US Institute of Medicine (2000)

1. Safety Express/QIPP (2011) Pressure ulcers Catheter UTI VTE Falls Liberating the NHS (2010) Safety Patient involvement House of Commons Select Committee Report 2009 2000 2002 2004 2006 2008 2010 • Building a Safer NHS Spinal injections • Prescribing errors • Suicides • Obstetric incidents • Teresa Innes • To err is human • Transfusion and medication errors • Preventable suicides • Infection control • Restraint injuries • Falls WHO patient safety undergraduate curriculum (2010) Primary Care Mental Health Paediatrics Patient safety walkarounds Falls Rapid response teams Infection Medicines management GTT and ADETT Northwick Park Hospital Leaders in Patient Safety (NHS Institute 2007) Department of Health (2001/2) Safer Patient Initiative (2004) US Institute of Medicine (2000) Department of Health (2000) Wayne Jowett National Patient Safety Agency (2004) 7 Steps to PS culture Understanding Patient Safety for people with LD Safer Patient Initiative (IHI 2006) NPSA (2006) 5 year report from Confidential Inquiry into suicide in people with mental health problems Patient safety practices that lead to better outcomes (Ranji & Shojaniah 2008) Patient Safety First Campaign (2008) Mid Staffs Hospital High risk medicines Deterioration Critical care Peri-operative care Leadership • Organisation with a • memory • Reporting systems • Open culture • Learning and changing • Human factors Physical restraint Misdiagnosis Choking Preventing absconding Observation Discharge planning Transitions of care