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An evidence-based toolkit for the development of effective and sustainable root cause analysis system safety solutions. | PSNet

psnet.ahrq.gov/issue/evidence-based-toolkit-development-effective-and-sustainable-root-cause-analysis-system

June 01, 2019 - Study An evidence-based toolkit for the development of effective and sustainable root cause analysis system safety solutions. Citation Text: Hettinger Z, Fairbanks RJ, Hegde S, et al. An evidence-based toolkit for the development of effective and sustainable root cause analysis syste…

Severe hypertension in pregnancy: progress made and future directions for patient safety, quality improvement, and implementation of a patient safety bundle. | PSNet

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October 23, 2024 - Commentary Severe hypertension in pregnancy: progress made and future directions for patient safety, quality improvement, and implementation of a patient safety bundle. Citation Text: Prior A, Taylor I, Gibson KS, et al. Severe hypertension in pregnancy: progress made and future directio…

Use of a novel, modified fishbone diagram to analyze diagnostic errors. | PSNet

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February 13, 2019 - Commentary Use of a novel, modified fishbone diagram to analyze diagnostic errors. Citation Text: Reilly JB, Myers JS, Salvador D, et al. Use of a novel, modified fishbone diagram to analyze diagnostic errors. Diagnosis (Berl). 2014;1(2):167-171. doi:10.1515/dx-2013-0040. Copy Citation…

Framing family conversation after early diagnosis of iatrogenic injury and incidental findings. | PSNet

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November 14, 2011 - Study Framing family conversation after early diagnosis of iatrogenic injury and incidental findings. Citation Text: Barrios L, Tsuda S, Derevianko A, et al. Framing family conversation after early diagnosis of iatrogenic injury and incidental findings. Surg Endosc. 2009;23(11):2535-42…

Emotional impact of patient safety incidents on family physicians and their office staff. | PSNet

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December 11, 2013 - Study Emotional impact of patient safety incidents on family physicians and their office staff. Citation Text: O'Beirne M, Sterling P, Palacios-Derflingher L, et al. Emotional impact of patient safety incidents on family physicians and their office staff. J Am Board Fam Med. 2012;25(2)…

Formal medicine reconciliation within the emergency department reduces the medication error rates for emergency admissions. | PSNet

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May 01, 2019 - Study Formal medicine reconciliation within the emergency department reduces the medication error rates for emergency admissions. Citation Text: Mills PR, McGuffie AC. Formal medicine reconciliation within the emergency department reduces the medication error rates for emergency admiss…

A multidisciplinary team approach to retained foreign objects. | PSNet

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June 10, 2010 - Study A multidisciplinary team approach to retained foreign objects. Citation Text: Cima RR, Kollengode A, Storsveen AS, et al. A multidisciplinary team approach to retained foreign objects. Jt Comm J Qual Saf. 2009;35(3):123-132. Copy Citation Format: Google Scholar PubMed…

Impact of anesthetic handover on mortality and morbidity in cardiac surgery: a cohort study. | PSNet

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August 04, 2021 - Study Impact of anesthetic handover on mortality and morbidity in cardiac surgery: a cohort study. Citation Text: Hudson CCC, McDonald B, Hudson JKC, et al. Impact of anesthetic handover on mortality and morbidity in cardiac surgery: a cohort study. J Cardiothorac Vasc Anesth. 2015;29(1)…

Enhancing pediatric safety: assessing and improving resident competency in life-threatening events with a computer-based interactive resuscitation tool. | PSNet

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December 14, 2016 - Study Enhancing pediatric safety: assessing and improving resident competency in life-threatening events with a computer-based interactive resuscitation tool. Citation Text: Lerner C, Gaca AM, Frush DP, et al. Enhancing pediatric safety: assessing and improving resident competency in l…

Quality gaps identified through mortality review. | PSNet

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November 11, 2015 - Study Quality gaps identified through mortality review. Citation Text: Kobewka DM, van Walraven C, Turnbull J, et al. Quality gaps identified through mortality review. BMJ Qual Saf. 2017;26(2):141-149. doi:10.1136/bmjqs-2015-004735. Copy Citation Format: DOI Google Scholar …

Adverse events detected by clinical surveillance on an obstetric service. | PSNet

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September 11, 2009 - Study Adverse events detected by clinical surveillance on an obstetric service. Citation Text: Forster AJ, Fung I, Caughey S, et al. Adverse events detected by clinical surveillance on an obstetric service. Obstet Gynecol. 2006;108(5):1073-83. Copy Citation Format: Google…

Joy in medical practice: clinician satisfaction in the Healthy Work Place trial. | PSNet

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January 23, 2017 - Study Joy in medical practice: clinician satisfaction in the Healthy Work Place trial. Citation Text: Linzer M, Sinsky CA, Poplau S, et al. Joy In Medical Practice: Clinician Satisfaction In The Healthy Work Place Trial. Health Aff (Millwood). 2017;36(10):1808-1814. doi:10.1377/hlthaff.2…

Development and evaluation of a 3-day patient safety curriculum to advance knowledge, self-efficacy and system thinking among medical students. | PSNet

psnet.ahrq.gov/issue/development-and-evaluation-3-day-patient-safety-curriculum-advance-knowledge-self-efficacy

July 01, 2016 - Study Development and evaluation of a 3-day patient safety curriculum to advance knowledge, self-efficacy and system thinking among medical students. Citation Text: Aboumatar HJ, Thompson DA, Wu AW, et al. Development and evaluation of a 3-day patient safety curriculum to advance knowl…

The influence of context on the effectiveness of hospital quality improvement strategies: a review of systematic reviews. | PSNet

psnet.ahrq.gov/issue/influence-context-effectiveness-hospital-quality-improvement-strategies-review-systematic

May 26, 2014 - Review The influence of context on the effectiveness of hospital quality improvement strategies: a review of systematic reviews. Citation Text: Kringos DS, Suñol R, Wagner C, et al. The influence of context on the effectiveness of hospital quality improvement strategies: a review of syst…

Guidelines for US hospitals and clinicians on assessment of electronic health record safety using SAFER Guides. | PSNet

psnet.ahrq.gov/issue/guidelines-us-hospitals-and-clinicians-assessment-electronic-health-record-safety-using-safer

June 24, 2020 - Commentary Guidelines for US hospitals and clinicians on assessment of electronic health record safety using SAFER Guides. Citation Text: Sittig DF, Sengstack P, Singh H. Guidelines for US hospitals and clinicians on assessment of electronic health record safety using SAFER Guides. JAMA.…

Care at the point of impact: insights into the second-victim experience. | PSNet

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January 03, 2017 - Commentary Care at the point of impact: insights into the second-victim experience. Citation Text: Scott SD, McCoig MM. Care at the point of impact: Insights into the second-victim experience. J Healthc Risk Manag. 2016;35(4):6-13. doi:10.1002/jhrm.21218. Copy Citation Format: …

Maintaining perioperative safety in uncertain times: COVID-19 pandemic response strategies. | PSNet

psnet.ahrq.gov/issue/maintaining-perioperative-safety-uncertain-times-covid-19-pandemic-response-strategies

December 23, 2020 - Commentary Maintaining perioperative safety in uncertain times: COVID-19 pandemic response strategies. Citation Text: Mazzola SM, Grous C. Maintaining perioperative safety in uncertain times: COVID-19 pandemic response strategies. AORN J. 2020;112(4):397-405. doi:10.1002/aorn.13195. Co…

A trial of automated decision support alerts for contraindicated medications using computerized physician order entry. | PSNet

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May 20, 2019 - Study A trial of automated decision support alerts for contraindicated medications using computerized physician order entry. Citation Text: Galanter W, Didomenico RJ, Polikaitis A. A trial of automated decision support alerts for contraindicated medications using computerized physician…

Nurses' perceptions of subspecialization in pediatric cardiac intensive care unit: quality and patient safety implications. | PSNet

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April 16, 2018 - Study Nurses' perceptions of subspecialization in pediatric cardiac intensive care unit: quality and patient safety implications. Citation Text: Kane JM, Preze E. Nurses' perceptions of subspecialization in pediatric cardiac intensive care unit: quality and patient safety implications.…

An anesthesiology department leads culture change at a hospital system level to improve quality and patient safety. | PSNet

psnet.ahrq.gov/issue/anesthesiology-department-leads-culture-change-hospital-system-level-improve-quality-and

March 30, 2011 - Commentary An anesthesiology department leads culture change at a hospital system level to improve quality and patient safety. Citation Text: Fleischut PM, Evans AS, Faggiani SL, et al. An anesthesiology department leads culture change at a hospital system level to improve quality and …

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