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psnet.ahrq.gov/node/36255/psn-pdf
February 02, 2011 - Interns' compliance with Accreditation Council for
Graduate Medical Education work-hour limits.
February 2, 2011
Landrigan CP, Barger LK, Cade BE, et al. Interns' compliance with accreditation council for graduate
medical education work-hour limits. JAMA. 2006;296(9):1063-70.
https://psnet.ahrq.gov/issue/interns-c…
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psnet.ahrq.gov/node/37572/psn-pdf
June 16, 2011 - Organizational factors associated with high performance
in quality and safety in academic medical centers.
June 16, 2011
Keroack MA, Youngberg BJ, Cerese JL, et al. Organizational factors associated with high performance in
quality and safety in academic medical centers. Acad Med. 2007;82(12):1178-86.
https://psne…
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psnet.ahrq.gov/node/844040/psn-pdf
February 08, 2023 - A customized triggers program: a children's hospital's
experience in improving trigger usability.
February 8, 2023
Reinhart RM, Safari-Ferra P, Badh R, et al. A customized triggers program: a children's hospital's
experience in improving trigger usability. Pediatrics. 2023;151(2):e2022056452. doi:10.1542/peds.2022-…
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psnet.ahrq.gov/node/43349/psn-pdf
July 16, 2014 - Multifaceted interventions improve adherence to the
surgical checklist.
July 16, 2014
Putnam LR, Levy SM, Sajid M, et al. Multifaceted interventions improve adherence to the surgical checklist.
Surgery. 2014;156(2):336-344. doi:10.1016/j.surg.2014.03.032.
https://psnet.ahrq.gov/issue/multifaceted-interventions-imp…
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psnet.ahrq.gov/node/38949/psn-pdf
January 28, 2010 - Implementing a pre-operative checklist to increase patient
safety: a 1-year follow-up of personnel attitudes.
January 28, 2010
Nilsson L, Lindberget O, Gupta A, et al. Implementing a pre-operative checklist to increase patient safety: a
1-year follow-up of personnel attitudes. Acta Anaesthesiol Scand. 2010;54(2):17…
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psnet.ahrq.gov/node/39570/psn-pdf
September 20, 2011 - Effect of a 19-item surgical safety checklist during urgent
operations in a global patient population.
September 20, 2011
Weiser TG, Haynes AB, Dziekan G, et al. Effect of A 19-Item Surgical Safety Checklist During Urgent
Operations in A Global Patient Population. Ann Surg. 2010;251(5). doi:10.1097/sla.0b013e3181d9…
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psnet.ahrq.gov/node/849125/psn-pdf
May 17, 2023 - Vestibular syndromes, diagnosis and diagnostic errors in
patients with dizziness presenting to the emergency
department: a cross-sectional study.
May 17, 2023
Comolli L, Korda A, Zamaro E, et al. Vestibular syndromes, diagnosis and diagnostic errors in patients with
dizziness presenting to the emergency department…
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psnet.ahrq.gov/node/60633/psn-pdf
July 01, 2020 - Frequency and types of patient-reported errors in
electronic health record ambulatory care notes.
July 1, 2020
Bell SK, Delbanco T, Elmore JG, et al. Frequency and types of patient-reported errors in electronic health
record ambulatory care notes. JAMA Netw Open. 2020;3(6):e205867.
doi:10.1001/jamanetworkopen.2020…
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psnet.ahrq.gov/node/47322/psn-pdf
September 12, 2018 - Crossing the Global Quality Chasm: Improving Health
Care Worldwide.
September 12, 2018
Committee on Improving the Quality of Health Care Globally. National Academies of Sciences,
Engineering, and Medicine. Washington DC: National Academies Press; August 2018. ISBN:
9780309483087.
https://psnet.ahrq.gov/issue/cros…
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psnet.ahrq.gov/node/44687/psn-pdf
June 21, 2016 - Free From Harm: Accelerating Patient Safety
Improvement Fifteen Years After To Err Is Human.
June 21, 2016
Boston, MA: National Patient Safety Foundation; 2015.
https://psnet.ahrq.gov/issue/free-harm-accelerating-patient-safety-improvement-fifteen-years-after-err-
human
This report provides an objective assessmen…
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psnet.ahrq.gov/node/73978/psn-pdf
October 20, 2021 - Preventing pregnancy-related mental health deaths:
insights from 14 US maternal mortality review
committees, 2008-17.
October 20, 2021
Trost SL, Beauregard JL, Smoots AN, et al. Preventing pregnancy-related mental health deaths: insights
from 14 US maternal mortality review committees, 2008-17. Health Aff (Millwoo…
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psnet.ahrq.gov/node/47661/psn-pdf
January 23, 2019 - Safety enhancements every hospital must consider in
wake of another tragic neuromuscular blocker event.
January 23, 2019
ISMP Medication Safety Alert! Acute Care Edition. January 17, 2019;24:1-6.
https://psnet.ahrq.gov/issue/safety-enhancements-every-hospital-must-consider-wake-another-tragic-
neuromuscular-blocke…
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psnet.ahrq.gov/node/50890/psn-pdf
February 12, 2020 - Impact of pharmacist-led multidisciplinary medication
review on the safety and medication cost of the elderly
people living in a nursing home: a before-after study.
February 12, 2020
Leguelinel-Blache G, Castelli C, Rolain J, et al. Impact of pharmacist-led multidisciplinary medication
review on the safety and med…
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psnet.ahrq.gov/node/73214/psn-pdf
May 05, 2021 - Patient and physician perspectives of deprescribing
potentially inappropriate medications in older adults with
a history of falls: a qualitative study.
May 5, 2021
Hahn EE, Munoz-Plaza CE, Lee EA, et al. Patient and physician perspectives of deprescribing potentially
inappropriate medications in older adults with …
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psnet.ahrq.gov/node/37510/psn-pdf
March 04, 2011 - Rare adverse medical events in VA inpatient care:
reliability limits to using patient safety indicators as
performance measures.
March 4, 2011
West AN, Weeks WB, Bagian JP. Rare adverse medical events in VA inpatient care: reliability limits to
using patient safety indicators as performance measures. Health Serv R…
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psnet.ahrq.gov/node/40891/psn-pdf
January 19, 2012 - Electronic health record-based surveillance of diagnostic
errors in primary care.
January 19, 2012
Singh H, Giardina TD, Forjuoh SN, et al. Electronic health record-based surveillance of diagnostic errors in
primary care. BMJ Qual Saf. 2012;21(2):93-100. doi:10.1136/bmjqs-2011-000304.
https://psnet.ahrq.gov/issue/…
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psnet.ahrq.gov/node/42232/psn-pdf
May 08, 2013 - The Measurement and Monitoring of Safety.
May 8, 2013
Vincent C, Burnett S, Carthey J. London, UK: Health Foundation; April 2013. ISBN: 9781906461447.
https://psnet.ahrq.gov/issue/measurement-and-monitoring-safety
Despite great effort, health care organizations are still learning how to identify safety problems, es…
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psnet.ahrq.gov/node/36089/psn-pdf
March 03, 2011 - The impact of the 80-hour resident workweek on surgical
residents and attending surgeons.
March 3, 2011
Hutter MM, Kellogg KC, Ferguson CM, et al. The impact of the 80-hour resident workweek on surgical
residents and attending surgeons. Ann Surg. 2006;243(6):864-71; discussion 871-5.
https://psnet.ahrq.gov/issue/i…
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psnet.ahrq.gov/node/61098/psn-pdf
November 04, 2020 - Nursing home staff turnover and perceived patient safety
culture: results from a national survey.
November 4, 2020
Temkin-Greener H, Cen X, Li Y. Nursing home staff turnover and perceived patient safety culture: results
from a national survey. Gerontologist. 2020;60(7):1303-1311. doi:10.1093/geront/gnaa015.
https:…
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psnet.ahrq.gov/node/837136/psn-pdf
May 18, 2022 - What can we learn from in-depth analysis of human errors
resulting in diagnostic errors in the emergency
department: an analysis of serious adverse event reports.
May 18, 2022
Baartmans MC, Hooftman J, Zwaan L, et al. What can we learn from in-depth analysis of human errors
resulting in diagnostic errors in the em…