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Psn-Pdf (pdf file)
psnet.ahrq.gov/node/46450/psn-pdfAugust 20, 2018 - Improving Diagnostic Quality and Safety Final Report. August 20, 2018 Washington, DC: National Quality Forum. September 19, 2017. https://psnet.ahrq.gov/issue/improving-diagnostic-quality-and-safety-final-report Although diagnostic error is a well-recognized source of preventable patient harm, measuring and mitiga… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/60680/psn-pdfJuly 15, 2020 - Contributing factors for pediatric ambulatory diagnostic process errors: Project RedDE. July 15, 2020 Dadlez NM, Adelman JS, Bundy DG, et al. Contributing factors for pediatric ambulatory diagnostic process errors: Project RedDE. Ped Qual Saf. 2020;5(3):e299-e305. doi:10.1097/pq9.0000000000000299. https://psnet.ah… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/850344/psn-pdfJune 14, 2023 - Green Cross method in a postanaesthesia care unit: a qualitative study of the healthcare professionals' experiences after 3 years, including the COVID-19 pandemic period. June 14, 2023 Birkeli GH, Ballangrud R, Jacobsen HK, et al. Green Cross method in a postanaesthesia care unit: a qualitative study of the healt… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/45277/psn-pdfJuly 01, 2017 - Cultural transformation after implementation of crew resource management: is it really possible? July 1, 2017 Hefner JL, Hilligoss B, Knupp A, et al. Cultural Transformation After Implementation of Crew Resource Management: Is It Really Possible? Am J Med Qual. 2017;32(4):384-390. doi:10.1177/1062860616655424. htt… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/47014/psn-pdfJuly 02, 2019 - Multisource evaluation of surgeon behavior is associated with malpractice claims. July 2, 2019 Lagoo J, Berry WR, Miller K, et al. Multisource Evaluation of Surgeon Behavior Is Associated With Malpractice Claims. Ann Surg. 2019;270(1):84-90. doi:10.1097/SLA.0000000000002742. https://psnet.ahrq.gov/issue/multisourc… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/38863/psn-pdfAugust 12, 2009 - Use of strategies from high-reliability organisations to the patient hand-off by resident physicians: practical implications. August 12, 2009 Philibert I. Use of strategies from high-reliability organisations to the patient hand-off by resident physicians: practical implications. Qual Saf Health Care. 2009;18(4):2… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/42266/psn-pdfMay 15, 2013 - Medication errors in the home: a multisite study of children with cancer. May 15, 2013 Walsh KE, Roblin DW, Weingart SN, et al. Medication errors in the home: a multisite study of children with cancer. Pediatrics. 2013;131(5):e1405-14. doi:10.1542/peds.2012-2434. https://psnet.ahrq.gov/issue/medication-errors-home… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/854831/psn-pdfJanuary 01, 2024 - Medication safety events after acute myocardial infarction among veterans treated at VA versus non-VA hospitals. October 25, 2023 Weeda ER, Ward R, Gebregziabher M, et al. Medication safety events after acute myocardial infarction among veterans treated at VA versus non-VA hospitals. Med Care. 2024;62(2):72-78. do… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/73427/psn-pdfJune 23, 2021 - Incidence and OR team awareness of “near-miss” and retained surgical sharps: a national survey on United States operating rooms. June 23, 2021 Weprin SA, Meyer D, Li R, et al. Incidence and OR team awareness of “near-miss” and retained surgical sharps: a national survey on United States operating rooms. Patient Sa… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/41404/psn-pdfDecember 31, 2014 - Effects of an online personal health record on medication accuracy and safety: a cluster-randomized trial. December 31, 2014 Schnipper JL, Gandhi TK, Wald JS, et al. Effects of an online personal health record on medication accuracy and safety: a cluster-randomized trial. J Am Med Inform Assoc. 2012;19(5):728-34. … -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/39802/psn-pdfNovember 16, 2010 - "Water cooler" learning: knowledge sharing at the clinical "backstage" and its contribution to patient safety. November 16, 2010 Waring J, Bishop S. "Water cooler" learning: knowledge sharing at the clinical "backstage" and its contribution to patient safety. J Health Organ Manag. 2010;24(4):325-42. https://psnet.… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/39655/psn-pdfJuly 07, 2010 - Errors of diagnosis in pediatric practice: a multisite survey. July 7, 2010 Singh H, Thomas EJ, Wilson L, et al. Errors of diagnosis in pediatric practice: a multisite survey. Pediatrics. 2010;126(1):70-9. doi:10.1542/peds.2009-3218. https://psnet.ahrq.gov/issue/errors-diagnosis-pediatric-practice-multisite-survey… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/44248/psn-pdfMay 26, 2016 - Wrong-site surgery, retained surgical items, and surgical fires: a systematic review of surgical never events. May 26, 2016 Hempel S, Maggard-Gibbons M, Nguyen DK, et al. Wrong-Site Surgery, Retained Surgical Items, and Surgical Fires : A Systematic Review of Surgical Never Events. JAMA Surg. 2015;150(8):796-805. … -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/837729/psn-pdfJuly 27, 2022 - Development of a multicomponent intervention to decrease racial bias among healthcare staff. July 27, 2022 Tajeu GS, Juarez L, Williams JH, et al. Development of a multicomponent intervention to decrease racial bias among healthcare staff. J Gen Intern Med. 2022;37(8):1970-1979. doi:10.1007/s11606-022-07464-x. htt… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/45754/psn-pdfSeptember 01, 2018 - Addressing ambulatory safety and malpractice: the Massachusetts PROMISES project. September 1, 2018 Schiff G, Nieva HR, Griswold P, et al. Addressing Ambulatory Safety and Malpractice: The Massachusetts PROMISES Project. Health Serv Res. 2016;51 Suppl 3:2634-2641. doi:10.1111/1475-6773.12621. https://psnet.ahrq.go… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/74139/psn-pdfDecember 01, 2021 - Situation awareness and the mitigation of risk associated with patient deterioration: a meta-narrative review of theories and models and their relevance to nursing practice. December 1, 2021 Walshe N, Ryng S, Drennan J, et al. Situation awareness and the mitigation of risk associated with patient deterioration: a… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/74163/psn-pdfDecember 08, 2008 - Follow-up of abnormal screening mammograms among low-income ethnically diverse women: findings from a qualitative study. December 8, 2008 Allen JD, Shelton RC, Harden E, et al. Follow-up of abnormal screening mammograms among low-income ethnically diverse women: findings from a qualitative study. Patient Educ Coun… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/866646/psn-pdfSeptember 04, 2024 - Adverse events and perceived abandonment: learning from patients' accounts of medical mishaps. September 4, 2024 Schlesinger M, Dhingra I, Fain BA, et al. Adverse events and perceived abandonment: learning from patients’ accounts of medical mishaps. BMJ Open Qual. 2024;13(3):e002848. doi:10.1136/bmjoq-2024- 002848… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/850162/psn-pdfJune 07, 2023 - Understanding medication safety involving patient transfer from intensive care to hospital ward: a qualitative sociotechnical factor study. June 7, 2023 Bourne RS, Jeffries M, Phipps DL, et al. Understanding medication safety involving patient transfer from intensive care to hospital ward: a qualitative sociotechn… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/45535/psn-pdfJanuary 23, 2017 - Surgical specimen management: a descriptive study of 648 adverse events and near misses. January 23, 2017 Steelman VM, Williams TL, Szekendi MK, et al. Surgical specimen management: a descriptive study of 648 adverse events and near misses. Arch Pathol Lab Med. 2016;140(12):1390-1396. https://psnet.ahrq.gov/issue/…
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