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psnet.ahrq.gov/perspective/key-issues-developing-successful-hospital-safety-program
July 01, 2006 - So, I think the answer is that if I'm sitting in an organization and a terrible event occurs and I look … at itthe answer is that the e-mail goes out to protect the next patient. … And, then when the media comes knocking on your door, the answer is that we're health care. … In the long run, if you take that approach, when it's reviewed, the answer will be that we did what was … AF: The answer there is actually pretty straightforward, and it's almost a purely mathematical model
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psnet.ahrq.gov/perspective/conversation-withjoseph-britto-md
February 01, 2007 - RW: Now when you were talking about what was different in 1999 than 1980, most of your answer emphasized … JB: The short answer is yes. … To try to answer the crucial question that we have when we use a diagnosis decision support systemwhat … And we can then use real-time epidemiology to help answer that question.
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psnet.ahrq.gov/web-mm/what-happened-telemetry
January 18, 2012 - interprofessional team should discuss all potential problems including lack of staff availability to answer
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psnet.ahrq.gov/issue/medication-errors-during-patient-transitions-nursing-homes-characteristics-and-association
August 07, 2013 - 16, 2020
The AHRQ Report on Diagnostic Errors in the Emergency Department: the wrong answer
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psnet.ahrq.gov/issue/anticoagulant-medication-errors-nursing-homes-characteristics-causes-outcomes-and-association
December 15, 2011 - 23, 2020
The AHRQ Report on Diagnostic Errors in the Emergency Department: the wrong answer
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psnet.ahrq.gov/issue/moving-beyond-weekend-effect-how-can-we-best-target-interventions-improve-patient-care
September 09, 2015 - 2023
The AHRQ Report on Diagnostic Errors in the Emergency Department: the wrong answer
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psnet.ahrq.gov/issue/nicu-medication-errors-identifying-risk-profile-medication-errors-neonatal-intensive-care
September 21, 2008 - WebM&M Cases
Fatal Error in Neonate: Does "Just Culture" Provide an Answer
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psnet.ahrq.gov/node/49720/psn-pdf
December 01, 2014 - stimulation.
0 = Alert; keenly responsive.
1 = Not alert; but arousable by minor
stimulation to obey, answer … The answer must be correct - there is no
partial credit for being close. … It is important that
only the initial answer be graded and that the examiner
not "help" the patient
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psnet.ahrq.gov/node/74242/psn-pdf
January 07, 2022 - The attending physician
stopped by to answer questions and to confirm that the procedure was running … While this may be a simplistic answer, it highlights an oft forgot source of verification – the
patient
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psnet.ahrq.gov/periodic-issue/periodic-issue-432
March 27, 2024 - explored areas for improvement with medical question answering (QA) systems, which are designed to answer
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psnet.ahrq.gov/node/44189/psn-pdf
September 09, 2015 - Variation in printed handoff documents: results and
recommendations from a multicenter needs assessment.
September 9, 2015
Rosenbluth G, Bale JF, Starmer AJ, et al. Variation in printed handoff documents: Results and
recommendations from a multicenter needs assessment. J Hosp Med. 2015;10(8):517-24.
doi:10.1002/jh…
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psnet.ahrq.gov/node/34763/psn-pdf
March 07, 2005 - The Limits of Safety: Organizations, Accidents and
Nuclear Weapons.
March 7, 2005
Sagan SD. Princeton NJ: Princeton University Press; 1993. ISBN: 9780691032214.
https://psnet.ahrq.gov/issue/limits-safety-organizations-accidents-and-nuclear-weapons
Two competing paradigms dominate the study of the hazards associate…
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psnet.ahrq.gov/web-mm/charcoal-lavage-lungs
January 01, 2016 - Simulations could be an answer if they were sufficiently sophisticated.( 4,5 ) Most simulations of common … A protocol aimed at high-risk situations is a practical answer.
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psnet.ahrq.gov/node/33778/psn-pdf
March 01, 2015 - taking a national certification examination showed that, for cases involving
diagnosis, changing an answer … from incorrect to correct occurred nearly twice as often as changing an
answer from correct to incorrect
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psnet.ahrq.gov/node/33679/psn-pdf
January 01, 2009 - suits, more lawsuits could actually lead to greater efforts to improve safety.(11)
The empirical answer … Even without a satisfying answer to the malpractice liability question, the ethical and legal mandates
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psnet.ahrq.gov/issue/pharmacists-play-key-role-patient-safety
March 29, 2023 - Newspaper/Magazine Article
Pharmacists play key role in patient safety.
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March 6, 2005
Description of a successful model from Duke…
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psnet.ahrq.gov/issue/payoff-preventing-errors-medication-management
November 07, 2007 - Newspaper/Magazine Article
Published November 7, 2007
The payoff: preventing errors medication management.
Crane AB. Hospitals & health networks . 2007; 81 :57-8, 60, 2 .
Topics
Approach to Improving Safety
Clinical Information Systems
Medication Reconciliation
Resource Type
Newspaper/Magazine Article
Setting…
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psnet.ahrq.gov/perspective/conversation-amy-c-edmondson-phd-am
February 01, 2017 - The answer is a tie.
AE : Right. So hierarchy matters. A lot! … Part of the answer lies in your question.
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psnet.ahrq.gov/perspective/new-insights-about-team-training-decade-teamstepps
February 01, 2017 - The answer is a tie.
AE : Right. So hierarchy matters. A lot! … Part of the answer lies in your question.
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psnet.ahrq.gov/perspective/diagnostic-errors-medicine-what-do-doctors-and-umpires-have-common
February 01, 2007 - RW: Now when you were talking about what was different in 1999 than 1980, most of your answer emphasized … JB: The short answer is yes. … To try to answer the crucial question that we have when we use a diagnosis decision support systemwhat … And we can then use real-time epidemiology to help answer that question.