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2241. Patient perspectives on test result communication in primary care: a qualitative study. | PSNet
      psnet.ahrq.gov/issue/patient-perspectives-test-result-communication-primary-care-qualitative-study
      November 20, 2015 - Study Patient perspectives on test result communication in primary care: a qualitative study. Citation Text: Litchfield I, Bentham L, Lilford RJ, et al. Patient perspectives on test result communication in primary care: a qualitative study. Br J Med Pract. 2015;65(632):e133-e140. doi:10.…

2242. The Comprehensive Unit-based Safety Program (CUSP) | Agency for Healthcare Research and Quality
      www.ahrq.gov/hai/tools/ambulatory-surgery/sections/implementation/implementation-guide/guide-cusp.html
      May 01, 2017 - Creating a Culture of Safety in the Ambulatory Surgery Environment: Implementation Guide The Comprehensive Unit-based Safety Program (CUSP) Previous Page Next Page Table of Contents Creating a Culture of Safety in the Ambulatory Surgery Environment: Implementation Guide Overview The Comprehensiv…

2243. Frequency and nature of communication and handoff failures in medical malpractice claims. | PSNet
      psnet.ahrq.gov/issue/frequency-and-nature-communication-and-handoff-failures-medical-malpractice-claims
      June 22, 2022 - Study Frequency and nature of communication and handoff failures in medical malpractice claims. Citation Text: Humphrey KE, Sundberg M, Milliren CE, et al. Frequency and nature of communication and handoff failures in medical malpractice claims. J Patient Saf. 2022;18(2):130-137. doi:10.…

2244. Can SBAR be implemented with high fidelity and does it improve communication between healthcare workers? A systematic review. | PSNet
      psnet.ahrq.gov/issue/can-sbar-be-implemented-high-fidelity-and-does-it-improve-communication-between-healthcare
      June 22, 2022 - Review Can SBAR be implemented with high fidelity and does it improve communication between healthcare workers? A systematic review. Citation Text: Lo L, Rotteau L, Shojania KG. Can SBAR be implemented with high fidelity and does it improve communication between healthcare workers? A sys…

2245. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/46361/psn-pdf
      May 23, 2018 - Inadequate hand-off communication. May 23, 2018 Inadequate hand-off communication. Sentinel event alert. 2017;58(58):1-6. https://psnet.ahrq.gov/issue/inadequate-hand-communication The Joint Commission publishes sentinel event alerts to draw attention to pressing or emerging safety issues and provide guidelines fo…

2246. TeamSTEPPS Video Debrief Guide: CUS and SBAR in Rural Community Clinic (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/teamstepps-program/video/cus-sbar-rural-clinic-guide.pdf
      June 02, 2025 - TeamSTEPPS Video Debrief Guide: CUS and SBAR in Rural Community Clinic TeamSTEPPS Video Debrief Guide: CUS and SBAR in Rural Community Clinic Video Objective To demonstrate how CUS is used to ensure patient safety and showcase the SBAR communication technique. TeamSTEPPS Tool or Concept CUS, SBAR. Brief V…

2247. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/50384/psn-pdf
      September 25, 2019 - Safety and communication in the operating room: a safety questionnaire after the implementation of a blood-borne pathogen exposure checkpoint in the surgical safety checklist preprocedure time-out. September 25, 2019 Kane P, Marley R, Daney B, et al. Safety and Communication in the Operating Room: A Safety Questi…

2248. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/46624/psn-pdf
      November 29, 2017 - Empowerment failure: how shortcomings in physician communication unwittingly undermine patient autonomy. November 29, 2017 Ubel PA, Scherr KA, Fagerlin A. Empowerment Failure: How Shortcomings in Physician Communication Unwittingly Undermine Patient Autonomy. Am J Bioeth. 2017;17(11):31-39. doi:10.1080/15265161.20…

2249. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49473/psn-pdf
      March 01, 2005 - On O.R. Off? March 1, 2005 Leonard M. On O.R. Off? PSNet [internet]. 2005. https://psnet.ahrq.gov/web-mm/or The Case An elderly man was admitted to the vascular surgery service with rest pain in his leg. Angiography demonstrated peripheral artery disease with anatomy suitable for revascularization. A consulting …

2250. Presentation Slides | Agency for Healthcare Research and Quality
      www.ahrq.gov/hai/cusp/modules/apply/sl-cusp.html
      December 01, 2012 - Presentation Slides CUSP Toolkit, Apply CUSP The Apply CUSP module of the CUSP Toolkit introduces Just Culture principles, which emphasize shared accountability and attitudes towards risk. This module also summarizes the concepts and activities of the other six modules in the CUSP Toolkit, including TeamSTEPP…

2251. Interruptions and miscommunications in surgery: an observational study. | PSNet
      psnet.ahrq.gov/issue/interruptions-and-miscommunications-surgery-observational-study
      August 11, 2021 - Study Interruptions and miscommunications in surgery: an observational study. Citation Text: Gillespie BM, Chaboyer W, Fairweather N. Interruptions and miscommunications in surgery: an observational study. AORN J. 2012;95(5):576-90. doi:10.1016/j.aorn.2012.02.012. Copy Citation For…

2252. Communication and teamwork in patient care: how much can we learn from aviation? | PSNet
      psnet.ahrq.gov/issue/communication-and-teamwork-patient-care-how-much-can-we-learn-aviation
      August 12, 2019 - Review Communication and teamwork in patient care: how much can we learn from aviation? Citation Text: Lyndon A. Communication and teamwork in patient care: how much can we learn from aviation? J Obstet Gynecol Neonatal Nurs. 2006;35(4):538-46. Copy Citation Format: Googl…

2253. Strategy 2: Communicating to Improve Quality | Agency for Healthcare Research and Quality
      www.ahrq.gov/patient-safety/patients-families/engagingfamilies/strategy2/index.html
      December 01, 2017 - Strategy 2: Communicating to Improve Quality Research shows that when patients are engaged in their health care, it can lead to measurable improvements in safety and quality. To promote stronger engagement, Agency for Healthcare Research and Quality developed the Guide to Patient and Family Engagement in Hospit…

2254. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/44938/psn-pdf
      September 28, 2017 - Walking the tightrope: communicating overdiagnosis in modern healthcare. September 28, 2017 McCaffery KJ, Jansen J, Scherer LD, et al. Walking the tightrope: communicating overdiagnosis in modern healthcare. BMJ. 2016;352:i348. doi:10.1136/bmj.i348. https://psnet.ahrq.gov/issue/walking-tightrope-communicating-over…

2255. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/34602/psn-pdf
      February 17, 2009 - Disclosure of unanticipated events: the next step in better communication with patients (part 1 of 3). February 17, 2009 Chicago, IL; American Society of Healthcare Risk Management: 2003. https://psnet.ahrq.gov/issue/disclosure-unanticipated-events-next-step-better-communication-patients-part- 1-3 The change in t…

2256. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/39572/psn-pdf
      January 03, 2017 - The tangible handoff: a team approach for advancing structured communication in labor and delivery. January 3, 2017 Block M, Ehrenworth JF, Cuce VM, et al. The tangible handoff: a team approach for advancing structured communication in labor and delivery. Jt Comm J Qual Patient Saf. 2010;36(6):282-287, 241. https:…

2257. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/866567/psn-pdf
      August 21, 2024 - A daily dose of communication to improve quality and safety outcomes. August 21, 2024 Halm MA. A daily dose of communication to improve quality and safety outcomes. Am J Crit Care. 2024;33(4):305-310. doi:10.4037/ajcc2024318. https://psnet.ahrq.gov/issue/daily-dose-communication-improve-quality-and-safety-outcomes…

2258. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/41152/psn-pdf
      June 19, 2012 - The ins and outs of change of shift handoffs between nurses: a communication challenge. June 19, 2012 Carroll JS, Williams M, Gallivan TM. The ins and outs of change of shift handoffs between nurses: a communication challenge. BMJ Qual Saf. 2012;21(7):586-93. doi:10.1136/bmjqs-2011-000614. https://psnet.ahrq.gov/i…

2259. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/40248/psn-pdf
      June 20, 2011 - Achieving quality improvement in the nursing home: influence of nursing leadership on communication and teamwork. June 20, 2011 Vogelsmeier A, Scott-Cawiezell J. Achieving quality improvement in the nursing home: influence of nursing leadership on communication and teamwork. J Nurs Care Qual. 2011;26(3):236-42. d…

2260. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/42825/psn-pdf
      December 18, 2013 - Primary care physician communication at hospital discharge reduces medication discrepancies. December 18, 2013 Lindquist LA, Yamahiro A, Garrett A, et al. Primary care physician communication at hospital discharge reduces medication discrepancies. J Hosp Med. 2013;8(12):672-7. doi:10.1002/jhm.2098. https://psnet.a…