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psnet.ahrq.gov/node/39500/psn-pdf
January 03, 2017 - Using in situ simulation to improve in-hospital
cardiopulmonary resuscitation.
January 3, 2017
Lighthall GK, Poon T, Harrison K. Using in situ simulation to improve in-hospital cardiopulmonary
resuscitation. Jt Comm J Qual Patient Saf. 2010;36(5):209-16.
https://psnet.ahrq.gov/issue/using-situ-simulation-improve-h…
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psnet.ahrq.gov/node/845346/psn-pdf
March 01, 2023 - The relationship between safety climate and safety
performance: a review.
March 1, 2023
Syed-Yahya SNN, Idris MA, Noblet AJ. The relationship between safety climate and safety performance: a
review. J Safety Res. 2022;83:105-118. doi:10.1016/j.jsr.2022.08.008.
https://psnet.ahrq.gov/issue/relationship-between-safe…
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psnet.ahrq.gov/node/36002/psn-pdf
March 28, 2011 - Persistence of unsafe practice in everyday work: an
exploration of organizational and psychological factors
constraining safety in the operating room.
March 28, 2011
Espin S, Lingard L, Baker GR, et al. Persistence of unsafe practice in everyday work: an exploration of
organizational and psychological factors cons…
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psnet.ahrq.gov/node/46855/psn-pdf
February 21, 2018 - Leadership and vision for a culture of safety.
February 21, 2018
Gandhi TK. NEJM Catalyst. February 8, 2018.
https://psnet.ahrq.gov/issue/leadership-and-vision-culture-safety
Leadership has an important role in establishing a culture of safety in health care organizations. This
commentary describes key skills requ…
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psnet.ahrq.gov/node/37150/psn-pdf
January 02, 2017 - Using the Communication and Teamwork Skills (CATS)
assessment to measure health care team performance.
January 2, 2017
Frankel A, Gardner R, Maynard L, et al. Using the Communication and Teamwork Skills (CATS)
Assessment to measure health care team performance. Jt Comm J Qual Patient Saf. 2007;33(9):549-58.
https:…
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psnet.ahrq.gov/node/60855/psn-pdf
August 26, 2020 - The paradoxes of defensive medicine.
August 26, 2020
Saks MJ, Landsman S. Health Matrix: J Law-Med. 2020;30(1):25-84.
https://psnet.ahrq.gov/issue/paradoxes-defensive-medicine
Defensive medicine behaviors seeking to avoid malpractice risk due to care omissions challenge patient
safety and value narratives. This le…
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psnet.ahrq.gov/node/40580/psn-pdf
July 06, 2011 - Teaching medical error apologies: development of a
multi-component intervention.
July 6, 2011
Gillies RA, Speers SH, Young SE, et al. Teaching medical error apologies: development of a multi-
component intervention. Fam Med. 2011;43(6):400-6.
https://psnet.ahrq.gov/issue/teaching-medical-error-apologies-developmen…
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psnet.ahrq.gov/node/41982/psn-pdf
January 07, 2015 - Multitasking during patient handover in the recovery
room.
January 7, 2015
van Rensen ELJ, Groen EST, Numan SC, et al. Multitasking during patient handover in the recovery room.
Anesth Analg. 2012;115(5):1183-7. doi:10.1213/ANE.0b013e31826996a2.
https://psnet.ahrq.gov/issue/multitasking-during-patient-handover-rec…
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psnet.ahrq.gov/node/36924/psn-pdf
April 21, 2011 - A cluster randomized clinical trial to improve prescribing
patterns in ambulatory pediatrics.
April 21, 2011
Davis RL, Wright J, Chalmers F, et al. A cluster randomized clinical trial to improve prescribing patterns in
ambulatory pediatrics. PLoS Clin Trials. 2007;2(5):e25.
https://psnet.ahrq.gov/issue/cluster-ran…
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psnet.ahrq.gov/node/38122/psn-pdf
September 05, 2009 - Implementation of a preoperative briefing protocol
improves accuracy of teamwork assessment in the
operating room.
September 5, 2009
Paige JT, Aaron DL, Yang T, et al. Implementation of a preoperative briefing protocol improves accuracy of
teamwork assessment in the operating room. Am Surg. 2008;74(9):817-823.
ht…
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psnet.ahrq.gov/node/44703/psn-pdf
December 16, 2015 - Defining the Role of Social Sciences in Patient Safety.
December 16, 2015
Su L, Fernandez R, Grand J, et al, eds. Curr Probl Pediatr Adolesc Health Care. 2015;45:365-394.
https://psnet.ahrq.gov/issue/defining-role-social-sciences-patient-safety
Applying principles from other fields, such as aviation and nuclear pow…
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psnet.ahrq.gov/node/50876/psn-pdf
April 22, 2021 - Veterans Accountability Improvement Act.
April 22, 2021
SB 1307, 117th Congress: 2021.
https://psnet.ahrq.gov/issue/veterans-accountability-improvement-act
Reporting clinicians who exhibit practice behaviors that are detrimental to safety is challenged by system
and cultural norms. This legislation aims to strengt…
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psnet.ahrq.gov/node/845658/psn-pdf
June 08, 2023 - Simulation Articles of Influence.
June 8, 2023
Society for Simulation in Healthcare. 2017-2023.
https://psnet.ahrq.gov/issue/simulation-articles-influence
Simulation can be used to reveal teamwork coordination gaps and latent factors that contribute to failure.
This article collection has been curated by experts i…
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psnet.ahrq.gov/node/36863/psn-pdf
August 29, 2011 - Embedding quality improvement and patient safety at
Liverpool Women's NHS Foundation Trust.
August 29, 2011
Scholefield H. Embedding quality improvement and patient safety at Liverpool Women's NHS Foundation
Trust. Best Pract Res Clin Obstet Gynaecol. 2007;21(4):593-607.
https://psnet.ahrq.gov/issue/embedding-qual…
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psnet.ahrq.gov/node/43356/psn-pdf
July 16, 2014 - Introducing the safety score audit for staff member and
patient safety.
July 16, 2014
Sinnott M, Eley R, Winch S. Introducing the safety score audit for staff member and patient safety. AORN
J. 2014;100(1):91-5. doi:10.1016/j.aorn.2014.05.006.
https://psnet.ahrq.gov/issue/introducing-safety-score-audit-staff-membe…
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psnet.ahrq.gov/node/60537/psn-pdf
May 27, 2020 - I can't turn my brain off.
May 27, 2020
Hoffman J. New York Times. May 16, 2020.
https://psnet.ahrq.gov/issue/i-cant-turn-my-brain
Health care worker stress is a known contributor to disruptive behavior, error and clinician suicide. This
story discusses the impact of the COVID-19 pandemic on psychological strain …
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psnet.ahrq.gov/node/45478/psn-pdf
October 26, 2016 - Core principles of quality improvement and patient safety.
October 26, 2016
Bartman T, McClead RE. Core Principles of Quality Improvement and Patient Safety. Pediatr Rev.
2016;37(10):407-417.
https://psnet.ahrq.gov/issue/core-principles-quality-improvement-and-patient-safety
This review discusses key patient safet…
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psnet.ahrq.gov/node/40067/psn-pdf
December 08, 2010 - Slowing down to stay out of trouble in the operating
room: remaining attentive in automaticity.
December 8, 2010
Moulton C-A, Regehr G, Lingard LA, et al. Slowing down to stay out of trouble in the operating room:
remaining attentive in automaticity. Acad Med. 2010;85(10):1571-7. doi:10.1097/ACM.0b013e3181f073dd.
…
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psnet.ahrq.gov/node/40517/psn-pdf
June 08, 2011 - Learning safe prescribing during post-take ward rounds.
June 8, 2011
Conroy-Smith E, Herring R, Caldwell G. Learning safe prescribing during post-take ward rounds. The
clinical teacher. 2011;8(2):75-8. doi:10.1111/j.1743-498X.2011.00432.x.
https://psnet.ahrq.gov/issue/learning-safe-prescribing-during-post-take-ward…
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psnet.ahrq.gov/node/38252/psn-pdf
November 26, 2008 - Hospital ethical climate and teamwork in acute care: the
moderating role of leaders.
November 26, 2008
Rathert C, Fleming DA. Hospital ethical climate and teamwork in acute care: the moderating role of
leaders. Health Care Manag Rev. 2008;33(4):323-331. doi:10.1097/01.HCM.0000318769.75018.8d.
https://psnet.ahrq.go…