Displaying 441 - 450 of 606 results
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Serious and Sentinel Events in New Zealand Hospitals 2006–2007Commentary on serious and sentinel events reported by District Health Boards in 2006–2007.
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Serious and Sentinel Events in New Zealand Hospitals 2007–2008Serious and Sentinel Events in New Zealand Hospitals 2007–2008.
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Serious and Sentinel Events in New Zealand Hospitals 2008–2009In this year three in 10,000 admissions to DHBs involved a potentially preventable serious or sentinel event. Of these 39 percent were a result of a clinical mismanagement problem
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Global trigger tool: Using data for improvementThis presentation given by global trigger tool clinical lead, Gillian Robb, provides an update on the use of trigger tools in New Zealand.
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Open Book: Accurate patient identification (December 2014)This report aims to alert providers to the key findings of a recent adverse event review. The emphasis is on the changes implemented by the provider involved to stop the event happening again.
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Open Book: Preventing retained items – laparoscopic surgery (January 2015)This report aims to alert providers to the key findings of two recent reviews, with emphasis on the changes implemented to prevent recurrence.
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Open Book: Different presentations of heparin (February 2015)This report aims to alert providers to the key findings of a recent review, with emphasis on the changes implemented by that provider to prevent recurrence.
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Open Book: Preventing retained items – gynaecology surgery (March 2015)This report aims to alert providers to the key findings of a recent review, with emphasis on the changes implemented to prevent recurrence.
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Open Book: Triage of patient with post-procedure ophthalmic symptoms in the emergency department (April 2015)This report aims to alert providers to the key findings of a recent review, with emphasis on the changes implemented to prevent recurrence. Providers are advised to consider this report, and whether the changes made are relevant to their own systems.
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Open Book: Lessons learnt from reviewing patient falls (April 2015)This edition of Open Book was written in collaboration with the Health Quality & Safety Commission’s Reducing Harm from Falls programme, and sets out a series of practice changes made by providers to prevent patients from being harmed by falling.