Resource library Whare rauemi

The Commission's annual report for the period 1 July 2014 to 30 June 2015 is available to download below.

Helen McKernan talks about her mother’s death, following a hospital medication error. Helen's mother was given the wrong medication for four days because of a chart mix up and inadequate checking.

This paper (Social Science and Medicine 73 (2011) 217-225) examines the challenges of investigating clinical incidents through the use of Root Cause Analysis.

Matthew was 16 years old when he developed appendicitis. His mum, Heather, took him to the local emergency department and he had surgery that night to remove his appendix.

Video 1 in the teamwork and communication roll-out.

This is a short summary version (7min 50 sec) of the video on preventing falls in hospitals.

Sheila from Te Pukaea (Whanganui DHB's consumer council) talks about her experience as an independent consumer representative on adverse event review panels.

Use this patient story as a supplement to Topic 1.