OBJECTIVE Home healthcare is an increasingly common part of healthcare. The patients are often aged, frail and have multiple diseases, and multiple caregivers are involved in their treatment. This study explores the origin, incidence, types and preventability of adverse events (AEs) that occur in patients receiving home healthcare. DESIGN A study using retrospective record review and trigger ...

BACKGROUND There is little satisfactory evidence on the harm of safety incidents to patients, in terms of lost potential health and life-years. OBJECTIVE To estimate the healthy life-years (HLYs) lost due to 6 incidents in English hospitals between the years 2005/2006 and 2009/2010, to compare burden across incidents, and estimate excess bed-days. RESEARCH DESIGN The study used cross-sectio...

OBJECTIVE To analyze the system factors related to "line, tube, and drain" (LTD) incidents in the intensive care unit (ICU). DESIGN Voluntary, anonymous Web-based patient safety reporting system. SETTING Eighteen ICUs in the United States. PATIENTS Incidents reported by ICU staff members during a 12-month period ending June 2003. INTERVENTIONS None. MEASUREMENTS Characteristics of the...

To cite: Shojania KG, Marang-van de Mheen PJ. BMJ Qual Saf 2015;24: 541–544. Two years ago, BMJ Quality & Safety published the first example of a longitudinal national adverse event (AE) study. That study included 400 admissions from each of 21 randomly selected hospitals in the Netherlands in 2004 and 200 admissions from 20 hospitals in 2008. The authors reported an increase in AEs (ie, harm f...

To cite: Franklin BD. BMJ Qual Saf Published Online First: [please include Day Month Year] doi:10.1136/ bmjqs-2014-002924 Medication error research typically focuses on just one stage of the medication use process: prescribing, transcribing, dispensing, administration or monitoring. Such simplification is required so that manageable boundaries can be set around the research, and to make it easi...

Peter J. Pronovost, MD, PhD* BACKGROUND Although the methods to measure preventable harm are imprecise and immature, preventable harm is one of the leading causes of death, disability, and increased costs of care. The field of anesthesiology has been recognized for its efforts to improve patient safety, but much work remains to reduce harm to patients having cardiac surgery. Despite significant...