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psnet.ahrq.gov/issue/embedding-quality-improvement-and-patient-safety-ucla-value-analysis-experience
October 02, 2019 - Commentary
Embedding quality improvement and patient safety - the UCLA value analysis experience.
Citation Text:
Gambone JC, Broder MS. Embedding quality improvement and patient safety: the UCLA value analysis experience. Best Pract Res Clin Obstet Gynaecol. 2007;21(4):581-92.
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psnet.ahrq.gov/issue/interview-peter-pronovost
July 01, 2017 - Award Recipient
An interview with Peter Pronovost
Citation Text:
Pronovost P. An interview with Peter Pronovost. Jt Comm J Qual Saf. 2004;30(12):659-64.
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psnet.ahrq.gov/issue/listen-carefully-risk-error-spoken-medication-orders
November 16, 2022 - Study
Listen carefully: the risk of error in spoken medication orders.
Citation Text:
Lambert BL, Dickey LW, Fisher WM, et al. Listen carefully: the risk of error in spoken medication orders. Soc Sci Med. 2010;70(10):1599-608. doi:10.1016/j.socscimed.2010.01.042.
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psnet.ahrq.gov/issue/electronic-fetal-heart-rate-monitoring-applying-principles-patient-safety
October 10, 2018 - Commentary
Electronic fetal heart rate monitoring: applying principles of patient safety.
Citation Text:
Miller DA, Miller L. Electronic fetal heart rate monitoring: applying principles of patient safety. Am J Obstet Gynecol. 2012;206(4):278-83. doi:10.1016/j.ajog.2011.08.016.
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psnet.ahrq.gov/issue/more-hospitals-move-confront-medical-errors-head
June 21, 2023 - Audiovisual
More hospitals move to confront medical errors head on.
Citation Text:
More hospitals move to confront medical errors head on. Gorenstein D. Tradeoffs. November 16, 2023.
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psnet.ahrq.gov/issue/audit-handover-ent-unit
October 28, 2020 - Study
Audit of handover in an ENT unit.
Citation Text:
Ellul D, Robson AK. Audit of handover in an ENT unit. J Laryngol Otol. 2011;125(9):924-7. doi:10.1017/S0022215111000880.
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psnet.ahrq.gov/issue/bundaberg-and-beyond-duty-disclose-adverse-events-patients
January 12, 2022 - Commentary
Bundaberg and beyond: duty to disclose adverse events to patients.
Citation Text:
Madden B, Cockburn T. Bundaberg and beyond: duty to disclose adverse events to patients. J Law Med. 2007;14(4):501-27.
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psnet.ahrq.gov/issue/patient-safety-organizations-hospital-participation-value-and-challenges
February 11, 2015 - Book/Report
Patient Safety Organizations: Hospital Participation, Value, and Challenges.
Citation Text:
Patient Safety Organizations: Hospital Participation, Value, and Challenges. US Department of Health and Human Services; Office of the Inspector General, September 2019. OIG Report N…
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psnet.ahrq.gov/issue/trends-adverse-events-over-time-why-are-we-not-improving
October 02, 2019 - Commentary
Trends in adverse events over time: why are we not improving?
Citation Text:
Shojania KG, Thomas EJ. Trends in adverse events over time: why are we not improving? BMJ Qual Saf. 2013;22(4):273-7. doi:10.1136/bmjqs-2013-001935.
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psnet.ahrq.gov/issue/looking-beyond-linkedin-case-excellence-and-academic-rigor-quality-and-safety-programs
January 04, 2019 - Commentary
Looking beyond LinkedIn: the case for excellence and academic rigor in quality and safety programs.
Citation Text:
Bearman G, Nori P. Looking beyond LinkedIn: the case for excellence and academic rigor in quality and safety programs. Am J Med. 2024;137(8):694-697. doi:10.1016/…
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psnet.ahrq.gov/issue/revitalizing-established-rapid-response-team
September 23, 2020 - Commentary
Revitalizing an established rapid response team.
Citation Text:
Genardi ME, Cronin SN, Thomas LD. Revitalizing an established rapid response team. Dimens Crit Care Nurs. 2008;27(3):104-9. doi:10.1097/01.DCC.0000286837.95720.8c.
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psnet.ahrq.gov/issue/make-no-mistake-about-it-chain-pharmacies-are-finding-innovative-ways-combat-medication
May 20, 2020 - Newspaper/Magazine Article
Make no mistake about it: chain pharmacies are finding innovative ways to combat medication errors.
Citation Text:
Make no mistake about it: chain pharmacies are finding innovative ways to combat medication errors. Levy S. Drug Topics. July 9, 2007
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psnet.ahrq.gov/issue/behind-human-error-second-edition
April 13, 2018 - Book/Report
Classic
Behind Human Error, Second Edition.
Citation Text:
Behind Human Error, Second Edition. Woods DD, Dekker S, Cook R, Johannesen L. Boca Raton, FL: CRC Press; 2017. ISBN: 9781317175537.
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psnet.ahrq.gov/issue/safe-practices-better-healthcare-2010-update
March 23, 2012 - Book/Report
Safe Practices for Better Healthcare: 2010 Update.
Citation Text:
Safe Practices for Better Healthcare: 2010 Update. Washington, DC: National Quality Forum; 2010.
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psnet.ahrq.gov/issue/unleash-power-patients-make-care-safer-around-world-essay-helen-haskell
January 08, 2020 - Commentary
Unleash the power of patients to make care safer around the world: an essay by Helen Haskell.
Citation Text:
Haskell H. Unleash the power of patients to make care safer around the world: an essay by Helen Haskell. BMJ. 2019;366:l5565. doi:10.1136/bmj.l5565.
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psnet.ahrq.gov/issue/drawn-curtains-muted-alarms-and-diverted-attention-lead-tragedy-postanesthesia-care-unit
June 10, 2018 - Newspaper/Magazine Article
Drawn curtains, muted alarms, and diverted attention lead to tragedy in the postanesthesia care unit.
Citation Text:
Drawn curtains, muted alarms, and diverted attention lead to tragedy in the postanesthesia care unit. ISMP Medication Safety Alert! Acute Care E…
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psnet.ahrq.gov/issue/impact-standard-medication-chart-prescribing-errors-and-after-audit
May 02, 2012 - Study
Impact of a standard medication chart on prescribing errors: a before-and-after audit.
Citation Text:
Coombes ID, Stowasser DA, Reid C, et al. Impact of a standard medication chart on prescribing errors: a before-and-after audit. Qual Saf Health Care. 2009;18(6):478-85. doi:10.11…
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psnet.ahrq.gov/issue/cognitive-health-system
September 04, 2024 - Commentary
The cognitive health system.
Citation Text:
Coiera E. The cognitive health system. Lancet. 2020;395(10222):463-466. doi:10.1016/s0140-6736(19)32987-3.
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psnet.ahrq.gov/issue/understanding-why-quality-initiatives-succeed-or-fail-sociotechnical-systems-perspective
March 10, 2021 - Commentary
Understanding why quality initiatives succeed or fail: a sociotechnical systems perspective.
Citation Text:
Wiegmann DA. Understanding Why Quality Initiatives Succeed or Fail: A Sociotechnical Systems Perspective. Ann Surg. 2016;263(1):9-11. doi:10.1097/SLA.0000000000001333.
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psnet.ahrq.gov/issue/algorithmic-bias-playbook
May 13, 2020 - Book/Report
Algorithmic Bias Playbook.
Citation Text:
Algorithmic Bias Playbook. Obermeyer Z, Nissan R, Stern M, et al. Center for Applied Artificial Intelligence, Chicago Booth: June 2021.
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