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psnet.ahrq.gov/issue/normalization-deviance-do-we-unknowingly-accept-doing-wrong-thing
May 23, 2018 - September 7, 2016
Infection prevention in the operating room anesthesia work area.
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psnet.ahrq.gov/issue/promoting-civility-or-ethical-imperative
September 12, 2016 - Perceptions of patient safety culture among physicians and RNs in the perioperative area
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psnet.ahrq.gov/issue/society-improve-diagnosis-medicine-dxqi-seed-grant-program
November 08, 2017 - Grant Announcement
Society to Improve Diagnosis in Medicine. DxQI Seed Grant Program.
Citation Text:
Society to Improve Diagnosis in Medicine. DxQI Seed Grant Program. Society to Improve Diagnosis in Medicine.
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psnet.ahrq.gov/issue/lessons-patient-safety
August 01, 2017 - Book/Report
Lessons in Patient Safety.
Citation Text:
Lessons in Patient Safety. Zipperer LA, Cushman S, eds. Chicago, IL; National Patient Safety Foundation: 2001.
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psnet.ahrq.gov/issue/eliminating-serious-preventable-and-costly-medical-errors-never-events
May 26, 2021 - Press Release/Announcement
Eliminating Serious, Preventable, and Costly Medical Errors - Never Events.
Citation Text:
Eliminating Serious, Preventable, and Costly Medical Errors - Never Events. Baltimore, MD: Centers for Medicare and Medicaid Services; May 18, 2006.
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psnet.ahrq.gov/issue/ismp-medication-errors-reporting-program
January 26, 2023 - Measurement Tool/Indicator
ISMP Medication Errors Reporting Program.
Citation Text:
ISMP Medication Errors Reporting Program. Institute for Safe Medication Practices
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psnet.ahrq.gov/issue/what-every-health-care-organization-should-know-about-sentinel-events
November 27, 2018 - Book/Report
What Every Health Care Organization Should Know about Sentinel Events.
Citation Text:
What Every Health Care Organization Should Know about Sentinel Events. Oakbrook Terrace, IL: Joint Commission on Accreditation of Healthcare Organizations; 2005. ISBN 9780866889117.
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psnet.ahrq.gov/node/49830/psn-pdf
May 01, 2018 - Suicide Risk in the Hospital
May 1, 2018
Mills PD. Suicide Risk in the Hospital. PSNet [internet]. 2018.
https://psnet.ahrq.gov/web-mm/suicide-risk-hospital
The Case
A 37-year-old woman with a past medical history of depression, anxiety, and posttraumatic stress disorder
presented to the emergency department (ED)…
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psnet.ahrq.gov/perspective/becoming-certified-professional-patient-safety-pharmacists-perspective
June 01, 2016 - There are ways to start to define the core characteristics of people who have expertise in this area. … safety culture is higher on Maslow's scale than satisfied and joyful clinicians or other workers in this area … Just like we see in other fields, we're going to have individuals who are working in the area who are … very focused in one area and not capable of rising up to that more general competency that we would
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psnet.ahrq.gov/issue/joint-commission-center-transforming-healthcare
February 28, 2018 - Audiovisual Presentation
Joint Commission Center for Transforming Healthcare.
Citation Text:
Joint Commission Center for Transforming Healthcare. Joint Commission.
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psnet.ahrq.gov/issue/sentinel-event-alert
May 30, 2012 - Newsletter/Journal
Sentinel Event Alert.
Citation Text:
Sentinel Event Alert. Oakbrook Terrace, IL: The Joint Commission.
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psnet.ahrq.gov/issue/implementing-program-patient-safety-small-rural-hospitals
December 24, 2008 - Book/Report
Implementing a Program of Patient Safety in Small Rural Hospitals.
Citation Text:
Implementing a Program of Patient Safety in Small Rural Hospitals. Rockville, MD: Agency for Healthcare Research and Quality; October 2004.
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psnet.ahrq.gov/issue/leape-ahead-award
September 29, 2017 - Award Announcement
Leape Ahead Award.
Citation Text:
Leape Ahead Award. American Association for Physician Leadership.
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psnet.ahrq.gov/issue/international-prize-resilient-health-care
August 14, 2018 - Award Announcement
International Prize in Resilient Health Care.
Citation Text:
International Prize in Resilient Health Care. The Australian Institute of Health Innovation.
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.191_slideshow.ppt
January 01, 2009 - or county) by EMS directors
Most cities or areas are divided into zones; patients in a particular area
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psnet.ahrq.gov/issue/eliminating-racial-and-ethnic-disparities-causing-mortality-and-morbidity-pregnant-and
December 23, 2016 - Sentinel Event Alerts
Eliminating racial and ethnic disparities causing mortality and morbidity in pregnant and postpartum patients.
Citation Text:
Eliminating racial and ethnic disparities causing mortality and morbidity in pregnant and postpartum patients. Sentinel Event Alert. January…
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psnet.ahrq.gov/issue/opening-door-change-nhs-safety-culture-and-need-transformation
February 08, 2017 - Book/Report
Opening the Door to Change. NHS Safety Culture and the Need for Transformation.
Citation Text:
Opening the Door to Change. NHS Safety Culture and the Need for Transformation. Newcastle upon Tyne, UK: Care Quality Commission; December 2018.
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psnet.ahrq.gov/issue/mislabeling-event-batched-drugs-unintended-consequences-practice-changes
May 07, 2014 - Newspaper/Magazine Article
A mislabeling event with batched drugs: the unintended consequences of practice changes.
Citation Text:
A mislabeling event with batched drugs: the unintended consequences of practice changes. ISMP Medication Safety Alert! Acute Care Edition. 2014;19:1-3.&nbs…
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psnet.ahrq.gov/issue/promote-culture-safety-good-catch-reports
November 06, 2015 - Newspaper/Magazine Article
Promote a culture of safety with good catch reports.
Citation Text:
Promote a culture of safety with good catch reports. Wallace SC, Mamrol C, Finley E. PA-PSRS Patient Saf Advis. September 2017;14.
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psnet.ahrq.gov/issue/losing-laura
June 06, 2018 - Newspaper/Magazine Article
Losing Laura.
Citation Text:
Losing Laura. DeMarco P. Globe Magazine. November 3, 2018.
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