Helping Make Health Care Safer for all Oregonians

From the Director

Recently, the Institute of Medicine (IOM) published Improving Diagnosis in Health Care, an essential report for healthcare safety. For a long time, inaccurate or delayed diagnoses have significantly contributed to patient harm. Most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. The IOM report is an urgent call to action with important recommendations. 

Overcoming diagnostic errors requires a comprehensive approach since errors stem from many causes. The Oregon Patient Safety Commission can support healthcare facilities with their approach. By reporting to the Patient Safety Reporting Program after diagnostic (or other) events, facilities can get hands-on assistance with reviewing events and developing action plans. In addition, when a provider uses Early Discussion and Resolution to request a conversation with a patient and their family after serious harm has occurred, that conversation is confidential and protected under Oregon law.

To learn more about the benefits of participating in the Patient Safety Commission’s patient safety programs, please contact us. Our staff is anxious to share more information with you.

Enjoy the fall season!

Bethany A. Walmsley
Bethany A. Walmsley, Executive Director

What’s New?

Institute of Medicine Report: Improving Diagnosis in Health Care »
A new report summarizing evidence and outlining recommendations to make medical diagnoses more accurate, reliable, efficient, and safe

Root Cause Analysis Toolkit »
A new toolkit for healthcare facilities seeking additional resources to strengthen their existing adverse event review process

Commission Publishes 2014 Patient Safety Reporting Program Annual Summary
Press Release »
Report »

Early Discussion and Resolution »
Visit the website about our newest program

Patient Safety and Medication Error Prevention for Pharmacy »
A new online course for pharmacists

Success Stories »
Read about exemplary work in Oregon to improve patient safety

News »

Events »

Popular Links

Quality Improvement Initiatives »
Grant-funded activity taking place at the Commission

2014 Annual Summary: Oregon Patient Safety Reporting Program »
Statewide, aggregate picture of information reported to the Patient Safety Reporting Program

Oregon Ambulatory Surgery Center Infection Prevention & Control Toolkit »
Guidance on the development and implementation of infection prevention programs

Oregon Adverse Event Disclosure Guide »
Understand the purpose of disclosure and get resources to help develop and improve disclosure programs

Statement of Preventing Harm from Oversedation »
Intended for use in efforts to decrease patient harm associated with oversedation

Our Partners in Safety

Oregon Health Authority      Oregon Health Care Association

Oregon Department of Human Services      Oregon Medical Board

Oregon Office of Rural Health      Oregon State Pharmacy Association

Oregon Health Care Quality Corporation      Oregon Medical Association

Oregon Rural Healthcare Quality Network

Oregon Association of Hospitals and Health Systems      Oregon Center for Nursing

Acumentra      LeadingAge Oregon

Northwest Renal Network      OASCA