Lesson Topics

• Rate of errors needs to addressed in health care.
• Institute of Medicines Report entitled To Err is Human deals with public policy on error management.
• MERS-TM is a comprehensive process that:
  • presents a method for collecting data, analyzing data, and interpreting information for system improvement
  • recognizes the importance of including "near miss" events (mistakes that were almost made)
  • looks beyond human error to systemic factors that contributed to the event
  • provides a local management tool and a method for sharing information and lessons learned through a central, national database