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1901. Debriefing in the OR: a quality improvement project. | PSNet
      psnet.ahrq.gov/issue/debriefing-or-quality-improvement-project
      April 24, 2018 - Commentary Debriefing in the OR: a quality improvement project. Citation Text: Finch EP, Langston M, Erickson D, et al. Debriefing in the OR: A Quality Improvement Project. AORN J. 2019;109(3):336-344. doi:10.1002/aorn.12616. Copy Citation Format: DOI Google Scholar PubMed …

1902. Inpatients notes: sensemaking—fostering a shared understanding in clinical teams. | PSNet
      psnet.ahrq.gov/issue/inpatients-notes-sensemaking-fostering-shared-understanding-clinical-teams
      November 25, 2020 - Commentary Inpatients notes: sensemaking—fostering a shared understanding in clinical teams. Citation Text: Leykum LK, O'Leary KJ. Web Exclusives. Annals for Hospitalists Inpatient Notes - Sensemaking-Fostering a Shared Understanding in Clinical Teams. Ann Intern Med. 2017;167(4):HO2-HO3…

1903. Teamwork and error in the operating room: analysis of skills and roles. | PSNet
      psnet.ahrq.gov/issue/teamwork-and-error-operating-room-analysis-skills-and-roles
      April 15, 2009 - Study Teamwork and error in the operating room: analysis of skills and roles. Citation Text: Catchpole K, Mishra A, Handa A, et al. Teamwork and error in the operating room: analysis of skills and roles. Ann Surg. 2008;247(4):699-706. doi:10.1097/SLA.0b013e3181642ec8. Copy Citation …

1904. Medication safety in emergency medical services: approaching an evidence-based method of verification to reduce errors. | PSNet
      psnet.ahrq.gov/issue/medication-safety-emergency-medical-services-approaching-evidence-based-method-verification
      September 28, 2022 - Study Medication safety in emergency medical services: approaching an evidence-based method of verification to reduce errors. Citation Text: Misasi P, Keebler JR. Medication safety in emergency medical services: approaching an evidence-based method of verification to reduce errors. Ther …

1905. Multidisciplinary crisis simulations: the way forward for training surgical teams. | PSNet
      psnet.ahrq.gov/issue/multidisciplinary-crisis-simulations-way-forward-training-surgical-teams
      July 31, 2008 - Study Multidisciplinary crisis simulations: the way forward for training surgical teams. Citation Text: Undre S, Koutantji M, Sevdalis N, et al. Multidisciplinary crisis simulations: the way forward for training surgical teams. World J Surg. 2007;31(9):1843-53. Copy Citation Form…

1906. Potential for medication overdose with ENFit low dose tip syringe: FDA Safety Communication. | PSNet
      psnet.ahrq.gov/issue/potential-medication-overdose-enfit-low-dose-tip-syringe-fda-safety-communication
      October 28, 2020 - Press Release/Announcement Potential for medication overdose with ENFit low dose tip syringe: FDA Safety Communication. Citation Text: Potential for medication overdose with ENFit low dose tip syringe: FDA Safety Communication. MedWatch Safety Alert. Silver Spring, MD: US Food and Drug A…

1907. Impact of teamwork improvement training on communication and teamwork climate in ambulatory reproductive health care. | PSNet
      psnet.ahrq.gov/issue/impact-teamwork-improvement-training-communication-and-teamwork-climate-ambulatory
      October 28, 2020 - Study Impact of teamwork improvement training on communication and teamwork climate in ambulatory reproductive health care. Citation Text: Dodge LE, Nippita S, Hacker MR, et al. Impact of teamwork improvement training on communication and teamwork climate in ambulatory reproductive healt…

1908. Development and validation of a tool to assess emergency physicians' nontechnical skills. | PSNet
      psnet.ahrq.gov/issue/development-and-validation-tool-assess-emergency-physicians-nontechnical-skills
      December 12, 2012 - Study Development and validation of a tool to assess emergency physicians' nontechnical skills. Citation Text: Flowerdew L, Brown R, Vincent CA, et al. Development and validation of a tool to assess emergency physicians' nontechnical skills. Ann Emerg Med. 2012;59(5):376-385.e4. doi:10…

1909. Improving the communication between teams managing boarded patients on a surgical specialty ward. | PSNet
      psnet.ahrq.gov/issue/improving-communication-between-teams-managing-boarded-patients-surgical-specialty-ward
      September 29, 2017 - Commentary Improving the communication between teams managing boarded patients on a surgical specialty ward. Citation Text: Puvaneswaralingam S, Ross D. Improving the communication between teams managing boarded patients on a surgical specialty ward. BMJ Qual Improv Rep. 2016;5(1). doi:1…

1910. The role of information technology in healthcare communications, efficiency, and patient safety: application and results. | PSNet
      psnet.ahrq.gov/issue/role-information-technology-healthcare-communications-efficiency-and-patient-safety
      October 19, 2022 - Commentary The role of information technology in healthcare communications, efficiency, and patient safety: application and results. Citation Text: Prince SB, Herrin DM. The role of information technology in healthcare communications, efficiency, and patient safety: application and res…

1911. A surgical procedure grid for safety and operating room communication in multisite surgery. | PSNet
      psnet.ahrq.gov/issue/surgical-procedure-grid-safety-and-operating-room-communication-multisite-surgery
      June 17, 2014 - Commentary A surgical procedure grid for safety and operating room communication in multisite surgery. Citation Text: Insalaco LF, Spiegel JH. A Surgical Procedure Grid for Safety and Operating Room Communication in Multisite Surgery. JAMA Facial Plast Surg. 2018;20(3):185-186. doi:10.10…

1912. Kaiser Permanente's performance improvement system, part 4: creating a learning organization. | PSNet
      psnet.ahrq.gov/issue/kaiser-permanentes-performance-improvement-system-part-4-creating-learning-organization
      July 19, 2023 - Commentary Kaiser Permanente's performance improvement system, part 4: creating a learning organization. Citation Text: Schilling L, Dearing JW, Staley P, et al. Kaiser Permanente's performance improvement system, Part 4: Creating a learning organization. Jt Comm J Qual Patient Saf. 2011…

1913. Student-observed surgical safety practices across an urban regional health authority. | PSNet
      psnet.ahrq.gov/issue/student-observed-surgical-safety-practices-across-urban-regional-health-authority
      August 12, 2020 - Study Student-observed surgical safety practices across an urban regional health authority. Citation Text: Spence J, Goodwin B, Enns C, et al. Student-observed surgical safety practices across an urban regional health authority. BMJ Qual Saf. 2011;20(7):580-6. doi:10.1136/bmjqs.2010.04…

1914. Medical errors: disclosure styles, interpersonal forgiveness, and outcomes. | PSNet
      psnet.ahrq.gov/issue/medical-errors-disclosure-styles-interpersonal-forgiveness-and-outcomes
      June 14, 2017 - Study Medical errors: disclosure styles, interpersonal forgiveness, and outcomes. Citation Text: Hannawa AF, Shigemoto Y, Little TD. Medical errors: Disclosure styles, interpersonal forgiveness, and outcomes. Social Sci Med. 2016;156:29-38. doi:10.1016/j.socscimed.2016.03.026. Copy Cit…

1915. Protecting patients from an unsafe system: the etiology and recovery of intraoperative deviations in care. | PSNet
      psnet.ahrq.gov/issue/protecting-patients-unsafe-system-etiology-and-recovery-intraoperative-deviations-care
      October 19, 2012 - Study Protecting patients from an unsafe system: the etiology and recovery of intraoperative deviations in care. Citation Text: Hu Y-Y, Arriaga AF, Roth EM, et al. Protecting patients from an unsafe system: the etiology and recovery of intraoperative deviations in care. Ann Surg. 2012;…

1916. Speaking across the drapes: communication strategies of anesthesiologists and obstetricians during a simulated maternal crisis. | PSNet
      psnet.ahrq.gov/issue/speaking-across-drapes-communication-strategies-anesthesiologists-and-obstetricians-during
      May 08, 2017 - Study Speaking across the drapes: communication strategies of anesthesiologists and obstetricians during a simulated maternal crisis. Citation Text: Minehart RD, Pian-Smith MCM, Walzer TB, et al. Speaking across the drapes: communication strategies of anesthesiologists and obstetrician…

1917. Implementation of a modified bedside handoff for a postpartum unit. | PSNet
      psnet.ahrq.gov/issue/implementation-modified-bedside-handoff-postpartum-unit
      November 16, 2022 - Commentary Implementation of a modified bedside handoff for a postpartum unit. Citation Text: Wollenhaup CA, Stevenson EL, Thompson J, et al. Implementation of a Modified Bedside Handoff for a Postpartum Unit. J Nurs Admin. 2017;47(6):320-326. doi:10.1097/NNA.0000000000000487. Copy Cit…

1918. Crisis resource management: evaluating outcomes of a multidisciplinary team. | PSNet
      psnet.ahrq.gov/issue/crisis-resource-management-evaluating-outcomes-multidisciplinary-team
      December 23, 2011 - Study Crisis resource management: evaluating outcomes of a multidisciplinary team. Citation Text: Jankouskas T, Bush MC, Murray B, et al. Crisis resource management: evaluating outcomes of a multidisciplinary team. Simul Healthc. 2007;2(2):96-101. doi:10.1097/SIH.0b013e31805d8b0d. Co…

1919. Miscommunication During the Interhospital Transport of a Critically Ill Child | PSNet
      psnet.ahrq.gov/web-mm/miscommunication-during-interhospital-transport-critically-ill-child
      March 27, 2024 - Miscommunication During the Interhospital Transport of a Critically Ill Child Citation Text: Rosenthal J, Hamline M. Miscommunication During the Interhospital Transport of a Critically Ill Child. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human …

1920. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/44457/psn-pdf
      September 29, 2017 - Hospitals slow to adopt patient apology policies. September 29, 2017 Rice S. Hospitals slow to adopt patient apology policies. Modern healthcare. 2015;45(33):16, 29-30. https://psnet.ahrq.gov/issue/hospitals-slow-adopt-patient-apology-policies Communication-and-resolution approaches to medical errors have garnered …