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  1. A mixed methods study exploring patient safety culture at 4 VHA Hospitals. | PSNet

    psnet.ahrq.gov/issue/mixed-methods-study-exploring-patient-safety-culture-4-vha-hospitals
    September 25, 2019 - Study A mixed methods study exploring patient safety culture at 4 VHA Hospitals. Citation Text: Sullivan JL, Shin MH, Ranusch A, et al. A mixed methods study exploring patient safety culture at 4 VHA Hospitals. Jt Comm J Qual Patient Saf. 2024;50(11):791-800. doi:10.1016/j.jcjq.2024.07.0…

  2. Clinic design for safety during the pandemic: safety or teamwork, can we only pick one? | PSNet

    psnet.ahrq.gov/issue/clinic-design-safety-during-pandemic-safety-or-teamwork-can-we-only-pick-one
    November 11, 2015 - Commentary Clinic design for safety during the pandemic: safety or teamwork, can we only pick one? Citation Text: Lim L, Zimring CM, DuBose JR, et al. Clinic design for safety during the pandemic: safety or teamwork, can we only pick one? HERD. 2022;15(3):28-41. doi:10.1177/1937586722109…

  3. Workarounds and test results follow-up in electronic health record–based primary care. | PSNet

    psnet.ahrq.gov/issue/workarounds-and-test-results-follow-electronic-health-record-based-primary-care
    August 20, 2014 - Study Workarounds and test results follow-up in electronic health record–based primary care. Citation Text: Menon S, Murphy DR, Singh H, et al. Workarounds and Test Results Follow-up in Electronic Health Record-Based Primary Care. Appl Clin Inform. 2016;7(2):543-559. doi:10.4338/ACI-2015…

  4. Errors of diagnosis in pediatric practice: a multisite survey. | PSNet

    psnet.ahrq.gov/issue/errors-diagnosis-pediatric-practice-multisite-survey
    November 13, 2024 - Study Errors of diagnosis in pediatric practice: a multisite survey. Citation Text: 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. Copy Citation Format: DOI Goog…

  5. Patient perspectives on how physicians communicate diagnostic uncertainty: an experimental vignette study. | PSNet

    psnet.ahrq.gov/issue/patient-perspectives-how-physicians-communicate-diagnostic-uncertainty-experimental-vignette
    August 07, 2019 - Study Classic Patient perspectives on how physicians communicate diagnostic uncertainty: an experimental vignette study. Citation Text: Bhise V, Meyer AND, Menon S, et al. Patient perspectives on how physicians communicate diagnostic uncertainty: An experimental…

  6. Identifying barriers to and opportunities for telehealth implementation amidst the COVID-19 pandemic by using a human factors approach: a leap into the future of health care delivery? | PSNet

    psnet.ahrq.gov/issue/identifying-barriers-and-opportunities-telehealth-implementation-amidst-covid-19-pandemic
    July 07, 2021 - Commentary Identifying barriers to and opportunities for telehealth implementation amidst the COVID-19 pandemic by using a human factors approach: a leap into the future of health care delivery? Citation Text: Zhang T, Mosier J, Subbian V. Identifying barriers to and opportunities for te…

  7. Adverse drug events caused by serious medication administration errors. | PSNet

    psnet.ahrq.gov/issue/adverse-drug-events-caused-serious-medication-administration-errors
    December 19, 2009 - Study Adverse drug events caused by serious medication administration errors. Citation Text: Kale A, Keohane C, Maviglia SM, et al. Adverse drug events caused by serious medication administration errors. BMJ Qual Saf. 2012;21(11):933-8. doi:10.1136/bmjqs-2012-000946. Copy Citation …

  8. Wisdom through adversity: learning and growing in the wake of an error. | PSNet

    psnet.ahrq.gov/issue/wisdom-through-adversity-learning-and-growing-wake-error
    October 08, 2016 - Study Wisdom through adversity: learning and growing in the wake of an error. Citation Text: Plews-Ogan M, Owens JE, May NB. Wisdom through adversity: learning and growing in the wake of an error. Patient Educ Couns. 2013;91(2):236-42. doi:10.1016/j.pec.2012.12.006. Copy Citation …

  9. Nurses' perceptions of error communication and reporting in the intensive care unit. | PSNet

    psnet.ahrq.gov/issue/nurses-perceptions-error-communication-and-reporting-intensive-care-unit
    February 20, 2008 - Study Nurses' perceptions of error communication and reporting in the intensive care unit. Citation Text: Elder NC, Brungs SM, Nagy M, et al. Nurses' Perceptions of Error Communication and Reporting in the Intensive Care Unit. J Patient Saf. 2008;4(3). doi:10.1097/pts.0b013e3181839b48.…

  10. Human errors in emergency medical services: a qualitative analysis of contributing factors. | PSNet

    psnet.ahrq.gov/issue/human-errors-emergency-medical-services-qualitative-analysis-contributing-factors
    July 07, 2021 - Study Human errors in emergency medical services: a qualitative analysis of contributing factors. Citation Text: Poranen A, Kouvonen A, Nordquist H. Human errors in emergency medical services: a qualitative analysis of contributing factors. Scand J Trauma Resusc Emerg Med. 2024;32(1):78.…

  11. National study on the frequency, types, causes, and consequences of voluntarily reported emergency department medication errors. | PSNet

    psnet.ahrq.gov/issue/national-study-frequency-types-causes-and-consequences-voluntarily-reported-emergency
    April 15, 2014 - Study National study on the frequency, types, causes, and consequences of voluntarily reported emergency department medication errors. Citation Text: Pham JC, Story JL, Hicks RW, et al. National study on the frequency, types, causes, and consequences of voluntarily reported emergency d…

  12. Client, caregiver, and provider perspectives of safety in palliative home care: a mixed method design. | PSNet

    psnet.ahrq.gov/issue/client-caregiver-and-provider-perspectives-safety-palliative-home-care-mixed-method-design
    March 02, 2016 - Study Client, caregiver, and provider perspectives of safety in palliative home care: a mixed method design. Citation Text: Lang A, Toon L, Cohen SR, et al. Client, caregiver, and provider perspectives of safety in palliative home care: a mixed method design. Safety Health. 2015;1(1):3. …

  13. Incidence and preventability of adverse events requiring intensive care admission: a systematic review. | PSNet

    psnet.ahrq.gov/issue/incidence-and-preventability-adverse-events-requiring-intensive-care-admission-systematic
    May 16, 2018 - Review Incidence and preventability of adverse events requiring intensive care admission: a systematic review. Citation Text: Vlayen A, Verelst S, Bekkering GE, et al. Incidence and preventability of adverse events requiring intensive care admission: a systematic review. J Eval Clin Pr…

  14. Providers contextualise care more often when they discover patient context by asking: meta-analysis of three primary data sets. | PSNet

    psnet.ahrq.gov/issue/providers-contextualise-care-more-often-when-they-discover-patient-context-asking-meta
    September 20, 2011 - Study Providers contextualise care more often when they discover patient context by asking: meta-analysis of three primary data sets. Citation Text: Schwartz A, Weiner SJ, Binns-Calvey A, et al. Providers contextualise care more often when they discover patient context by asking: meta-an…

  15. Prospective risk analysis of health care processes: a systematic evaluation of the use of HFMEA in Dutch health care. | PSNet

    psnet.ahrq.gov/issue/prospective-risk-analysis-health-care-processes-systematic-evaluation-use-hfmea-dutch-health
    March 10, 2010 - Study Prospective risk analysis of health care processes: a systematic evaluation of the use of HFMEA in Dutch health care. Citation Text: Habraken MMP, van der Schaaf TW, Leistikow IP, et al. Prospective risk analysis of health care processes: a systematic evaluation of the use of HFM…

  16. A 38-year-old woman with fetal loss and hysterectomy. | PSNet

    psnet.ahrq.gov/issue/38-year-old-woman-fetal-loss-and-hysterectomy
    January 12, 2011 - Commentary Classic A 38-year-old woman with fetal loss and hysterectomy. Citation Text: Sachs BP. A 38-Year-Old Woman With Fetal Loss and Hysterectomy. JAMA. 2005;294(7):833-840. doi:10.1001/jama.294.7.833. Copy Citation Format: DOI Google Schola…

  17. Influence of surgeon behavior on trainee willingness to speak up: a randomized controlled trial. | PSNet

    psnet.ahrq.gov/issue/influence-surgeon-behavior-trainee-willingness-speak-randomized-controlled-trial
    February 22, 2019 - Study Influence of surgeon behavior on trainee willingness to speak up: a randomized controlled trial. Citation Text: Salazar MJB, Minkoff H, Bayya J, et al. Influence of surgeon behavior on trainee willingness to speak up: a randomized controlled trial. J Am Coll Surg. 2014;219(5):1001-…

  18. Fostering a just culture in healthcare organizations: experiences in practice. | PSNet

    psnet.ahrq.gov/issue/fostering-just-culture-healthcare-organizations-experiences-practice
    August 10, 2022 - Study Fostering a just culture in healthcare organizations: experiences in practice. Citation Text: van Baarle E, Hartman L, Rooijakkers S, et al. Fostering a just culture in healthcare organizations: experiences in practice. BMC Health Serv Res. 2022;22(1):1035. doi:10.1186/s12913-022-0…

  19. Patients' perceptions of safety if interpersonal continuity of care were to be disrupted. | PSNet

    psnet.ahrq.gov/issue/patients-perceptions-safety-if-interpersonal-continuity-care-were-be-disrupted
    July 21, 2021 - Study Patients' perceptions of safety if interpersonal continuity of care were to be disrupted. Citation Text: Pandhi N, Schumacher J, Flynn KE, et al. Patients' perceptions of safety if interpersonal continuity of care were to be disrupted. Health Expect. 2008;11(4):400-8. doi:10.…

  20. What do patients think about year-end resident continuity clinic handoffs?: a qualitative study. | PSNet

    psnet.ahrq.gov/issue/what-do-patients-think-about-year-end-resident-continuity-clinic-handoffs-qualitative-study
    March 28, 2018 - Study What do patients think about year-end resident continuity clinic handoffs?: a qualitative study. Citation Text: Pincavage A, Lee WW, Beiting KJ, et al. What do patients think about year-end resident continuity clinic handoffs? A qualitative study. J Gen Intern Med. 2013;28(8):999-1…
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