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psnet.ahrq.gov/issue/incident-learning-radiation-oncology-review
October 14, 2020 - Review
Emerging Classic
Incident learning in radiation oncology: a review.
Citation Text:
Ford E, Evans SB. Incident learning in radiation oncology: A review. Med Phys. 2018;45(5):e100-e119. doi:10.1002/mp.12800.
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psnet.ahrq.gov/issue/situativity-family-social-cognitive-theories-clinical-reasoning-and-error
June 08, 2022 - Special or Theme Issue
Situativity: A Family of Social Cognitive Theories for Clinical Reasoning and Error.
Citation Text:
Situativity: A Family of Social Cognitive Theories for Clinical Reasoning and Error. Durning S, Holmboe E, Graber ML, eds. Diagnosis(Berl). 2020;7(3):151-344.
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psnet.ahrq.gov/issue/nurses-role-medication-safety
June 26, 2024 - Review
Nurses' role in medication safety.
Citation Text:
Choo J, Hutchinson A, Bucknall T. Nurses' role in medication safety. J Nurs Manag. 2010;18(7):853-61. doi:10.1111/j.1365-2834.2010.01164.x.
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psnet.ahrq.gov/issue/mitigating-bias-ai-point-care
March 08, 2023 - Newspaper/Magazine Article
Mitigating bias in AI at the point of care.
Citation Text:
Mitigating bias in AI at the point of care. Decamp M, Lindvall C. Science. 2023;381(6654):150-152.
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psnet.ahrq.gov/perspective/accountability-patient-safety
January 01, 2018 - Annual Perspective
Accountability in Patient Safety
Christopher Moriates, MD, and Robert M. Wachter, MD | January 1, 2015
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Citation Text:
Moriates C, Wachter R. Accountability in Patient Safety. PSNet [internet]. Rock…
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psnet.ahrq.gov/issue/patient-safety-consumers-perspective
January 12, 2022 - Study
Patient safety: a consumer's perspective.
Citation Text:
Hovey RB, Dvorak ML, Burton T, et al. Patient safety: a consumer's perspective. Qual Health Res. 2011;21(5):662-72. doi:10.1177/1049732311399779.
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psnet.ahrq.gov/issue/improving-communication-diagnostic-uncertainty-families-hospitalized-children
December 23, 2020 - Study
Improving communication of diagnostic uncertainty to families of hospitalized children.
Citation Text:
Young EE, Kane J, Timmons K, et al. Improving communication of diagnostic uncertainty to families of hospitalized children. Diagnosis (Berl). 2024;11(2):186-191. doi:10.1515/dx-20…
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psnet.ahrq.gov/web-mm/back-basics
July 13, 2010 - Patient safety and inpatient glycemic control: translating concepts into action.
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psnet.ahrq.gov/issue/criminalization-human-error-and-guilty-verdict-travesty-justice-threatens-patient-safety
September 07, 2022 - Newspaper/Magazine Article
Criminalization of human error and a guilty verdict: a travesty of justice that threatens patient safety.
Citation Text:
Criminalization of human error and a guilty verdict: a travesty of justice that threatens patient safety. ISMP Medication Safety Alert! Acut…
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psnet.ahrq.gov/issue/systems-science-primer-high-reliability
March 23, 2022 - Review
Systems science: a primer on high reliability.
Citation Text:
Roberson DW, Kirsh ER. Systems science: a primer on high reliability. Otolaryngol Clin North Am. 2019;52(1):1-9. doi:10.1016/j.otc.2018.08.001.
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psnet.ahrq.gov/issue/emotional-fallout-culture-blame-and-shame
October 28, 2020 - Commentary
The emotional fallout from the culture of blame and shame.
Citation Text:
Ferguson CC. The emotional fallout from the culture of blame and shame. JAMA Pediatr. 2017;171(12):1141. doi:10.1001/jamapediatrics.2017.2691.
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psnet.ahrq.gov/issue/what-happened-patient-safety
August 23, 2007 - Audiovisual
What Happened to Patient Safety.
Citation Text:
What Happened to Patient Safety. Sheridan S. Turn on the Lights. Institute for Healthcare Improvement. May 2023
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psnet.ahrq.gov/issue/fatal-outcome-after-inadvertent-injection-topical-epinephrine
May 07, 2018 - Newspaper/Magazine Article
Fatal outcome after inadvertent injection of topical epinephrine.
Citation Text:
Fatal outcome after inadvertent injection of topical epinephrine. ISMP Medication Safety Alert! Acute Care Edition. March 26, 2009;14:1-2.
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psnet.ahrq.gov/issue/role-personal-health-information-management-promoting-patient-safety-home-qualitative
June 15, 2022 - Study
The role of personal health information management in promoting patient safety in the home: a qualitative analysis
Citation Text:
Demiris G, Lin S-Y, Turner AM. The role of personal health information management in promoting patient safety in the home: a qualitative analysis. Stud …
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psnet.ahrq.gov/issue/systems-approach-sharp-end
April 21, 2021 - Commentary
The systems approach at the sharp end.
Citation Text:
Cross SRH. The systems approach at the sharp end. Future Healthc J. 2019;5(3):176-180. doi:10.7861/futurehosp.5-3-176.
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psnet.ahrq.gov/web-mm/getting-diagnosis-both-right-and-wrong
May 29, 2024 - beginning to answer this question: dual process theory and situated cognition. 3-6 Although these concepts
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psnet.ahrq.gov/issue/wicked-problem-patient-misidentification-how-could-technological-revolution-help-address
July 10, 2024 - Commentary
The wicked problem of patient misidentification: how could the technological revolution help address patient safety?
Citation Text:
Ferguson C, Hickman L, Macbean C, et al. The wicked problem of patient misidentification: How could the technological revolution help address pat…
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psnet.ahrq.gov/issue/ahrq-psnet-annual-webinar-evidence-advancing-rapid-response-systems-and-opioid-stewardship
December 10, 2024 - Webinar
AHRQ PSNet Annual Webinar: Evidence on Advancing Rapid Response Systems and Opioid Stewardship.
Citation Text:
Agency for Healthcare Quality and Research. AHRQ PSNet Annual Webinar: Evidence on Advancing Rapid Response Systems and Opioid Stewardship. February 10, 2025, 1:00pm-2:0…
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psnet.ahrq.gov/issue/complications-acknowledging-managing-and-coping-human-error
March 13, 2024 - Review
Complications: acknowledging, managing, and coping with human error.
Citation Text:
Helo S, Moulton C-AE. Complications: acknowledging, managing, and coping with human error. Transl Androl Urol. 2017;6(4):773-782. doi:10.21037/tau.2017.06.28.
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psnet.ahrq.gov/issue/fifth-discipline-art-practice-learning-organization-revised-updated-edition
May 12, 2010 - Book/Report
Classic
The Fifth Discipline: The Art & Practice of The Learning Organization. Revised & Updated Edition.
Citation Text:
The Fifth Discipline: The Art & Practice of The Learning Organization. Revised & Updated Edition. Senge PM. New York, NY: Currenc…