Confusing medication names and packaging may cause or contribute to potentially harmful medication errors. The names of several chemotherapy and supportive agents can look or sound like the names of other chemotherapy agents or unrelated medications and can be inadvertently interchanged, or mixed up. Poor handwriting, abbreviations of medication names, unclear verbal medication orders, memory l...

Computerized medication alerts (e.g., drug-drug interaction alerts), which are intended to protect patient safety, should also be designed to support prescriber workflow. However, relatively few studies have examined the use of medication alerts during patient care processes. To assess barriers associated with the use of medication alerts, we directly observed medication prescribing during rout...

Improving quality and safety across an entire healthcare system in multiple clinical areas within a short time frame is challenging. We describe our experience with improving inpatient quality and safety at Kaiser Permanente Northern California. The foundations of performance improvement are a "four-wheel drive" approach and a comprehensive driver diagram linking improvement goals to focal area...

Several alert correlation methods were proposed in the past several years to construct high-level attack scenarios from low-level intrusion alerts reported by intrusion detection systems (IDSs). These correlation methods have different strengths and limitations; none of them clearly dominate the others. However, all of these methods depend heavily on the underlying IDSs, and perform poorly when...

Parenteral nutrition (PN) provision is complex, as it is a high-alert medication and prone to a variety of potential errors. With changes in clinical practice models and recent federal rulings, the number of PN prescribers may be increasing. Safe prescribing of this therapy requires that competency for prescribers from all disciplines be demonstrated using a standardized process. A standardized...

OBJECTIVE Alert fatigue represents a common problem associated with the use of clinical decision support systems in electronic health records (EHR). This problem is particularly profound with drug-drug interaction (DDI) alerts for which studies have reported override rates of approximately 90%. The objective of this study is to report consensus-based recommendations of an expert panel on DDI th...

BACKGROUND Cardiovascular disease is a leading cause of death in older people, and the impact of being exposed or not exposed to preventive cardiovascular medicines is accordingly high. Underutilization of beneficial drugs is common, but prevalence estimates differ across settings, knowledge on predictors is limited, and clinical consequences are rarely investigated. METHODS Using data from a...