Just Culture Champion Certification Course in St. Louis, MO on December 2-4! Don’t miss this opportunity to obtain certification in Just Culture directly from Outcome Engenuity in St. Louis on December 2-4. Register today – space is limited! Come join us for this session, hosted by the Center and SSM Health to spread
A study published in Anesthesiology found that about one in every 20 medication administrations during surgery involved an error, and up to one-third of those harmed the patient. The authors attribute the error rate in part to the absence of the safeguards that prevent errors in other parts of the hospital, such as bar coding
Almost everyone will experience a diagnostic error, sometimes with devastating circumstances. Today, the National Academies of Science released its long-awaited, and important, report on diagnostic error. The Committee highlighted eight goals along with recommendations. These include improving the identification and reporting of diagnostic error, improving the safety culture of communication and teamwork, improving education and
Annually, the majority of events submitted to the Center for Patient Safety’s PSO result in no harm to the patient, however, there is a steady increase in events reported to the PSO which supports continued learning. With nearly 35,000 events from healthcare organizations, medication events continue to be the highest reported event type, followed by
A success story from Cox Health The survey of patient safety culture has become a key improvement tool for CoxHealth, a health system across 5 campuses with 954 licensed beds. CoxHealth spans 83 clinics and serves 25 counties across southwestern Missouri. They have used the survey administered by the Center for Patient Safety (CPS) since
DOWNLOAD NEWSLETTER We hope you enjoy the latest newsletter from the Center for Patient Safety PSO! Articles include: Aligning Culture with the Strategic Plan, A success story from SSM Health.1 CPS Culture Stats.2 Culture Measurement as Key Improvement Tool, A success story from Cox Health.3 LTC & EMS Updates.4-5 Pointers for Implementing Change.6 PSO Legal
The Agency for Healthcare Research and Quality (AHRQ) released their latest morbidity and mortality round on the web (WebM&M). AHRQ WebM&M is an educational journal that highlights medical errors or other patient safety/quality issues. Cases are submitted anonymously by healthcare organizations. This month’s cases include: Abdominal Pain in Early Pregnancy A Fumbled Handoff to Inpatient
New Patient Safety Primer from AHRQ on Second Victims A health professional is often required to put emotions aside for the sake of their patients. But despite the emotional resilience that allows healthcare providers to care for their patients under stressful, high-stakes circumstances, an unexpected clinical event or outcome can have a heavy emotional impact.