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psnet.ahrq.gov/node/73141/psn-pdf
April 14, 2021 - Investigating hospital supervision: a case study of
regulatory inspectors' roles as potential co-creators of
resilience.
April 14, 2021
Øyri SF, Braut GS, Macrae C, et al. Investigating Hospital Supervision: A Case Study of Regulatory
Inspectors’ Roles as Potential Co-creators of Resilience. J Patient Saf. 2021;17…
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psnet.ahrq.gov/node/73441/psn-pdf
June 30, 2021 - Assessment of patient-preferred language to achieve
goal-aligned deprescribing in older adults.
June 30, 2021
Green AR, Aschmann H, Boyd CM, et al. Assessment of patient-preferred language to achieve goal-
aligned deprescribing in older adults. JAMA Netw Open. 2021;4(4):e212633.
doi:10.1001/jamanetworkopen.2021.26…
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psnet.ahrq.gov/node/73440/psn-pdf
June 30, 2021 - Bridging the feedback gap: a sociotechnical approach to
informing clinicians of patients' subsequent clinical
course and outcomes.
June 30, 2021
Cifra CL, Sittig DF, Singh H. Bridging the feedback gap: a sociotechnical approach to informing clinicians of
patients’ subsequent clinical course and outcomes. BMJ Qual …
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psnet.ahrq.gov/node/47374/psn-pdf
April 07, 2019 - Developing a conceptual framework for patient safety
culture in emergency department: a review of the
literature.
April 7, 2019
Alshyyab MA, FitzGerald G, Dingle K, et al. Developing a conceptual framework for patient safety culture in
emergency department: A review of the literature. Int J Health Plann Manage. 20…
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psnet.ahrq.gov/node/850170/psn-pdf
June 07, 2023 - A scoping review of distributed cognition in acute care
clinical decision-making.
June 7, 2023
Wilson E, Daniel M, Rao A, et al. A scoping review of distributed cognition in acute care clinical decision-
making. Diagnosis (Berl). 2023;10(2):68-88. doi:10.1515/dx-2022-0095.
https://psnet.ahrq.gov/issue/scoping-revi…
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psnet.ahrq.gov/node/44543/psn-pdf
June 07, 2016 - Sleep deprivation and starvation in hospitalised patients:
how medical care can harm patients.
June 7, 2016
Xu T, Wick EC, Makary MA. Sleep deprivation and starvation in hospitalised patients: how medical care
can harm patients. BMJ Qual Saf. 2016;25(5):311-314. doi:10.1136/bmjqs-2015-004395.
https://psnet.ahrq.go…
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psnet.ahrq.gov/node/43169/psn-pdf
May 07, 2014 - Copy, paste, and cloned notes in electronic health
records: prevalence, benefits, risks, and best practice
recommendations.
May 7, 2014
Weis JM, Levy PC. Copy, paste, and cloned notes in electronic health records: prevalence, benefits, risks,
and best practice recommendations. Chest. 2014;145(3):632-8. doi:10.1378…
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psnet.ahrq.gov/node/847054/psn-pdf
April 05, 2023 - Patient generated research priorities to improve
diagnostic safety: a systematic prioritization exercise.
April 5, 2023
Zwaan L, Smith KM, Giardina TD, et al. Patient generated research priorities to improve diagnostic safety:
a systematic prioritization exercise. Patient Educ Couns. 2023;110:107650.
doi:10.1016/j…
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psnet.ahrq.gov/node/34067/psn-pdf
January 04, 2017 - Does full disclosure of medical errors affect malpractice
liability? The jury is still out.
January 4, 2017
Kachalia A, Shojania KG, Hofer TP, et al. Does full disclosure of medical errors affect malpractice liability?
The jury is still out. Jt Comm J Qual Saf. 2003;29(10):503-11.
https://psnet.ahrq.gov/issue/does…
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psnet.ahrq.gov/node/39856/psn-pdf
December 21, 2014 - Patient perceptions of mistakes in ambulatory care.
December 21, 2014
Kistler CE, Walter LC, Mitchell M, et al. Patient perceptions of mistakes in ambulatory care. Arch Intern
Med. 2010;170(16):1480-7. doi:10.1001/archinternmed.2010.288.
https://psnet.ahrq.gov/issue/patient-perceptions-mistakes-ambulatory-care
Pat…
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psnet.ahrq.gov/node/46999/psn-pdf
June 27, 2018 - Empowering patients and agents to help prevent errors
with living wills, DNRs, and POLSTs.
June 27, 2018
Hoffman RM, Mirarchi FL. PA-PSRS Patient Saf Advis. June 2018;15.
https://psnet.ahrq.gov/issue/empowering-patients-and-agents-help-prevent-errors-living-wills-dnrs-and-
polsts
Patient harm associated with adva…
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psnet.ahrq.gov/node/46365/psn-pdf
September 06, 2017 - Learning to overcome hierarchical pressures to achieve
safer patient care: an interprofessional simulation for
nursing, medical, and physician assistant students.
September 6, 2017
Reeves SA, Denault D, Huntington JT, et al. Learning to Overcome Hierarchical Pressures to Achieve
Safer Patient Care: An Interprofess…
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psnet.ahrq.gov/node/46351/psn-pdf
December 19, 2017 - Intraoperative surgical performance measurement and
outcomes: choose your tools carefully.
December 19, 2017
Aggarwal R. Intraoperative Surgical Performance Measurement and Outcomes: Choose Your Tools
Carefully. JAMA Surg. 2017;152(11):995-996. doi:10.1001/jamasurg.2017.0837.
https://psnet.ahrq.gov/issue/intraoper…
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psnet.ahrq.gov/node/45683/psn-pdf
January 23, 2017 - Consensus bundle on prevention of surgical site
infections after major gynecologic surgery.
January 23, 2017
Pellegrini JE, Toledo P, Soper DE, et al. Consensus Bundle on Prevention of Surgical Site Infections After
Major Gynecologic Surgery. Obstet Gynecol. 2017;129(1):50-61. doi:10.1097/AOG.0000000000001751.
htt…
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psnet.ahrq.gov/node/36784/psn-pdf
February 24, 2011 - The many faces of error disclosure: a common set of
elements and a definition.
February 24, 2011
Fein SP, Hilborne LH, Spiritus EM, et al. The many faces of error disclosure: a common set of elements
and a definition. J Gen Intern Med. 2007;22(6):755-761.
https://psnet.ahrq.gov/issue/many-faces-error-disclosure-co…
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psnet.ahrq.gov/node/44377/psn-pdf
August 05, 2015 - Connecting patients and clinicians: the anticipated effects
of Open Notes on patient safety and quality of care.
August 5, 2015
Bell SK, Folcarelli PH, Anselmo MK, et al. Connecting patients and clinicians: the anticipated effects of
Open Notes on patient safety and quality of care. Jt Comm J Qual Patient Saf. 2015…
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psnet.ahrq.gov/node/73464/psn-pdf
July 07, 2021 - Errors in breast imaging: how to reduce errors and
promote a safety environment.
July 7, 2021
Sivarajah R, Dinh ML, Chetlen A. Errors in breast imaging: how to reduce errors and promote a safety
environment. J Breast Imaging. 2021;3(2):221-230. doi:10.1093/jbi/wbaa118.
https://psnet.ahrq.gov/issue/errors-breast-im…
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psnet.ahrq.gov/node/852271/psn-pdf
August 09, 2023 - Redesign of health care systems to reduce diagnostic
errors: leveraging human experience and artificial
intelligence.
August 9, 2023
Abid MH. Redesign of health care systems to reduce diagnostic errors: leveraging human experience and
artificial intelligence. J Clin Outcomes Manag. 2023;30(3):67-70. doi:10.12788/j…
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psnet.ahrq.gov/node/36668/psn-pdf
June 29, 2011 - Language proficiency and adverse events in US
hospitals: a pilot study.
June 29, 2011
Divi C, Koss RG, Schmaltz SP, et al. Language proficiency and adverse events in US hospitals: a pilot
study. Int J Qual Health Care. 2007;19(2):60-67. doi:10.1093/intqhc/mzl069.
https://psnet.ahrq.gov/issue/language-proficiency-a…
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psnet.ahrq.gov/node/840145/psn-pdf
November 16, 2022 - Failure of crisis leadership in a global pandemic: some
reflections on COVID-19 and future recommendations.
November 16, 2022
Okoli J, Arroteia NP, Ogunsade AI. Failure of crisis leadership in a global pandemic: some reflections on
COVID-19 and future recommendations. Leadersh Health Serv (Bradf Engl). 2023;36(2):1…