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psnet.ahrq.gov/issue/system-based-approach-managing-patient-safety-ambulatory-care-and-beyond
December 09, 2020 - Newspaper/Magazine Article
A system-based approach to managing patient safety in ambulatory care (and beyond).
Citation Text:
A system-based approach to managing patient safety in ambulatory care (and beyond). Burger C, Eaton P, Hess K, et al. Patient Saf Qual Healthc. December 12, 2017.…
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psnet.ahrq.gov/issue/reducing-diagnostic-errors-through-effective-communication-harnessing-power-information
March 10, 2011 - Commentary
Reducing diagnostic errors through effective communication: harnessing the power of information technology.
Citation Text:
Singh H, Naik AD, Rao R, et al. Reducing Diagnostic Errors through Effective Communication: Harnessing the Power of Information Technology. J Gen Intern…
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psnet.ahrq.gov/issue/learning-samples-one-or-fewer
December 21, 2017 - Review
Classic
Learning from samples of one or fewer.
Citation Text:
Learning from samples of one or fewer. March JG, Sproull LS, Tamuz M. Org Sci.1991;2:1-13. (reprinted in: Qual Saf Health Care 2003;12:465-472.)
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psnet.ahrq.gov/issue/sentara-norfolk-general-hospital-accelerating-improvement-focusing-building-culture-safety
June 08, 2010 - Commentary
Sentara Norfolk General Hospital: accelerating improvement by focusing on building a culture of safety.
Citation Text:
Yates GR, Hochman RF, Sayles SM, et al. Sentara Norfolk General Hospital: accelerating improvement by focusing on building a culture of safety. Jt Comm J Qu…
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psnet.ahrq.gov/issue/patient-safety-emergency-medical-services-systematic-review-literature
June 22, 2022 - Review
Patient safety in emergency medical services: a systematic review of the literature.
Citation Text:
Bigham BL, Buick JE, Brooks SC, et al. Patient safety in emergency medical services: a systematic review of the literature. Prehosp Emerg Care. 2012;16(1):20-35. doi:10.3109/10903…
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psnet.ahrq.gov/issue/medical-groups-adoption-electronic-health-records-and-information-systems
January 14, 2011 - Study
Medical groups' adoption of electronic health records and information systems.
Citation Text:
Gans DN, Kralewski J, Hammons T, et al. Medical Groups’ Adoption Of Electronic Health Records And Information Systems. Health Aff. 2005;24(5):1323-1333. doi:10.1377/hlthaff.24.5.1323.
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psnet.ahrq.gov/issue/enhanced-morbidity-and-mortality-meeting-and-patient-safety-education-specialty-trainees
December 31, 2012 - Study
Enhanced morbidity and mortality meeting and patient safety education for specialty trainees.
Citation Text:
Singh HP, Durani P, Dias JJ. Enhanced Morbidity and Mortality Meeting and Patient Safety Education for Specialty Trainees. J Patient Saf. 2019;15(1):37-48. doi:10.1097/PTS.0…
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psnet.ahrq.gov/issue/hand-communications
January 04, 2017 - Multi-use Website
Hand-off Communications.
Citation Text:
DeRosier JM, Stalhandske E, Bagian JP, et al. Using health care Failure Mode and Effect Analysis: the VA National Center for Patient Safety's prospective risk analysis system.
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psnet.ahrq.gov/issue/assessing-organisational-culture-quality-and-safety-improvement-national-survey-tools-and
March 08, 2017 - Study
Assessing organisational culture for quality and safety improvement: a national survey of tools and tool use.
Citation Text:
Mannion R, Konteh FH, Davies HTO. Assessing organisational culture for quality and safety improvement: a national survey of tools and tool use. Qual Saf He…
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psnet.ahrq.gov/issue/creating-comprehensive-unit-based-approach-detecting-and-preventing-harm-neonatal-intensive
December 15, 2021 - Commentary
Creating a comprehensive, unit-based approach to detecting and preventing harm in the neonatal intensive care unit.
Citation Text:
Creating a comprehensive, unit-based approach to detecting and preventing harm in the neonatal intensive care unit. Sedlock EW, Ottosen M, Nether …
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psnet.ahrq.gov/issue/using-simulation-improve-patient-safety-dawn-new-era
October 29, 2017 - Commentary
Using simulation to improve patient safety: dawn of a new era.
Citation Text:
Cheng A, Grant V, Auerbach M. Using simulation to improve patient safety: dawn of a new era. JAMA Pediatr. 2015;169(5):419-20. doi:10.1001/jamapediatrics.2014.3817.
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psnet.ahrq.gov/issue/intraoperative-surgical-performance-measurement-and-outcomes-choose-your-tools-carefully
June 17, 2015 - Commentary
Intraoperative surgical performance measurement and outcomes: choose your tools carefully.
Citation Text:
Aggarwal R. Intraoperative Surgical Performance Measurement and Outcomes: Choose Your Tools Carefully. JAMA Surg. 2017;152(11):995-996. doi:10.1001/jamasurg.2017.0837.
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psnet.ahrq.gov/issue/surgical-ward-round-quality-and-impact-variable-patient-outcomes
June 17, 2015 - Study
Surgical ward round quality and impact on variable patient outcomes.
Citation Text:
Pucher PH, Aggarwal R, Darzi A. Surgical ward round quality and impact on variable patient outcomes. Ann Surg. 2014;259(2):222-6. doi:10.1097/SLA.0000000000000376.
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psnet.ahrq.gov/issue/effective-perioperative-communication-enhance-patient-care
March 17, 2015 - Commentary
Effective perioperative communication to enhance patient care.
Citation Text:
Garrett H. Effective Perioperative Communication to Enhance Patient Care. AORN J. 2016;104(2):111-20. doi:10.1016/j.aorn.2016.06.001.
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psnet.ahrq.gov/issue/mirror-mirror-wall-update-quality-american-health-care-through-patients-lens
August 15, 2007 - Book/Report
Mirror, Mirror on the Wall: An Update on the Quality of American Health Care Through the Patient's Lens.
Citation Text:
Mirror, Mirror on the Wall: An Update on the Quality of American Health Care Through the Patient's Lens. Davis K, Schoen S, Schoenbaum SC, et al. New Yo…
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psnet.ahrq.gov/issue/improving-safety-culture-results-rhode-island-icus-lessons-learned-development-action
September 17, 2010 - Study
Improving safety culture results in Rhode Island ICUs: lessons learned from the development of action-oriented plans.
Citation Text:
Vigorito MC, McNicoll L, Adams L, et al. Improving safety culture results in Rhode Island ICUs: lessons learned from the development of action-orie…
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digital.ahrq.gov/project-background
January 01, 2023 - This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: https://digital.ahrq.gov/contact-us . Let us know th…
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www.ahrq.gov/talkingquality/resources/writing/tip3.html
May 01, 2015 - Tip 3. Make It Easy to Skim Your Health Care Quality Report
While some people will read a report from beginning to end, many do not move systematically through the information. By interviewing readers and watching what they do, researchers have found that some people flip through reports in search of useful i…
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psnet.ahrq.gov/issue/observational-study-laterality-errors-sample-clinical-records
April 19, 2011 - Study
An observational study of laterality errors in a sample of clinical records.
Citation Text:
Elghrably I, Fraser SG. An observational study of laterality errors in a sample of clinical records. Eye (Lond). 2008;22(3):340-3.
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psnet.ahrq.gov/issue/organizational-and-intraorganizational-development-disasters
May 12, 2021 - Review
Classic
The organizational and intraorganizational development of disasters.
Citation Text:
Turner BA. The Organizational and Interorganizational Development of Disasters. Adm Sci Q. 1976;21(3):378. doi:10.2307/2391850.
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