What have we learned about interventions to reduce medical errors?

Helen I. Woodward, Oliver T. Mytton, Claire Lemer, Iain E. Yardley, Benjamin M. Ellis, Paul D. Rutter, Felix E.C. Greaves, Douglas J. Noble, Edward Kelley, Albert W. Wu

Research output: Contribution to journalReview articlepeer-review

Abstract

Medical errors and adverse events are now recognized as major threats to both individual and public health worldwide. This review provides a broad perspective on major effective, established, or promising strategies to reduce medical errors and harm. Initiatives to improve safety can be conceptualized as a "safety onion" with layers of protection, depending on their degree of remove from the patient. Interventions discussed include those applied at the levels of the patient (patient engagement and disclosure), the caregiver (education, teamwork, and checklists), the local workplace (culture and workplace changes), and the system (information technology and incident reporting systems). Promising interventions include forcing functions, computerized prescriber order entry with decision support, checklists, standardized handoffs and simulation training. Many of the interventions described still lack strong evidence of benefit, but this should not hold back implementation. Rather, it should spur innovation accompanied by evaluation and publication to share the results.

Original languageEnglish (US)
Pages (from-to)479-497
Number of pages19
JournalAnnual review of public health
Volume31
DOIs
StatePublished - Apr 21 2010

Keywords

  • Adverse event
  • Checklist
  • Information technology
  • Patient safety
  • Safety culture

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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