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psnet.ahrq.gov/node/73420/psn-pdf
June 23, 2021 - This study conducted root cause
analyses of 82 adverse event reports involving opioid use at the Veterans
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psnet.ahrq.gov/node/851356/psn-pdf
July 12, 2023 - https://psnet.ahrq.gov/issue/does-standardisation-improve-post-operative-anaesthesia-handoffs-meta-analyses-provider
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psnet.ahrq.gov/node/867596/psn-pdf
January 22, 2025 - implementing-root-cause-analysis-and-action-integrating-human-factors-create-strong
https://psnet.ahrq.gov/issue/rca2-improving-root-cause-analyses-and-actions-prevent-harm
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psnet.ahrq.gov/node/836966/psn-pdf
April 20, 2022 - The authors suggest that explicitly addressing performance variability in sentinel event analyses
can
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psnet.ahrq.gov/node/72814/psn-pdf
March 10, 2021 - implementing-human-factors-approach-rca2-tools-processes-and-strategies
https://psnet.ahrq.gov/issue/rca2-improving-root-cause-analyses-and-actions-prevent-harm
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psnet.ahrq.gov/node/73610/psn-pdf
January 01, 2022 - Analyses suggest that atypical presentation was often characterized by functional decline or altered
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psnet.ahrq.gov/node/50432/psn-pdf
September 04, 2019 - inpatient-suicide-mental-health-units-veterans-affairs-va-hospitals-avoiding-environmental
https://psnet.ahrq.gov/issue/root-cause-analyses-suicides-mental-health-clients
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psnet.ahrq.gov/node/73634/psn-pdf
August 25, 2021 - Analyses show that the e-trigger identified missed diagnoses of stroke with a modest positive predictive
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psnet.ahrq.gov/node/838077/psn-pdf
September 14, 2022 - Analyses showed that patients were designated as “alternate
level of care” (ALC) for an average of 56
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psnet.ahrq.gov/node/837794/psn-pdf
August 10, 2022 - Analyses identified limited improvement in quality and
patient safety indicators.
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psnet.ahrq.gov/node/74200/psn-pdf
January 01, 2022 - Subgroup analyses indicate that this relationship is driven by worse outcomes among female patients
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psnet.ahrq.gov/node/862608/psn-pdf
February 14, 2024 - Thematic analyses identified
three priority areas to improve patient experience and safety during preterm
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psnet.ahrq.gov/issue/studying-organisational-cultures-and-their-effects-safety
April 20, 2014 - The author shares examples of cultural analyses and provides suggestions for effective research on safety
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psnet.ahrq.gov/issue/investigation-and-analysis-critical-incidents-and-adverse-events-healthcare
March 05, 2014 - Study
Classic
The investigation and analysis of critical incidents and adverse events in healthcare.
Citation Text:
Woloshynowych M, Rogers S, Taylor-Adams S, et al. The investigation and analysis of critical incidents and adverse events in healthcare. Health …
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psnet.ahrq.gov/issue/conducting-safety-research-safely-policy-based-approach-conducting-research-peer-review
June 15, 2022 - for the use of peer review protected information (such as voluntary event reports and root causes analyses
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psnet.ahrq.gov/issue/factors-associated-potentially-missed-diagnosis-appendicitis-emergency-department
December 16, 2020 - Stratified analyses based on undifferentiated symptoms found that women and patients with comorbidities
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psnet.ahrq.gov/issue/value-assessment-deprescribing-interventions-suggestions-improvement
August 04, 2021 - This article outlines several recommendations for improved cost-effectiveness analyses of deprescribing
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psnet.ahrq.gov/issue/diagnostic-reliability-teledermatology-systematic-review-and-meta-analysis
September 23, 2020 - The overall average diagnostic agreement was 68.9%, but subgroup analyses identified significantly higher
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psnet.ahrq.gov/issue/evidence-based-toolkit-development-effective-and-sustainable-root-cause-analysis-system
June 01, 2019 - The authors reviewed 334 root cause analyses (RCA) using systems science principles to create a toolkit
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psnet.ahrq.gov/node/60643/psn-pdf
July 01, 2020 - Analyses also found an association between PPE discomfort and
situational awareness, but this association