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psnet.ahrq.gov/node/49699/psn-pdf
February 01, 2014 - Multifactorial Medication Mishap
February 1, 2014
Yang A. Multifactorial Medication Mishap. PSNet [internet]. 2014.
https://psnet.ahrq.gov/web-mm/multifactorial-medication-mishap
Case Objectives
Understand the system-based causes of medication errors.
Describe a model for a systems approach to error analysis.
Id…
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psnet.ahrq.gov/sites/default/files/2024-03/delayed_diagnosis_and_treatment_of_sle.pdf
January 01, 2024 - Microsoft PowerPoint - Spotlight Case_Delayed Diagnosis and Treatment of Lupus_SLIDES - FINAL.pptx
Spotlight
Delayed Diagnosis and Treatment of Systemic Lupus
Erythematosus with a Psychiatric Presentation
Source and Credits
• This presentation is based on the March 2024 AHRQ WebM&M
Spotlight Case
o See the full …
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psnet.ahrq.gov/node/854897/psn-pdf
October 31, 2023 - This behavior in turn jeopardizes patient
safety if health professionals neglect or miss alerts that
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psnet.ahrq.gov/web-mm/hazards-distraction-ticking-all-ehr-boxes
April 09, 2014 - SPOTLIGHT CASE
The Hazards of Distraction: Ticking All the EHR Boxes
Citation Text:
Easty AC. The Hazards of Distraction: Ticking All the EHR Boxes. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2017.
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…
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psnet.ahrq.gov/web-mm/discharging-our-responsibility
January 16, 2019 - Participating hospitals received comparative feedback data on a quarterly basis; otherwise, no specific behavior-modification
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psnet.ahrq.gov/web-mm/weight-and-height-juxtaposition-electronic-medical-record-causing-accidental-medication
March 15, 2023 - This behavior in turn jeopardizes patient safety if health professionals neglect or miss alerts that
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psnet.ahrq.gov/node/49573/psn-pdf
January 01, 2009 - Assumptions and Lessons from the Literature
Assumptions Lessons
Human behavior in professional settings
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psnet.ahrq.gov/web-mm/mothers-milk-whose-mother
November 15, 2023 - April 22, 2016
Development and validation of the Johns Hopkins Disruptive Clinician Behavior
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psnet.ahrq.gov/node/49712/psn-pdf
June 01, 2014 - Relationship of physician behavior to patient compliance.
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psnet.ahrq.gov/node/33738/psn-pdf
December 01, 2012 - process, and payment
reform—if you take all these variables and a deep understanding of cognitive behavior
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psnet.ahrq.gov/web-mm/failure-latch
November 27, 2012 - physicians' lack of knowledge about breastfeeding.( 4 ) The presented case demonstrates how a physician's behavior
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psnet.ahrq.gov/primer/burnout
November 20, 2024 - Burnout
Citation Text:
Yellowlees P, Rea M. Burnout. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2022.
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Format:
Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId RIS
Do…
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psnet.ahrq.gov/perspective/second-victim-phenomenon-harsh-reality-health-care-professions
November 13, 2024 - Concerns and the LGBTQ+ Population
February 1, 2023
Disruptive clinician behavior
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psnet.ahrq.gov/node/847934/psn-pdf
April 26, 2023 - Patient Safety Indicators
April 26, 2023
Tokareva I, Romano P. Patient Safety Indicators. PSNet [internet]. 2023.
https://psnet.ahrq.gov/primer/patient-safety-indicators
Background
Over the past 25 years, policymakers and providers, payers, and purchasers of health care have
increasingly focused attention on pati…
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psnet.ahrq.gov/web-mm/result-stopped-here
December 01, 2006 - However, failure to do so represents a common noncognitive error—an unconscious lapse in an automatic behavior
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psnet.ahrq.gov/web-mm/check-wristband
August 03, 2009 - Check the Wristband
Citation Text:
Rosenthal M. Check the Wristband. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2003.
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Format:
Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId …
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psnet.ahrq.gov/web-mm/dose-makes-poison-medication-error-during-procedural-sedation-pediatric-emergency-department
January 23, 2017 - “I’m concerned”: a multi-site assessment of emergency medicine resident speaking up behaviors
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psnet.ahrq.gov/perspective/zero-harm-striving-reduce-preventable-harms-point-counterpoint-and-areas-agreement
September 24, 2024 - we know the conditions that make error more likely, and we know the individual, team, and leadership behaviors … So you get this gaming behavior that is obviously detrimental to learning and to really improving care
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psnet.ahrq.gov/perspective/conversation-withdean-schillinger-md
March 01, 2009 - care providers should review key self-care activities and verify that patients are performing health behaviors
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psnet.ahrq.gov/perspective/role-health-literacy-patient-safety
March 22, 2009 - care providers should review key self-care activities and verify that patients are performing health behaviors