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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/34870/psn-pdf
    April 18, 2016 - Unintended medication discrepancies at the time of hospital admission. April 18, 2016 Cornish PL, Knowles SR, Marchesano R, et al. Unintended medication discrepancies at the time of hospital admission. Arch Intern Med. 2005;165(4):424-9. https://psnet.ahrq.gov/issue/unintended-medication-discrepancies-time-hospita…
  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/34731/psn-pdf
    July 08, 2016 - Crossing the Quality Chasm: A New Health System for the 21st Century. July 8, 2016 Committee on Quality of Health Care in America, Institute of Medicine. Washington DC: National Academies Press; 2001. ISBN: 9780309072809. https://psnet.ahrq.gov/issue/crossing-quality-chasm-new-health-system-21st-century Following…
  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/72657/psn-pdf
    January 20, 2021 - Establishing a multi-institutional quality and patient safety consortium: collaboration across affiliates in a community-based medical school. January 20, 2021 Hillman E, Paul J, Neustadt M, et al. Establishing a multi-institutional quality and patient safety consortium: collaboration across affiliates in a commun…
  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/837031/psn-pdf
    May 04, 2022 - Indicators for implementation outcome monitoring of reporting and learning systems in hospitals: an underestimated need for patient safety. May 4, 2022 Kuske S, Willmeroth T, Schneider J, et al. Indicators for implementation outcome monitoring of reporting and learning systems in hospitals: an underestimated need …
  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/836822/psn-pdf
    March 30, 2022 - Leveraging a safety event management system to improve organizational learning and safety culture. March 30, 2022 Dawson R, Saulnier T, Campbell A, et al. Leveraging a safety event management system to improve organizational learning and safety culture. Hosp Pediatr. 2022;12(4):407-417. doi:10.1542/hpeds.2021- 006…
  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/836915/psn-pdf
    April 13, 2022 - Workarounds in electronic health record systems and the revised Sociotechnical Electronic Health Record Workaround Analysis Framework: scoping review. April 13, 2022 Blijleven V, Hoxha F, Jaspers MWM. Workarounds in electronic health record systems and the revised sociotechnical Electronic Health Record workaround…
  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/73567/psn-pdf
    August 04, 2021 - Pharmacist-led educational interventions provided to healthcare providers to reduce medication errors: a systematic review and meta-analysis. August 4, 2021 Jaam M, Naseralallah LM, Hussain TA, et al. Pharmacist-led educational interventions provided to healthcare providers to reduce medication errors: a systemati…
  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/849610/psn-pdf
    May 31, 2023 - Implementation of ED I-PASS as a standardized handoff tool in the pediatric emergency department. May 31, 2023 Yanni E, Calaman S, Wiener E, et al. Implementation of ED I-PASS as a standardized handoff tool in the pediatric emergency department. J Healthc Qual. 2023;45(3):140-147. doi:10.1097/jhq.0000000000000374.…
  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/837304/psn-pdf
    June 01, 2022 - Does standardisation improve post-operative anaesthesia handoffs? Meta-analyses on provider, patient, organisational, and handoff outcomes. June 1, 2022 Lazzara EH, Simonson RJ, Gisick LM, et al. Does standardisation improve post-operative anaesthesia handoffs? Meta-analyses on provider, patient, organisational, a…
  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/838252/psn-pdf
    October 05, 2022 - A longitudinal study of a multifaceted intervention to reduce newborn falls while preserving rooming-in on a mother-baby unit. October 5, 2022 Whatley C, Schlogl J, Whalen BL, et al. A longitudinal study of a multifaceted intervention to reduce newborn falls while preserving rooming-in on a mother-baby unit. Jt Co…
  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/73413/psn-pdf
    June 23, 2021 - Interventions to reduce pediatric prescribing errors in professional healthcare settings: a systematic review of the last decade. June 23, 2021 Koeck JA, Young NJ, Kontny U, et al. Interventions to Reduce Pediatric Prescribing Errors in Professional Healthcare Settings: A Systematic Review of the Last Decade. Pedi…
  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/73563/psn-pdf
    August 04, 2021 - Understanding complaints made about surgical departments in a UK district general hospital. August 4, 2021 Claydon O, Keeler B, Khanna A. Understanding complaints made about surgical departments in a UK district general hospital. Int J Qual Health Care. 2021;33(3). doi:10.1093/intqhc/mzab095. https://psnet.ahrq.go…
  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/845630/psn-pdf
    March 08, 2023 - The effect of transitions intervention to ensure patient safety and satisfaction when transferred from hospital to home health care-a systematic review. March 8, 2023 Oksholm T, Gissum KR, Hunskår I, et al. The effect of transitions intervention to ensure patient safety and satisfaction when transferred from hospi…
  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/74034/psn-pdf
    November 03, 2021 - Logo Adaptation and implementation of the WHO Safe Childbirth Checklist around the world. November 3, 2021 Molina RL, Benski A-C, Bobanski L, et al. Adaptation and implementation of the WHO Safe Childbirth Checklist around the world. Implement Sci Commun. 2021;2(1):76. doi:10.1186/s43058-021-00176-z. https://psne…
  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/853429/psn-pdf
    September 13, 2023 - Multifaceted intervention to improve patient safety incident reporting in intensive care units. September 13, 2023 Griffeth EM, Gajic O, Schueler N, et al. Multifaceted intervention to improve patient safety incident reporting in intensive care units. J Patient Saf. 2023;19(7):422-428. doi:10.1097/pts.0000000000001…
  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33932/psn-pdf
    May 27, 2011 - Preventable anesthesia mishaps: a study of human factors. May 27, 2011 Cooper JB, Newbower RS, Long CD, et al. Preventable anesthesia mishaps: a study of human factors. Anesthesiology. 1978;49(6):399-406. https://psnet.ahrq.gov/issue/preventable-anesthesia-mishaps-study-human-factors This study reports on the ret…
  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/34982/psn-pdf
    July 14, 2010 - Development of the ICU safety reporting system. July 14, 2010 Wu AW, Holzmueller CG, Lubomski LH, et al. J Patient Saf. 2005;1(1):23-32. https://psnet.ahrq.gov/issue/development-icu-safety-reporting-system This AHRQ-funded study describes the development of a Web-based, voluntary, and anonymous reporting system. T…
  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/35553/psn-pdf
    July 03, 2013 - Maximizing the Use of State Adverse Event Data to Improve Patient Safety. July 3, 2013 Rosenthal J, Booth M. National Academy for State Health Policy; 2005. https://psnet.ahrq.gov/issue/maximizing-use-state-adverse-event-data-improve-patient-safety This report, generated by the National Academy for State Health Po…
  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/34800/psn-pdf
    December 23, 2008 - A classification system for incidents and accidents in the health-care system. December 23, 2008 Runciman WB, Helps SC, Sexton EJ, et al. A classification for incidents and accidents in the health-care system. J Qual Clin Pract. 1998;18(3):199-211. https://psnet.ahrq.gov/issue/classification-system-incidents-and-a…
  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46900/psn-pdf
    August 29, 2018 - Developing agreement on never events in primary care dentistry: an international eDelphi study. August 29, 2018 Ensaldo-Carrasco E, Carson-Stevens A, Cresswell K, et al. Developing agreement on never events in primary care dentistry: an international eDelphi study. Br Dent J. 2018;224(9):733-740. doi:10.1038/sj.bd…

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