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psnet.ahrq.gov/issue/top-10-list-safe-and-effective-sign-out
April 12, 2019 - Commentary
The top 10 list for a safe and effective sign-out.
Citation Text:
Kemp CD, Bath JM, Berger J, et al. The top 10 list for a safe and effective sign-out. Arch Surg. 2008;143(10):1008-10. doi:10.1001/archsurg.143.10.1008.
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psnet.ahrq.gov/node/33847/psn-pdf
August 01, 2017 - psnet.ahrq.gov/perspective/conversation-john-d-birkmeyer-md
https://psnet.ahrq.gov/issue/surgical-skill-and-complication-rates-after-bariatric-surgery
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psnet.ahrq.gov/issue/morbidity-and-mortality-conference-based-classification-system-adverse-events-surgical
January 28, 2009 - Study
A morbidity and mortality conference-based classification system for adverse events: surgical outcome analysis: part I.
Citation Text:
Antonacci AC, Lam S, Lavarias V, et al. A morbidity and mortality conference-based classification system for adverse events: surgical outcome ana…
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psnet.ahrq.gov/issue/report-card-system-using-error-profile-analysis-and-concurrent-morbidity-and-mortality-review
June 18, 2008 - Study
A report card system using error profile analysis and concurrent morbidity and mortality review: surgical outcome analysis, part II.
Citation Text:
Antonacci AC, Lam S, Lavarias V, et al. A report card system using error profile analysis and concurrent morbidity and mortality rev…
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psnet.ahrq.gov/issue/electronic-health-record-based-triggers-detect-adverse-events-after-outpatient-orthopaedic
December 19, 2017 - Study
Electronic health record-based triggers to detect adverse events after outpatient orthopaedic surgery.
Citation Text:
Menendez ME, Janssen SJ, Ring D. Electronic health record-based triggers to detect adverse events after outpatient orthopaedic surgery. BMJ Qual Saf. 2016;25(1):25-…
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psnet.ahrq.gov/node/45943/psn-pdf
March 15, 2017 - Identifying and reducing complications after emergency
room discharge.
March 15, 2017
Hofmann PB, Bagian JP. Patient Saf Qual Healthc. February 20, 2017.
https://psnet.ahrq.gov/issue/identifying-and-reducing-complications-after-emergency-room-discharge
Emergency departments are complex environments that harbor fac…
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psnet.ahrq.gov/node/74112/psn-pdf
April 14, 2017 - Structural racism and health inequities in the USA:
evidence and interventions.
April 14, 2017
Bailey ZD, Krieger N, Agénor M, et al. Structural racism and health inequities in the USA: evidence and
interventions. Lancet. 2017;389(10077):1453-1463. doi:10.1016/s0140-6736(17)30569-x.
https://psnet.ahrq.gov/issue/st…
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psnet.ahrq.gov/node/38731/psn-pdf
April 30, 2014 - Preventable morbidity at a mature trauma center.
April 30, 2014
Teixeira PGR, Inaba K, Salim A, et al. Arch Surg. 2009;144(6):536-541.
https://psnet.ahrq.gov/issue/preventable-morbidity-mature-trauma-center
Patient safety in trauma poses unique challenges given the acuity of the patients and the need for rapid
ass…
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psnet.ahrq.gov/issue/more-750-hospitals-face-medicare-crackdown-patient-injuries
June 27, 2018 - Newspaper/Magazine Article
More than 750 hospitals face Medicare crackdown on patient injuries.
Citation Text:
More than 750 hospitals face Medicare crackdown on patient injuries. Rau J. Kaiser Health News. June 22, 2014.
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psnet.ahrq.gov/node/39729/psn-pdf
September 20, 2011 - Contextual errors and failures in individualizing patient
care: a multicenter study.
September 20, 2011
Weiner SJ, Schwartz A, Weaver FM, et al. Contextual errors and failures in individualizing patient care: a
multicenter study. Ann Intern Med. 2010;153(2):69-75. doi:10.7326/0003-4819-153-2-201007200-00002.
https…
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psnet.ahrq.gov/node/39314/psn-pdf
December 21, 2014 - Patient characteristics and the occurrence of never
events.
December 21, 2014
Fry DE, Pine M, Jones BL, et al. Patient characteristics and the occurrence of never events. Arch Surg.
2010;145(2):148-51. doi:10.1001/archsurg.2009.277.
https://psnet.ahrq.gov/issue/patient-characteristics-and-occurrence-never-events
…
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psnet.ahrq.gov/node/46615/psn-pdf
January 23, 2019 - The surgical safety checklist and patient outcomes after
surgery: a prospective observational cohort study,
systematic review and meta-analysis.
January 23, 2019
Abbott TEF, Ahmad T, Phull MK, et al. The surgical safety checklist and patient outcomes after surgery: a
prospective observational cohort study, systema…
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psnet.ahrq.gov/node/41317/psn-pdf
January 31, 2013 - Variation in 17 obstetric care pathways: potential danger
for health professionals and patient safety?
January 31, 2013
Sarrechia M, Van Gerven E, Hermans L, et al. Variation in 17 obstetric care pathways: potential danger for
health professionals and patient safety? J Adv Nurs. 2013;69(2):278-85. doi:10.1111/j.136…
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psnet.ahrq.gov/web-mm/infection-after-carpal-tunnel-surgery
May 28, 2014 - Assess urgency if symptoms suggest a potential complication and require prompt attention such as wound
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psnet.ahrq.gov/node/37756/psn-pdf
December 15, 2008 - Do the AHRQ Patient Safety Indicators flag conditions
that are present at the time of hospital admission?
December 15, 2008
Bahl V, Thompson MA, Kau T-Y, et al. Do the AHRQ patient safety indicators flag conditions that are
present at the time of hospital admission? Med Care. 2008;46(5):516-22.
doi:10.1097/MLR.0b0…
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psnet.ahrq.gov/node/44056/psn-pdf
May 19, 2018 - Impact of inpatient harms on hospital finances and
patient clinical outcomes.
May 19, 2018
Adler L, Yi D, Li M, et al. Impact of Inpatient Harms on Hospital Finances and Patient Clinical Outcomes. J
Patient Saf. 2018;14(2):67-73. doi:10.1097/PTS.0000000000000171.
https://psnet.ahrq.gov/issue/impact-inpatient-harms…
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psnet.ahrq.gov/node/39231/psn-pdf
January 13, 2010 - The Checklist Manifesto: How to Get Things Right.
January 13, 2010
Gawande A. New York, NY: Metropolitan Books; 2009. ISBN: 9780805091748.
https://psnet.ahrq.gov/issue/checklist-manifesto-how-get-things-right
Harvard surgeon Atul Gawande has emerged as this generation's preeminent physician–author, through
his art…
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psnet.ahrq.gov/node/33665/psn-pdf
March 01, 2008 - During our first year, when use of the MPS was elective, we utilized these data to demonstrate that
complication
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psnet.ahrq.gov/node/42454/psn-pdf
September 09, 2013 - A perinatal care quality and safety initiative: are there
financial rewards for improved quality?
September 9, 2013
Kozhimannil KB, Sommerness SA, Rauk P, et al. A perinatal care quality and safety initiative: are there
financial rewards for improved quality? Jt Comm J Qual Patient Saf. 2013;39(8):339-48.
https://…
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psnet.ahrq.gov/node/46307/psn-pdf
August 20, 2018 - Post-operative mortality, missed care and nurse staffing
in nine countries: a cross-sectional study.
August 20, 2018
Ball JE, Bruyneel L, Aiken LH, et al. Post-operative mortality, missed care and nurse staffing in nine
countries: A cross-sectional study. Int J Nurs Stud. 2018;78:10-15. doi:10.1016/j.ijnurstu.2017.…