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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/39091/psn-pdf
    June 28, 2011 - Integration of prospective and retrospective methods for risk analysis in hospitals. … Integration of prospective and retrospective methods for risk analysis in hospitals. … https://psnet.ahrq.gov/issue/integration-prospective-and-retrospective-methods-risk-analysis-hospitals … https://psnet.ahrq.gov/issue/integration-prospective-and-retrospective-methods-risk-analysis-hospitals … https://psnet.ahrq.gov/primer/root-cause-analysis

  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/40004/psn-pdf
    February 01, 2011 - Application of failure mode and effect analysis in a radiology department. … Application of Failure Mode and Effect Analysis in a Radiology Department. … https://psnet.ahrq.gov/issue/application-failure-mode-and-effect-analysis-radiology-department This … commentary introduces the failure mode and effects analysis process developed by the United States Department … https://psnet.ahrq.gov/issue/application-failure-mode-and-effect-analysis-radiology-department https:

  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/39865/psn-pdf
    May 28, 2014 - Failure Mode and Effects Analysis in Health Care: Proactive Risk Reduction, Third Edition. … https://psnet.ahrq.gov/issue/failure-mode-and-effects-analysis-health-care-proactive-risk-reduction-third … edition This publication provides strategies for organizations to utilize the Failure Mode and Effects Analysis … https://psnet.ahrq.gov/issue/failure-mode-and-effects-analysis-health-care-proactive-risk-reduction-third-edition … https://psnet.ahrq.gov/issue/failure-mode-and-effects-analysis-health-care-proactive-risk-reduction-third-edition

  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43795/psn-pdf
    December 17, 2014 - Systematic Systems Analysis: A Practical Approach to Patient Safety Reviews. … https://psnet.ahrq.gov/issue/systematic-systems-analysis-practical-approach-patient-safety-reviews Drawing … from human factors and system analysis techniques, this guide describes an approach to identifying … https://psnet.ahrq.gov/issue/systematic-systems-analysis-practical-approach-patient-safety-reviews https … https://psnet.ahrq.gov/issue/cross-sectional-analysis-investigating-organizational-factors-influence-near-miss-error

  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/36800/psn-pdf
    August 26, 2011 - Application of the human factors analysis and classification system methodology to the cardiovascular … Application of the human factors analysis and classification system methodology to the cardiovascular … https://psnet.ahrq.gov/issue/application-human-factors-analysis-and-classification-system-methodology … - cardiovascular The authors adapted an incident analysis model used in aviation to understand the … https://psnet.ahrq.gov/issue/application-human-factors-analysis-and-classification-system-methodology-cardiovascular

  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/35322/psn-pdf
    July 14, 2009 - Safe chemotherapy administration: using failure mode and effects analysis in computerized prescriber … Safe chemotherapy administration: Using failure mode and effects analysis in computerized prescriber … https://psnet.ahrq.gov/issue/safe-chemotherapy-administration-using-failure-mode-and-effects-analysis … - computerized This case study describes one hospital’s use of failure mode and effects analysis (FMEA … https://psnet.ahrq.gov/issue/safe-chemotherapy-administration-using-failure-mode-and-effects-analysis-computerized

  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/37086/psn-pdf
    October 03, 2011 - Failure mode and effects analysis: a useful tool for risk identification and injury prevention. … Failure mode and effects analysis: a useful tool for risk identification and injury prevention. … https://psnet.ahrq.gov/issue/failure-mode-and-effects-analysis-useful-tool-risk-identification-and-injury … proactive risk assessment and provides insights on the successful use of failure mode and effects analysis … https://psnet.ahrq.gov/issue/failure-mode-and-effects-analysis-useful-tool-risk-identification-and-injury-prevention

  8. The health information infrastructure in America today . . . . (pdf file)

    hcup-us.ahrq.gov/datainnovations/clinicaldata/AHRQHCUPfinalNov09BDiefenbach.pdf
    November 01, 2009 - Agency for Health Care Administration Florida Center for Health Information and Policy Analysis HCUP … Learned Agency for Health Care Administration Florida Center for Health Information and Policy Analysis … Hospital Agency for Health Care Administration Florida Center for Health Information and Policy Analysis … Agency for Health Care Administration Florida Center for Health Information and Policy Analysis Data … Agency for Health Care Administration Florida Center for Health Information and Policy Analysis LOINC

  9. Labeling morphine milligram equivalents on opioid packaging: a potential patient safety intervention. | PSNet

    psnet.ahrq.gov/issue/labeling-morphine-milligram-equivalents-opioid-packaging-potential-patient-safety
    March 06, 2019 - June 16, 2019 ISMP medication error report analysis. … June 16, 2019 ISMP medication error report analysis. … June 16, 2019 ISMP medication error report analysis. … June 16, 2019 ISMP medication error report analysis. … June 16, 2019 ISMP medication error report analysis.

  10. Predictors of warfarin-associated adverse events in hospitalized patients: opportunities to prevent patient harm. | PSNet

    psnet.ahrq.gov/issue/predictors-warfarin-associated-adverse-events-hospitalized-patients-opportunities-prevent
    August 03, 2016 - June 16, 2019 ISMP medication error report analysis. … June 16, 2019 ISMP medication error report analysis. … June 16, 2019 ISMP medication error report analysis. … June 16, 2019 ISMP medication error report analysis. … June 16, 2019 ISMP medication error report analysis.

  11. Impact of a standard medication chart on prescribing errors: a before-and-after audit. | PSNet

    psnet.ahrq.gov/issue/impact-standard-medication-chart-prescribing-errors-and-after-audit
    May 02, 2012 - June 16, 2019 ISMP medication error report analysis. … June 16, 2019 ISMP medication error report analysis. … June 16, 2019 ISMP medication error report analysis. … June 16, 2019 ISMP medication error report analysis. … June 16, 2019 ISMP medication error report analysis.

  12. National Patient Safety Goals. | PSNet

    psnet.ahrq.gov/issue/national-patient-safety-goals
    May 30, 2012 - June 16, 2019 ISMP medication error report analysis. … June 16, 2019 ISMP medication error report analysis. … June 16, 2019 ISMP medication error report analysis. … June 16, 2019 ISMP medication error report analysis. … June 16, 2019 ISMP medication error report analysis.

  13. ISMP Targeted Medication Safety Best Practices for Community Pharmacy. | PSNet

    psnet.ahrq.gov/issue/ismp-targeted-medication-safety-best-practices-community-pharmacy
    March 21, 2012 - June 16, 2019 ISMP medication error report analysis. … June 16, 2019 ISMP medication error report analysis. … June 16, 2019 ISMP medication error report analysis. … June 16, 2019 ISMP medication error report analysis. … June 16, 2019 ISMP medication error report analysis.

  14. Implementing a bar-code medication administration system. | PSNet

    psnet.ahrq.gov/issue/implementing-bar-code-medication-administration-system
    May 11, 2014 - June 16, 2019 ISMP medication error report analysis. … June 16, 2019 ISMP medication error report analysis. … June 16, 2019 ISMP medication error report analysis. … June 16, 2019 ISMP medication error report analysis. … June 16, 2019 ISMP medication error report analysis.

  15. Preventing harm from high-alert medications. | PSNet

    psnet.ahrq.gov/issue/preventing-harm-high-alert-medications
    August 14, 2017 - June 16, 2019 ISMP medication error report analysis. … June 16, 2019 ISMP medication error report analysis. … June 16, 2019 ISMP medication error report analysis. … June 16, 2019 ISMP medication error report analysis. … June 16, 2019 ISMP medication error report analysis.

  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/39948/psn-pdf
    December 21, 2014 - Wrong-site and wrong-patient procedures in the Universal Protocol era: analysis of a prospective database … Wrong-site and wrong-patient procedures in the universal protocol era: analysis of a prospective database … https://psnet.ahrq.gov/issue/wrong-site-and-wrong-patient-procedures-universal-protocol-era-analysis- … However, this analysis of WSPEs that were voluntarily reported to a Colorado malpractice insurance company … Root cause analysis revealed a number of contributing causes, with diagnostic errors and communication

  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/34794/psn-pdf
    November 18, 2015 - Accident analysis of large-scale technological disasters applied to an anaesthetic complication. … Accident analysis of large-scale technological disasters applied to an anaesthetic complication. … https://psnet.ahrq.gov/issue/accident-analysis-large-scale-technological-disasters-applied-anaesthetic … The model discussed focuses on two types of failures, which share equal importance in analysis but distinguish … They conclude that analysis of past disasters has offered a useful model to differentiate provider from

  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42670/psn-pdf
    January 09, 2014 - Meta-analysis of surgical safety checklist effects on teamwork, communication, morbidity, mortality, … Meta-analysis of surgical safety checklist effects on teamwork, communication, morbidity, mortality, … https://psnet.ahrq.gov/issue/meta-analysis-surgical-safety-checklist-effects-teamwork-communication- … morbidity-mortality This meta-analysis of 19 surgical checklist studies found that checklists improved … https://psnet.ahrq.gov/issue/meta-analysis-surgical-safety-checklist-effects-teamwork-communication-morbidity-mortality

  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/38753/psn-pdf
    July 01, 2009 - Evaluation of safety in a radiation oncology setting using failure mode and effects analysis. … Evaluation of safety in a radiation oncology setting using failure mode and effects analysis. … /psnet.ahrq.gov/issue/evaluation-safety-radiation-oncology-setting-using-failure-mode-and-effects- analysis … Failure mode and effects analysis was used to prospectively analyze an external beam radiation therapy … ://psnet.ahrq.gov/issue/evaluation-safety-radiation-oncology-setting-using-failure-mode-and-effects-analysis

  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41554/psn-pdf
    January 03, 2017 - Using root cause analysis to reduce falls with injury in community settings. … Using root cause analysis to reduce falls with injury in community settings. … https://psnet.ahrq.gov/issue/using-root-cause-analysis-reduce-falls-injury-community-settings This study … used root cause analysis (RCA) to identify hazards leading to falls among community-dwelling elderly … /psnet.ahrq.gov/primer/root-cause-analysis https://psnet.ahrq.gov/primer/ambulatory-care-safety
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