The JAG safety (previously ISREE) initiative promotes learning from medical errors and patient safety incidents. 

This initiative was developed from the premise that to make endoscopy services safer, we need to better understand, record, and draw on patient safety incidents as opportunities for learning.

Learning from endoscopy patient safety incidents: case of the month

Each month JAG publishes a case of the month highlighting a real life clinical scenario which has impacted patient safety. Case studies are contributed by JAG leads and endoscopy services across the UK and are designed to provide a opportunity for discussion and to share learning. 

Read our case studies below:

August 2019: a mugful of coffee ground vomit 

September 2019: going down the rabbit hole

October 2019: mind the patch

November 2019: forget me not

December 2019: pass the baton

January 2020: wrong site endoscopy

February 2020: losing the pot

June 2020: TB or not TB? A question of infection control

September 2020: safe health workers, safe patients

November 2020: ‘upper GI-only’ for rectal bleeding