Bates DW, et al. The impact of a physician computerized order entry system on prevention of serious medication errors. Journal of the American Medical Association. 1998;280:1311-1316.

To evaluate the impact of computerized physician order entry (POE), patients admitted to three medical units were studied for seven- to ten-week periods in four different years. The baseline period was the year before implementation of a POE, and the remaining three years were after implementation. Sophistication of POE increased with each successive period. During the study, the non-missed dose medication error rate fell 81 percent.

Deming WE
Cambridge, Massachusetts, USA: MIT Press; 2000

Deming offers a theory of management style based on his "14 points for management". Arguing that American companies require a total transformation of management technique in order to maintain employment levels, he believes that management must be judged for its innovation.

Shojania KG, Duncan BW, McDonald KM, Wachter RM. Safe but sound: Patient safety meets evidence-based medicine. Journal of the American Medical Association. 2002;288(4):508-513.

This article responds to the concerns raised by Leape et al (see: What practices will most improve patient safety? Evidence-based medicine meets patient safety. JAMA. 2002;288(4):501-7.) and defends an evidence-based approach to patient safety.

Leape LL, Berwick DM, Bates DW. What practices will most improve safety? Evidence-based medicine meets patient safety. Journal of the American Medical Association. 2002;288(4):501-507.

This article discusses the Agency for Healthcare Research and Quality study — recommended by the IOM following their report "To Err is Human" — to determine best practices in patient safety and the evidence supporting those practices.

Making Health Care Safer: A Critical Analysis of Patient Safety Practices. Agency for Healthcare Research and Quality; 2001. (AHRQ Publication No. 01-EO58)

AHRQ commissioned the University of California at San Francisco (UCSF)—Stanford University Evidence-based Practice Center (EPC) in January 2001 to review the scientific literature regarding safety improvement. Chapter 20 of this report specifically focuses on the prevention of surgical site infections.

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Rozich JD, Haraden CR, Resar RK. Adverse drug event trigger tool: A practical methodology for measuring medication related harm. Quality and Safety in Health Care. 2003;12:194-200.

This article describes how to use of the "trigger tool", which has been proven to increase the rate of adverse drug event detection approximately 50-fold over traditional reporting methodologies.

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The National Coalition on Health Care and The Institute for Healthcare Improvement. Reducing medical errors and improving patient safety: Success stories from the front lines of medicine. Accelerating Change Today (A.C.T.). February 2000.

Profiles of institutions and organizations that made a committment to change and a difference.

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Caroline White. UK agency unveils plans to cut infusion device errors. British Medical Journal. 2003 May 17;326(7398):1053.

The National Patient Safety Agency in the UK has described its plans to reduce the number of mistakes caused by infusion devices.

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Committee on Quality of Health Care in America, Institute of Medicine
Washington, DC, USA: National Academies Press; 2001

This report from the Institute of Medicine focuses on closing the quality gap between what we know to be good health care and the health care that people actually receive. The report recommends a redesign of the American health care system by providing six "Aims for Improvement": Safety, Effectiveness, Patient-Centeredness, Timeliness, Efficiency, Equity. These principles set forth a specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others to improve the US health care system.

Blendon R, Schoen C, DesRoches C, Osborn R, Zapert K. Common concerns amid diverse systems: Health care experiences in five countries. Health Affairs. 2003;22(3):106-121.

The article discusses findings from a survey of the health care experiences of adults age 18 or older who reported fair or poor health, a serious illness, injury, or disability, or major surgery or hospitalization for something other than a normal delivery in the past two years.