The Wrong Shot: Error Disclosure (AHRQ)55974A child is mistakenly vaccinated for hepatitis A, rather than B. Despite forthright disclosure and no evident harm to the child, the father becomes incredibly angry at the providers.4/8/2014 8:55:23 PMCase Study from AHRQ WebM&M   Learning Objectives: At the end of this acticity, you will be able to Describe the rationale for disclosing harmful errors to patients STS_ListItem_PublishingPageshttp://www.ihi.org/education/IHIOpenSchool/resources/Pages/Activities344273800http://www.ihi.org4/8/2014 8:55:23 PMhtmlFalseaspx1616~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_WebPage.js
Learning from Medical Errors (Part 1)56036A patient suffers horrible burns. An operation takes twice as long as it should. A child dies from internal bleeding. All because a doctor, a nurse, or another care provider made a mistake. In this video, prominent clinicians describe the errors that still haunt them today — and point out ways those errors could have been prevented. 5/26/2017 2:12:52 PM Leape, MD, Adjunct Professor of Health Policy at the Harvard School of Public Health; Kathy Duncan, RN, 5 Million Lives Campaign Faculty, Institute for Healthcare Improvement STS_ListItem_PublishingPageshttp://www.ihi.org/education/IHIOpenSchool/resources/Pages/Activities425472450http://www.ihi.org5/26/2017 2:12:52 PMhtmlFalseaspx1616~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_WebPage.js
One Dose, Fifty Pills (AHRQ)55972Told to give a patient one gram of steroids, an intern mistakenly orders fifty 20-mg pills. Although a pharmacist questions the order, the intern insists that the medication be given as ordered.4/7/2014 6:56:59 PMLearning Objectives: At the end of this activity, you will be able to Identify the risks involved with improper supervision in a health care setting She suggested to the intern that STS_ListItem_PublishingPageshttp://www.ihi.org/education/IHIOpenSchool/resources/Pages/Activities169253940http://www.ihi.org4/7/2014 6:56:59 PMhtmlFalseaspx1616~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_WebPage.js
Mutiny56027The behavior of a superior starts to put your patients at risk. What would you do? The University of Rochester’s Dr. Paul Griner presents the final installment in a series of case studies for the IHI Open School.4/11/2014 7:51:52 PMClick here to view all of Dr. Paul Griner's case studies Dr. Paul Griner, Professor Emeritus of Medicine at the University of Rochester Learning Objectives: At the end of this STS_ListItem_PublishingPageshttp://www.ihi.org/education/IHIOpenSchool/resources/Pages/Activities329843020http://www.ihi.org4/11/2014 7:51:52 PMhtmlFalseaspx1616~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_WebPage.js
Misread Label (AHRQ) 55971An infant born with sluggish breathing is given Lanoxin instead of naloxone, and dies of digoxin toxicity.4/7/2014 6:57:09 PMCase Study from AHRQ WebM&M; Discussion questions submitted by Andrew Carson-Stevens, Medical Student, Cardiff University, Cardiff, United Kingdom; Jennifer Boehne, PharmD STS_ListItem_PublishingPageshttp://www.ihi.org/education/IHIOpenSchool/resources/Pages/Activities187562150http://www.ihi.org4/7/2014 6:57:09 PMhtmlFalseaspx1616~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_WebPage.js
What Are the Dangers of Alert Fatigue?56001In a new IHI Open School short, patient safety expert Dr. Bob Wachter talks about the dangers of alert fatigue in health care.10/10/2017 3:44:42 PMFinding and Creating Joy in Work April 6, 2021 | IHI Online Course with Coaching To help reverse the worrying trend of burnout among health care STS_ListItem_PublishingPageshttp://www.ihi.org/education/IHIOpenSchool/resources/Pages/Activities19128920http://www.ihi.org10/10/2017 3:44:42 PMhtmlFalseaspx1616~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_WebPage.js
Why Do Errors Happen? How Can We Prevent Them?56005Millions of people suffer every year from mistakes in health care. Lucian Leape explains why those mistakes happen — and how to prevent them.5/26/2017 2:44:16 PM Leape, MD, Adjunct Professor of Health Policy at the Harvard School of Public Health         Learning Objectives: After viewing this video, students will be able to STS_ListItem_PublishingPageshttp://www.ihi.org/education/IHIOpenSchool/resources/Pages/Activities238863200http://www.ihi.org5/26/2017 2:44:16 PMhtmlFalseaspx1616~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_WebPage.js
The Patient and the Anesthesiologist56031Linda Kenney went into the hospital for an ankle replacement. She came out with a host of complications resulting from a mistake that no one was willing to admit. Until Rick van Pelt, MD, her anesthesiologist, stepped forward. In this three-part video case study, you’ll find out what happened in the immediate aftermath of the surgery, watch Kenney and van Pelt describe their first meeting after the surgery, and watch Kathy Duncan, RN, and Don Berwick, MD, analyze the case.10/30/2018 4:00:05 PMDonald Berwick, MD, MPP, President Emeritus and Senior Fellow, Institute for Healthcare Improvement; Kathy Duncan, RN, Faculty, Institute for Healthcare Improvement; Linda Kenney STS_ListItem_PublishingPageshttp://www.ihi.org/education/IHIOpenSchool/resources/Pages/Activities326182860http://www.ihi.org10/30/2018 4:00:05 PMhtmlFalseaspx1616~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_WebPage.js
Disruptive Behavior: A Slap on the Hand55895When you’re rude and disrespectful to your co-workers, you put your patients at risk. In this video, former nurse Jill Duncan recalls watching a senior nurse bully a medical resident. She explains why this behavior happens, and how you should respond if you’re on the receiving end.5/26/2017 1:50:30 PM Duncan, RN, MS, MPH, Director, Institute for Healthcare Improvement; Former Staff Nurse and Clinical Nurse Specialist   Learning Objectives: At the end of this activity, you STS_ListItem_PublishingPageshttp://www.ihi.org/education/IHIOpenSchool/resources/Pages/Activities7244260http://www.ihi.org5/26/2017 1:50:30 PMhtmlFalseaspx1616~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_WebPage.js
Glucose Roller Coaster (AHRQ)55969A woman hospitalized for congestive heart failure (with no history of diabetes) is given several rounds of insulin and D50, after repeated blood tests show her glucose to be dangerously high, then dangerously low. Turns out, the blood samples were drawn incorrectly and the signouts were incomplete.4/7/2014 6:57:49 PMLearning Objectives: At the end of this activity, you will be able to Explain why good communication is critical to patient safety Description: A woman hospitalized for congestive STS_ListItem_PublishingPageshttp://www.ihi.org/education/IHIOpenSchool/resources/Pages/Activities154831220http://www.ihi.org4/7/2014 6:57:49 PMhtmlFalseaspx1616~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_WebPage.js

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