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psnet.ahrq.gov/web-mm/chest-pain-rural-hospital
June 02, 2021 - SPOTLIGHT CASE
Chest Pain in a Rural Hospital
Citation Text:
MacKinney CA, Mohr NM. Chest Pain in a Rural Hospital. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2018.
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Google Scholar Bi…
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psnet.ahrq.gov/web-mm/delayed-breast-cancer-diagnosis-false-sense-security
May 01, 2005 - We know that patient behavior may contribute to diagnostic delays.
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psnet.ahrq.gov/curated-library/diagnostic-safety-improvement
October 27, 2025 - Contributing factors identified included several manifestations of unprofessional behavior on the part
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psnet.ahrq.gov/perspective/improving-diagnostic-safety-and-quality
January 31, 2024 - Annual Perspective
Improving Diagnostic Safety and Quality
Jawad Al-Khafaji, MD, MHSA, Merton Lee, PhD, PharmD, Sarah Mossburg, RN, PhD
| April 26, 2023
View more articles from the same authors.
Citation Text:
Al-Khafaji J, Lee M, Mossburg S. Improving Di…
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psnet.ahrq.gov/web-mm/sudden-collapse-during-upper-gastrointestinal-endoscopy-expect-unexpected
September 25, 2024 - Verbal Communication During Airway Management and Emergent Endotracheal Intubation: Observations of Team Behavior
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psnet.ahrq.gov/perspective/conversation-tejal-k-gandhi-md-mph
February 26, 2025 - programs to measure is important but also having real intervention tools to try to get at disruptive behavior
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psnet.ahrq.gov/web-mm/hospital-acquired-diabetic-ketoacidosis
October 28, 2020 - Hospital-Acquired Diabetic Ketoacidosis.
Citation Text:
Zuidema D, Bagley B, Tan CL. Hospital-Acquired Diabetic Ketoacidosis.. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2023.
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psnet.ahrq.gov/web-mm/airway-obstruction-during-anterior-cervical-spine-surgery
January 29, 2021 - Simulation has been shown to improve knowledge, skill, and behavior of health care professionals. 18,19
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psnet.ahrq.gov/node/33783/psn-pdf
April 01, 2015 - we talk about changing systems or changing process, what we're
really talking about is changing the behavior
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psnet.ahrq.gov/node/848107/psn-pdf
April 26, 2023 - Improving Diagnostic Safety and Quality
April 26, 2023
Al-Khafaji J, Lee M, Mossburg S. Improving Diagnostic Safety and Quality . PSNet [internet]. 2023.
https://psnet.ahrq.gov/perspective/improving-diagnostic-safety-and-quality
Introduction
During an annual editorial review of featured articles in the Agency for …
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psnet.ahrq.gov/perspective/implementing-patient-safety-program-large-national-health-system
January 01, 2008 - 4, 2015
Surgeons in difficulty: an exploration of differences in assistance-seeking behaviors
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psnet.ahrq.gov/perspective/conversation-andrew-gettinger-md
September 01, 2017 - monitoring user activity logs ( 21 ), system error logs, and system performance to identify anomalous behaviors
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psnet.ahrq.gov/perspective/assessing-safety-electronic-health-records-what-have-we-learned
September 01, 2017 - monitoring user activity logs ( 21 ), system error logs, and system performance to identify anomalous behaviors
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psnet.ahrq.gov/node/867022/psn-pdf
October 30, 2024 - in this case:
suspected skull fracture; scalp hematoma; any neurologic deficit; GCS < 15; abnormal behavior
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psnet.ahrq.gov/node/865466/psn-pdf
March 27, 2024 - implicit
biases, or negative attitudes toward groups based on race or ethnicity that unconsciously affect behavior
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psnet.ahrq.gov/perspective/promising-areas-patient-safety-research
November 02, 2016 - Promising Areas for Patient Safety Research
P. Jeffrey Brady, MD, MPH; William B. Munier, MD, MBA; Irim Azam, MPH | December 1, 2003
View more articles from the same authors.
Citation Text:
Brady JP, Munier WB, Azam I. Promising Areas for Patient Safety Research. …
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psnet.ahrq.gov/perspective/conversation-ann-gaffey-rn-msn-cphrm-and-bruce-spurlock-md
March 30, 2020 - In Conversation With... Ann Gaffey, RN, MSN, CPHRM and Bruce Spurlock, MD
March 30, 2020
Also Read the Essay
Citation Text:
In Conversation With.. Ann Gaffey, RN, MSN, CPHRM and Bruce Spurlock, MD. PSNet [internet]. 2020.In Conversation With... Ann Gaffey, RN, MS…
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psnet.ahrq.gov/perspective/becoming-certified-professional-patient-safety-registered-nurses-perspective
June 01, 2016 - need folks who can draw on a variety of experiences, like human factors engineering and organizational behavior
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psnet.ahrq.gov/node/49768/psn-pdf
September 01, 2016 - A Pill Organizing Plight
September 1, 2016
McGalliard B, Shane R, Rosen S. A Pill Organizing Plight. PSNet [internet]. 2016.
https://psnet.ahrq.gov/web-mm/pill-organizing-plight
Case Objectives
Identify patients at high risk for adverse drug events.
List drugs that are considered inappropriate in older patients.
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psnet.ahrq.gov/node/867653/psn-pdf
February 26, 2025 - How are we looking at human error versus reckless
behavior (i.e., just culture)?