caused by workflow issues, which are errors caused by failure to note … Exclusion Errors The fact that with exclusion errors the patient is not in the report means that the … All reports contain errors, and 2.

33. Preventing Medication Errors in Ambulatory Care: The Importance of Establishing Regimen Concordance (pdf file)
    www.healthcare411.ahrq.gov/downloads/pub/advances/vol1/Schillinger.pdf
    January 01, 2004 - Preventing Medication Errors in Ambulatory Care: The Importance of Establishing Regimen Concordance … 199 Preventing Medication Errors in Ambulatory Care: The Importance of Establishing Regimen … medication adherence in the treatment of chronic diseases7 and can help prevent medication-related errors … Reducing medication-related communication errors will likely involve rigorous reviews of medication … Factors related to errors in medication prescribing. JAMA 1997 277(4):312–7. 9.

34. Toolkit to Engage High-Risk Patients In Safe Transitions Across Ambulatory Settings | Agency for Healthcare Research and Quality
    www.healthcare411.ahrq.gov/hai/tools/ambulatory-care/safe-transitions.html
    December 01, 2017 - from one ambulatory care facility clinician to another are especially vulnerable to patient safety errors … This toolkit is designed to help staff actively engage patients and their care partners to prevent errors … The toolkit is designed to help staff actively engage patients and their care partners to prevent errors

35. Using Patient Input to Improve Diagnostic Safety | Agency for Healthcare Research and Quality
    www.healthcare411.ahrq.gov/funding/grantee-profiles/grtprofile-bell.html
    March 01, 2022 - Efforts to identify the nature of diagnostic errors and how to prevent them have come a long way in just … “The traditional tools  and measures to identify diagnostic errors were developed and used by clinicians … Diagnostic errors occur in part because diagnosis itself is a multi-layered process, potentially involving … Documentation errors occur frequently, with about one in five patients reporting a perceived serious … After analyzing more than 2,000 patient-reported errors from 25,000 respondents, researchers identified

36. Federal Interagency Workgroup on Improving Diagnostic Safety--March Meeting Summary (pdf file)
    www.healthcare411.ahrq.gov/sites/default/files/wysiwyg/topics/DxSafety-March2019-MeetingNotes.pdf
    March 08, 2019 - a strategy and framework for healthcare organizations to measure, analyze, and reduce diagnostic errors … DOD • Deep-dive analysis of treatment delays that result in significant errors. … • Contributions of human factors to errors that have led to harm. … The Society to Improve Diagnosis in Medicine will hold its annual Diagnostic Errors in Medicine meeting

37. Resources Related to Diagnostic Safety and Quality | Agency for Healthcare Research and Quality
    www.healthcare411.ahrq.gov/diagnostic-safety/resources/index.html
    March 01, 2024 - Issue Briefs Journal Articles The PRIDx framework to engage payers in reducing diagnostic errors … AHRQ Views Blogs With Increased Funding, AHRQ To Explore Scope and Causes of Diagnostic Errors (March … Safety's Next Great Frontier (October 2016) New Coalition Broadens Efforts To Reduce Diagnostic Errors …  (September 2015) New Report Outlines Goals and Recommendations To Reduce Diagnostic Errors  (September

38. Study Section Research Foci | Agency for Healthcare Research and Quality
    www.healthcare411.ahrq.gov/funding/process/study-section/resfoci.html
    October 01, 2020 - Healthcare Safety and Quality Improvement Research (HSQR) Identify Risks/Hazards that Lead to Medical Errors … and Find Ways to Prevent Medical Errors – Improve Patient Safety Research on Scopes / Impacts of Medical … Errors on Costs/Qualities & Efficiencies/Effectiveness of Cares Examine/Improve Medical Liability … Quality Improvement Research Dissemination/Translation Research Findings and Methods to Reduce Medical Errors

39. Advancing Patient Safety | Agency for Healthcare Research and Quality
    www.healthcare411.ahrq.gov/patient-safety/reports/advancing/index.html
    July 01, 2022 - While the IOM made recommendations to Congress for investigating medical errors and improving patient … The IOM noted that many of the errors in health care result from a culture and system that is fragmented … Later in 2000, under AHRQ leadership, that task force held a National Summit on Medical Errors and Patient … While the Institute of Medicine made recommendations to Congress for investigating medical errors and … and Patient Safety; Doing What Counts for Patient Safety: Federal Actions to Reduce Medical Errors

40. National Academy of Medicine (NAM) Reports | Agency for Healthcare Research and Quality
    www.healthcare411.ahrq.gov/patient-safety/reports/national-academy-medicine.html
    February 01, 2018 - AHRQ: Improving Diagnosis in Health Care ,  published in 2015, this report investigates diagnostic errors … Preventing Medication Errors: Quality Chasm Series  Released: July 20, 2006 According to one estimate … Preventing Medication Errors puts forward a national agenda for reducing medication errors based on estimates … of the incidence and cost of such errors and evidence on the efficacy of various prevention strategies … by which government, health care providers, industry, and consumers can reduce preventable medical errors