Patient Safety Learning Series

As one of the nation's first and most trusted Patient Safety Organizations, we champion the importance of knowledge sharing in order to improve the quality of healthcare. Clarity PSO's Patient Safety Learning Series focuses on the risk-quality-safety (RQS) issues we have spotted through the incident report data collection and analyses of Clarity PSO participating providers. Each report includes our findings on a given topic and our recommendations on how to use knowledge to mitigate risk and improve patient safety.


Topic: Harm and the Care Delivery Process


Topic: The 3 D's of Debriefing

Topic: Falls and the Question "Why?"

Topic: High-Alert Medications

Topic: Human Factors and Perinatal Events

Topic: Handoffs - Old Topic, New Perspective

Topic: Surgery & Anesthesia Safety Event Reporting - Widening the Lens for Learning

Topic: Patient Transfers and Delays in Medication Therapy

Topic: Pressure Ulcers

Topic: Medications and Secondary IV Piggybacks

Topic: Surgical Errors

Topic: Dosing Omissions

Topic: Falls Prevention

Topic: Health Information Technology

Topic: Culture of Patient Safety

Topic: A Continued Exploration of Ambulatory Safety

Topic: Ambulatory Safety

Topic: Medication Safety


CLARITY PSO & YOU - learn more about this important program -