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2041. Rates of medical errors and preventable adverse events among hospitalized children following implementation of a resident handoff bundle. | PSNet
      psnet.ahrq.gov/issue/rates-medical-errors-and-preventable-adverse-events-among-hospitalized-children-following
      November 12, 2014 - Study Classic Rates of medical errors and preventable adverse events among hospitalized children following implementation of a resident handoff bundle. Citation Text: Starmer AJ, Sectish TC, Simon DW, et al. Rates of medical errors and preventable adverse events…

2042. Comparison of methods to reduce bias from clinical prediction models of postpartum depression. | PSNet
      psnet.ahrq.gov/issue/comparison-methods-reduce-bias-clinical-prediction-models-postpartum-depression
      April 15, 2020 - Study Comparison of methods to reduce bias from clinical prediction models of postpartum depression. Citation Text: Park Y, Hu J, Singh M, et al. Comparison of methods to reduce bias from clinical prediction models of postpartum depression. JAMA Netw Open. 2021;4(4):e213909. doi:10.1001/…

2043. A cross-sectional study on the relationship between utilization of root cause analysis and patient safety at 139 Department of Veterans Affairs medical centers. | PSNet
      psnet.ahrq.gov/issue/cross-sectional-study-relationship-between-utilization-root-cause-analysis-and-patient-safety
      January 11, 2017 - Study A cross-sectional study on the relationship between utilization of root cause analysis and patient safety at 139 Department of Veterans Affairs medical centers. Citation Text: Percarpio KB, Watts V. A cross-sectional study on the relationship between utilization of root cause ana…

2044. Coping with medical error: a systematic review of papers to assess the effects of involvement in medical errors on healthcare professionals' psychological well-being. | PSNet
      psnet.ahrq.gov/issue/coping-medical-error-systematic-review-papers-assess-effects-involvement-medical-errors
      March 04, 2015 - Review Coping with medical error: a systematic review of papers to assess the effects of involvement in medical errors on healthcare professionals' psychological well-being. Citation Text: Sirriyeh R, Lawton R, Gardner P, et al. Coping with medical error: a systematic review of papers …

2045. Multispecialty physician online survey reveals that burnout related to adverse event involvement may be mitigated by peer support. | PSNet
      psnet.ahrq.gov/issue/multispecialty-physician-online-survey-reveals-burnout-related-adverse-event-involvement-may
      July 13, 2022 - Study Multispecialty physician online survey reveals that burnout related to adverse event involvement may be mitigated by peer support. Citation Text: Gupta K, Rivadeneira NA, Lisker S, et al. Multispecialty physician online survey reveals that burnout related to adverse event involveme…

2046. The 'go-between' study: a simulation study comparing the 'Traffic Lights' and 'SBAR' tools as a means of communication between anaesthetic staff. | PSNet
      psnet.ahrq.gov/issue/go-between-study-simulation-study-comparing-traffic-lights-and-sbar-tools-means-communication
      March 01, 2023 - Study The 'go-between' study: a simulation study comparing the 'Traffic Lights' and 'SBAR' tools as a means of communication between anaesthetic staff. Citation Text: MacDougall-Davis SR, Kettley L, Cook TM. The 'go-between' study: a simulation study comparing the 'Traffic Lights' and 'S…

2047. Patient handoffs and multi-specialty trainee perspectives across an institution: informing recommendations for health systems and an expanded conceptual framework for handoffs. | PSNet
      psnet.ahrq.gov/issue/patient-handoffs-and-multi-specialty-trainee-perspectives-across-institution-informing
      February 23, 2022 - Study Patient handoffs and multi-specialty trainee perspectives across an institution: informing recommendations for health systems and an expanded conceptual framework for handoffs. Citation Text: Williams SR, Sebok-Syer SS, Caretta-Weyer H, et al. Patient handoffs and multi-specialty t…

2048. Making Health Care Safer II: An Updated Critical Analysis of the Evidence for Patient Safety Practices. | PSNet
      psnet.ahrq.gov/issue/making-health-care-safer-ii-updated-critical-analysis-evidence-patient-safety-practices
      March 13, 2013 - Book/Report Classic Making Health Care Safer II: An Updated Critical Analysis of the Evidence for Patient Safety Practices. Citation Text: Shekelle PG, Wachter RM, Pronovost PJ, et al. Making Health Care Safer Ii: An Updated Critical Analysis Of The Evidence For…

2049. How can never event data be used to reflect or improve hospital safety performance? | PSNet
      psnet.ahrq.gov/issue/how-can-never-event-data-be-used-reflect-or-improve-hospital-safety-performance
      March 30, 2022 - Study How can never event data be used to reflect or improve hospital safety performance? Citation Text: Olivarius‐McAllister J, Pandit M, Sykes A, et al. How can never event data be used to reflect or improve hospital safety performance? Anaesthesia. 2021;76(12):1616-1624. doi:10.1111/a…

2050. We Want to Know-a mixed methods evaluation of a comprehensive program designed to detect and address patient-reported breakdowns in care. | PSNet
      psnet.ahrq.gov/issue/we-want-know-mixed-methods-evaluation-comprehensive-program-designed-detect-and-address
      October 17, 2018 - Study We Want to Know-a mixed methods evaluation of a comprehensive program designed to detect and address patient-reported breakdowns in care. Citation Text: Fisher KA, Smith KM, Gallagher TH, et al. We Want to Know-a mixed methods evaluation of a comprehensive program designed to detec…

2051. Missed nursing care during the COVID-19 pandemic: a comparative observational study. | PSNet
      psnet.ahrq.gov/issue/missed-nursing-care-during-covid-19-pandemic-comparative-observational-study
      June 22, 2022 - Study Missed nursing care during the COVID-19 pandemic: a comparative observational study. Citation Text: von Vogelsang A‐C, Göransson KE, Falk A‐C, et al. Missed nursing care during the COVID‐19 pandemic: a comparative observational study. J Nurs Manag. 2021;29(8):2343-2352. doi:10.1111…

2052. Risk assessment of the acute stroke diagnostic process using failure modes, effects, and criticality analysis. | PSNet
      psnet.ahrq.gov/issue/risk-assessment-acute-stroke-diagnostic-process-using-failure-modes-effects-and-criticality
      July 21, 2021 - Study Risk assessment of the acute stroke diagnostic process using failure modes, effects, and criticality analysis. Citation Text: Liberman AL, Holl JL, Romo E, et al. Risk assessment of the acute stroke diagnostic process using failure modes, effects, and criticality analysis. Acad Eme…

2053. Factors influencing second victim experiences and support needs of OB/GYN and pediatric healthcare professionals after adverse patient events. | PSNet
      psnet.ahrq.gov/issue/factors-influencing-second-victim-experiences-and-support-needs-obgyn-and-pediatric
      January 31, 2024 - Study Factors influencing second victim experiences and support needs of OB/GYN and pediatric healthcare professionals after adverse patient events. Citation Text: Rivera-Chiauzzi EY, Riggan KA, Huang L, et al. Factors influencing second victim experiences and support needs of OB/GYN and…

2054. Evaluation of symptom checkers for self diagnosis and triage: audit study. | PSNet
      psnet.ahrq.gov/issue/evaluation-symptom-checkers-self-diagnosis-and-triage-audit-study
      December 08, 2021 - Study Classic Evaluation of symptom checkers for self diagnosis and triage: audit study. Citation Text: Semigran HL, Linder JA, Gidengil C, et al. Evaluation of symptom checkers for self diagnosis and triage: audit study. BMJ. 2015;351:h3480. doi:10.1136/bmj.h34…

2055. Assessment of incorrect surgical procedures within and outside the operating room. A follow-up study from US Veterans Health Administration medical centers. | PSNet
      psnet.ahrq.gov/issue/assessment-incorrect-surgical-procedures-within-and-outside-operating-room-follow-study-us
      October 24, 2018 - Study Assessment of incorrect surgical procedures within and outside the operating room. A follow-up study from US Veterans Health Administration medical centers. Citation Text: Neily J, Soncrant C, Mills PD, et al. Assessment of Incorrect Surgical Procedures Within and Outside the Opera…

2056. Association between implementation of a medical team training program and surgical mortality. | PSNet
      psnet.ahrq.gov/issue/association-between-implementation-medical-team-training-program-and-surgical-mortality
      December 21, 2014 - Study Classic Association between implementation of a medical team training program and surgical mortality. Citation Text: Neily J, Mills PD, Young-Xu Y, et al. Association between implementation of a medical team training program and surgical mortality. JAMA. 2…

2057. Medical team training and coaching in the veterans health administration; assessment and impact on the first 32 facilities in the programme. | PSNet
      psnet.ahrq.gov/issue/medical-team-training-and-coaching-veterans-health-administration-assessment-and-impact-first
      December 21, 2014 - Study Medical team training and coaching in the veterans health administration; assessment and impact on the first 32 facilities in the programme. Citation Text: Neily J, Mills PD, Lee P, et al. Medical team training and coaching in the Veterans Health Administration; assessment and im…

2058. Characteristics of disease-specific and generic diagnostic pitfalls: a qualitative study. | PSNet
      psnet.ahrq.gov/issue/characteristics-disease-specific-and-generic-diagnostic-pitfalls-qualitative-study
      December 02, 2020 - Study Characteristics of disease-specific and generic diagnostic pitfalls: a qualitative study. Citation Text: Schiff GD, Volodarskaya M, Ruan E, et al. Characteristics of disease-specific and generic diagnostic pitfalls: a qualitative study. JAMA Netw Open. 2022;5(1):e2144531. doi:10.10…

2059. Role of knowledge and reasoning processes as predictors of resident physicians' susceptibility to anchoring bias in diagnostic reasoning: a randomised controlled experiment. | PSNet
      psnet.ahrq.gov/issue/role-knowledge-and-reasoning-processes-predictors-resident-physicians-susceptibility
      March 18, 2020 - Study Role of knowledge and reasoning processes as predictors of resident physicians' susceptibility to anchoring bias in diagnostic reasoning: a randomised controlled experiment. Citation Text: Mamede S, Zandbergen A, de Carvalho-Filho MA, et al. Role of knowledge and reasoning processe…

2060. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/33567/psn-pdf
      June 15, 2024 - Handoffs June 15, 2024 Handoffs and Signouts. PSNet [internet]. 2019. https://psnet.ahrq.gov/primer/handoffs PSNet primers are regularly reviewed and updated by the UC Davis PSNet Editorial Team to ensure that they reflect current research and practice in the patient safety field. Last reviewed in 2024. Backgroun…