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Free-text computerized provider order entry orders used as workaround for communicating medication information. | PSNet

psnet.ahrq.gov/issue/free-text-computerized-provider-order-entry-orders-used-workaround-communicating-medication

July 29, 2020 - Study Free-text computerized provider order entry orders used as workaround for communicating medication information. Citation Text: Kandaswamy S, Grimes J, Hoffman D, et al. Free-text computerized provider order entry orders used as workaround for communicating medication information. J…

Unexpected increased mortality after implementation of a commercially sold computerized physician order entry system. | PSNet

psnet.ahrq.gov/issue/unexpected-increased-mortality-after-implementation-commercially-sold-computerized-physician

September 23, 2020 - Study Classic Unexpected increased mortality after implementation of a commercially sold computerized physician order entry system. Citation Text: Han YY, Carcillo JA, Venkataraman ST, et al. Unexpected increased mortality after implementation of a commerciall…

Do telephone call interruptions have an impact on radiology resident diagnostic accuracy? | PSNet

psnet.ahrq.gov/issue/do-telephone-call-interruptions-have-impact-radiology-resident-diagnostic-accuracy

July 19, 2023 - Study Do telephone call interruptions have an impact on radiology resident diagnostic accuracy? Citation Text: Balint BJ, Steenburg SD, Lin H, et al. Do telephone call interruptions have an impact on radiology resident diagnostic accuracy? Acad Radiol. 2014;21(12):1623-8. doi:10.1016/j.a…

Physician antipsychotic overprescribing letters and cognitive, behavioral, and physical health outcomes among people with dementia: a secondary analysis of a randomized clinical trial. | PSNet

psnet.ahrq.gov/issue/physician-antipsychotic-overprescribing-letters-and-cognitive-behavioral-and-physical-health

March 05, 2025 - Study Physician antipsychotic overprescribing letters and cognitive, behavioral, and physical health outcomes among people with dementia: a secondary analysis of a randomized clinical trial. Citation Text: Harnisch M, Barnett ML, Coussens S, et al. Physician antipsychotic overprescribing…

Hospital-wide cardiac arrest in situ simulation to identify and mitigate latent safety threats. | PSNet

psnet.ahrq.gov/issue/hospital-wide-cardiac-arrest-situ-simulation-identify-and-mitigate-latent-safety-threats

April 14, 2021 - Study Hospital-wide cardiac arrest in situ simulation to identify and mitigate latent safety threats. Citation Text: Bentley SK, Meshel A, Boehm L, et al. Hospital-wide cardiac arrest in situ simulation to identify and mitigate latent safety threats. Adv Simul (Lond). 2022;7(1):15. doi:1…

A policy-based intervention for the reduction of communication breakdowns in inpatient surgical care: results from a Harvard surgical safety collaborative. | PSNet

psnet.ahrq.gov/issue/policy-based-intervention-reduction-communication-breakdowns-inpatient-surgical-care-results

January 04, 2010 - Study A policy-based intervention for the reduction of communication breakdowns in inpatient surgical care: results from a Harvard surgical safety collaborative. Citation Text: Arriaga AF, Elbardissi AW, Regenbogen SE, et al. A policy-based intervention for the reduction of communication…

Turning the medical gaze in upon itself: root cause analysis and the investigation of clinical error. | PSNet

psnet.ahrq.gov/issue/turning-medical-gaze-upon-itself-root-cause-analysis-and-investigation-clinical-error

June 14, 2011 - Study Turning the medical gaze in upon itself: root cause analysis and the investigation of clinical error. Citation Text: Iedema RAM, Jorm C, Long D, et al. Turning the medical gaze in upon itself: root cause analysis and the investigation of clinical error. Soc Sci Med. 2006;62(7):16…

Improving critical incident reporting in primary care through education and involvement. | PSNet

psnet.ahrq.gov/issue/improving-critical-incident-reporting-primary-care-through-education-and-involvement

September 07, 2022 - Study Improving critical incident reporting in primary care through education and involvement. Citation Text: Müller BS, Beyer M, Blazejewski T, et al. Improving critical incident reporting in primary care through education and involvement. BMJ Open Qual. 2019;8(3):e000556. doi:10.1136/b…

A mixed-methods study of challenges experienced by clinical teams in measuring improvement. | PSNet

psnet.ahrq.gov/issue/mixed-methods-study-challenges-experienced-clinical-teams-measuring-improvement

February 20, 2019 - Study A mixed-methods study of challenges experienced by clinical teams in measuring improvement. Citation Text: Woodcock T, Liberati EG, Dixon-Woods M. A mixed-methods study of challenges experienced by clinical teams in measuring improvement. BMJ Qual Saf. 2021;30(2):106-115. doi:10.11…

Effects of a communication-and-resolution program on hospitals' malpractice claims and costs. | PSNet

psnet.ahrq.gov/issue/effects-communication-and-resolution-program-hospitals-malpractice-claims-and-costs

October 11, 2017 - Study Effects of a communication-and-resolution program on hospitals' malpractice claims and costs. Citation Text: Kachalia A, Sands K, Van Niel M, et al. Effects Of A Communication-And-Resolution Program On Hospitals' Malpractice Claims And Costs. Health Aff (Millwood). 2018;37(11):1836…

Uncovering system errors using a rapid response team: cross-coverage caught in the crossfire. | PSNet

psnet.ahrq.gov/issue/uncovering-system-errors-using-rapid-response-team-cross-coverage-caught-crossfire

April 24, 2018 - Study Uncovering system errors using a rapid response team: cross-coverage caught in the crossfire. Citation Text: Kaplan LJ, Maerz LL, Schuster KM, et al. Uncovering System Errors Using a Rapid Response Team: Cross-Coverage Caught in the Crossfire. The Journal of Trauma: Injury, Infect…

Breast cancer screening in Denmark: a cohort study of tumor size and overdiagnosis. | PSNet

psnet.ahrq.gov/issue/breast-cancer-screening-denmark-cohort-study-tumor-size-and-overdiagnosis

July 10, 2018 - Study Classic Breast cancer screening in Denmark: a cohort study of tumor size and overdiagnosis. Citation Text: Jørgensen KJ, Gøtzsche PC, Kalager M, et al. Breast Cancer Screening in Denmark: A Cohort Study of Tumor Size and Overdiagnosis. Ann Intern Med. 2017…

An analysis of electronic health record–related patient safety concerns. | PSNet

psnet.ahrq.gov/issue/analysis-electronic-health-record-related-patient-safety-concerns

January 21, 2019 - Study Classic An analysis of electronic health record–related patient safety concerns. Citation Text: Meeks DW, Smith MW, Taylor L, et al. An analysis of electronic health record-related patient safety concerns. J Am Med Inform Assoc. 2014;21(6):1053-9. doi:10.1…

Patient safety concerns in COVID-19–related events: a study of 343 event reports from 71 hospitals in Pennsylvania. | PSNet

psnet.ahrq.gov/issue/patient-safety-concerns-covid-19-related-events-study-343-event-reports-71-hospitals

July 24, 2024 - Study Patient safety concerns in COVID-19–related events: a study of 343 event reports from 71 hospitals in Pennsylvania. Citation Text: Taylor M, Kepner S, Gardner LA, et al. Patient safety concerns in COVID-19–related events: a study of 343 event reports from 71 hospitals in Pennsylvan…

Drug-related hospitalizations in a tertiary care internal medicine service of a Canadian hospital: a prospective study. | PSNet

psnet.ahrq.gov/issue/drug-related-hospitalizations-tertiary-care-internal-medicine-service-canadian-hospital

April 22, 2011 - Study Drug-related hospitalizations in a tertiary care internal medicine service of a Canadian hospital: a prospective study. Citation Text: Samoy LJ, Zed PJ, Wilbur K, et al. Drug-related hospitalizations in a tertiary care internal medicine service of a Canadian hospital: a prospecti…

Demonstrating high reliability on accountability measures at The Johns Hopkins Hospital. | PSNet

psnet.ahrq.gov/issue/demonstrating-high-reliability-accountability-measures-johns-hopkins-hospital

January 27, 2016 - Study Demonstrating high reliability on accountability measures at The Johns Hopkins Hospital. Citation Text: Pronovost P, Demski R, Callender T, et al. Demonstrating high reliability on accountability measures at the Johns Hopkins Hospital. Jt Comm J Qual Patient Saf. 2013;39(12):531…

The analysis of hospital readmission rates after the implementation of Hospital Readmissions Reduction Program. | PSNet

psnet.ahrq.gov/issue/analysis-hospital-readmission-rates-after-implementation-hospital-readmissions-reduction

October 12, 2022 - Study The analysis of hospital readmission rates after the implementation of Hospital Readmissions Reduction Program. Citation Text: Muchiri S, Azadeh-Fard N, Pakdil F. The analysis of hospital readmission rates after the implementation of hospital readmissions reduction program. J Patie…

Data omission by physician trainees on ICU rounds. | PSNet

psnet.ahrq.gov/issue/data-omission-physician-trainees-icu-rounds

January 23, 2017 - Study Data omission by physician trainees on ICU rounds. Citation Text: Artis KA, Bordley J, Mohan V, et al. Data Omission by Physician Trainees on ICU Rounds. Crit Care Med. 2019;47(3):403-409. doi:10.1097/CCM.0000000000003557. Copy Citation Format: DOI Google Scholar PubM…

The safety implications of missed test results for hospitalised patients: a systematic review. | PSNet

psnet.ahrq.gov/issue/safety-implications-missed-test-results-hospitalised-patients-systematic-review

November 26, 2014 - Review Classic The safety implications of missed test results for hospitalised patients: a systematic review. Citation Text: Callen J, Georgiou A, Li J, et al. The safety implications of missed test results for hospitalised patients: a systematic review. BMJ Q…

A patient-initiated voluntary online survey of adverse medical events: the perspective of 696 injured patients and families. | PSNet

psnet.ahrq.gov/issue/patient-initiated-voluntary-online-survey-adverse-medical-events-perspective-696-injured

May 20, 2020 - Study Classic A patient-initiated voluntary online survey of adverse medical events: the perspective of 696 injured patients and families. Citation Text: Southwick FS, Cranley NM, Hallisy JA. A patient-initiated voluntary online survey of adverse medical events:…

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