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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/867849/psn-pdf
    February 26, 2025 - High Reliability Organization (HRO) Principles and Patient Safety February 26, 2025 Vogus T, Lee M, Mossburg SE. High Reliability Organization (HRO) Principles and Patient Safety. PSNet [internet]. 2025. https://psnet.ahrq.gov/perspective/high-reliability-organization-hro-principles-and-patient-safety In To Err I…
  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33695/psn-pdf
    April 01, 2010 - #ref17 https://psnet.ahrq.gov//#ref20 https://psnet.ahrq.gov//#ref20 In the absence of a national approach
  3. psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.167_slideshow.ppt
    January 01, 2008 - Spotlight Case [MONTH] 2003 Spotlight Case January 2008 How Do Providers Recover from Errors? Source and Credits This presentation is based on the January 2008 AHRQ WebM&M Spotlight Case See the full article at http://webmm.ahrq.gov CME credit is available Commentary by: Colin P. West, MD, PhD, Mayo Clini…
  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/50391/psn-pdf
    September 25, 2019 - Think Like a Surgeon September 25, 2019 Cooper Z. Think Like a Surgeon. PSNet [internet]. 2019. https://psnet.ahrq.gov/web-mm/think-surgeon The Case A patient with a history of T6 paraplegia due to a motor vehicle accident was brought to the emergency department due to delirium. He was found to be hypotensive and…
  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33772/psn-pdf
    September 01, 2014 - An alternative approach would be to say we must be even more proactive.
  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46746/psn-pdf
    March 07, 2018 - Safety with nebulized medications requires an interdisciplinary team approach. … https://psnet.ahrq.gov/issue/safety-nebulized-medications-requires-interdisciplinary-team-approach Myriad … https://psnet.ahrq.gov/issue/safety-nebulized-medications-requires-interdisciplinary-team-approach https
  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/40206/psn-pdf
    June 15, 2011 - The authors argue that their findings reinforce the need to adopt a systems approach to prevention rather … swiss-cheese-model https://psnet.ahrq.gov/issue/critical-incident-technique https://psnet.ahrq.gov/primer/systems-approach … https://psnet.ahrq.gov/primer/systems-approach
  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43218/psn-pdf
    July 28, 2014 - The approach consists of students enhancing their clinical skills, analyzing information to augment … decision making, and applying a systems approach to detect underlying causes. … principles-risk-management-and-patient-safety https://psnet.ahrq.gov/issue/yours-learning-organization https://psnet.ahrq.gov/primer/systems-approach
  9. psnet.ahrq.gov/issue/interprofessional-approaches-patient-safety
    October 15, 2008 - Special or Theme Issue Interprofessional Approaches to Patient Safety. Citation Text: Interprofessional Approaches to Patient Safety. J Interprof Care. 2006;20(5):461-563. Copy Citation Save Save to your library Print Download PDF Share …
  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42363/psn-pdf
    September 19, 2013 - characterisation of patient safety hazards in community pharmacies using a sociotechnical systems approach … characterisation of patient safety hazards in community pharmacies using a sociotechnical systems approach … e-prescribing-characterisation-patient-safety-hazards-community-pharmacies-using https://psnet.ahrq.gov/issue/e-prescribing-focused-review-and-new-approach-addressing-safety-pharmacies-and-primary-care
  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46622/psn-pdf
    December 06, 2017 - https://psnet.ahrq.gov/issue/white-paper-recommendation-systems-based-practice-competency A systems approach … /white-paper-recommendation-systems-based-practice-competency https://psnet.ahrq.gov/primer/systems-approach … psnet.ahrq.gov/primer/patient-safety-101 https://psnet.ahrq.gov/issue/quality-and-safety-nursing-competency-approach-improving-outcomes-second-edition
  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46326/psn-pdf
    October 18, 2017 - Surgical Patient Safety: A Case-Based Approach. October 18, 2017 Stahel PF, ed. … https://psnet.ahrq.gov/issue/surgical-patient-safety-case-based-approach Surgical residency can be a … https://psnet.ahrq.gov/issue/surgical-patient-safety-case-based-approach https://psnet.ahrq.gov/issue
  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41300/psn-pdf
    April 22, 2012 - knowledge-self-efficacy A 3-day course for second year medical students that emphasized teamwork skills and the systems approach … day-patient-safety-curriculum-advance-knowledge-self-efficacy https://psnet.ahrq.gov/primer/systems-approach … https://psnet.ahrq.gov/primer/systems-approach
  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/35501/psn-pdf
    June 15, 2011 - Lucian Leape, begins with a retrospective view on the birth of patient safety initiatives, the systems approach … to addressing problems, progress made in changing systems, and challenges with this systems approach … ethical-issues-patient-safety https://psnet.ahrq.gov/issue/interview-lucian-leape https://psnet.ahrq.gov/primer/systems-approach
  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44624/psn-pdf
    March 02, 2016 - Researchers found that the most common patient safety research topic using this approach to date is … The authors suggest that more methodological rigor is needed to apply the approach to patient safety … what-methods-are-used-apply-positive-deviance-within-healthcare-organisations-systematic https://psnet.ahrq.gov/issue/positive-deviance-different-approach-achieving-patient-safety
  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44689/psn-pdf
    February 24, 2018 - concept of a just culture has become popular for balancing individual accountability with a systems approach … https://psnet.ahrq.gov/perspective/accountability-patient-safety https://psnet.ahrq.gov/primer/systems-approach … https://psnet.ahrq.gov/primer/systems-approach https://psnet.ahrq.gov/perspective/conversation-mary-dixon-woods-dphil
  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44812/psn-pdf
    February 15, 2017 - Investigators also tested a combined approach. … Although both team training and system redesign individually demonstrated improvement, the combined approach … was more successful than either individual approach.
  18. psnet.ahrq.gov/perspective/accountability-patient-safety
    January 01, 2018 - New articles exploring the role of individual skill in safety have heightened the need for an approach … This approach to mistakes was an ineffective strategy for preventing further patient safety mishaps, … This approach was codified as the cornerstone for the field of patient safety by its central role in … The systems-based approach was not only more likely to fix underlying patient safety problems, but … A prior PSNet perspective summarizes a stepwise approach for managing problem behaviors.
  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46781/psn-pdf
    August 20, 2018 - risk industries may not be straightforward: a qualitative study of the hierarchy of risk controls approach … risk industries may not be straightforward: a qualitative study of the hierarchy of risk controls approach … /errors-and-near-misses-what-health-care-could-learn-aviation https://psnet.ahrq.gov/primer/systems-approach
  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41858/psn-pdf
    November 21, 2012 - This study applied the systems approach to analyze cases presented at surgical M&M conferences over … disorganized-care-findings-iterative-depth-analysis-surgical-morbidity-and-mortality https://psnet.ahrq.gov/primer/systems-approach … /discussion-medical-errors-morbidity-and-mortality-conferences https://psnet.ahrq.gov/issue/systems-approach-morbidity-and-mortality-conference

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