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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/848384/psn-pdf
    May 03, 2023 - Roadmap to Health Care Safety for Massachusetts. May 3, 2023 Massachusetts Healthcare Safety and Quality Consortium. Boston, MA: Betsy Lehman Center for Patient Safety; April 2023. https://psnet.ahrq.gov/issue/roadmap-health-care-safety-massachusetts Collective engagement and focus are required to attain large sys…

  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/34659/psn-pdf
    April 07, 2010 - Leading change: why transformation efforts fail. April 7, 2010 Kotter JP. Harvard Bus Rev  1995;73(2);59-67. https://psnet.ahrq.gov/issue/leading-change-why-transformation-efforts-fail Kotter, a professor at Harvard Business School, outlines the eight stages of a successful change process, as well a…

  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/35415/psn-pdf
    December 21, 2008 - Acting Locally: Working in Clinical Microsystems CD- ROM. December 21, 2008 Oakbrook Terrance, IL: Joint Commission Resources; 2005. ISBN 9780866889865. https://psnet.ahrq.gov/issue/acting-locally-working-clinical-microsystems-cd-rom This resource represents a collection of special articles published in the Joint …

  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/40235/psn-pdf
    May 11, 2011 - Assessing and improving safety climate in a large cohort of intensive care units. May 11, 2011 Sexton B, Berenholtz SM, Goeschel CA, et al. Assessing and improving safety climate in a large cohort of intensive care units. Crit Care Med. 2011;39(5):934-9. doi:10.1097/CCM.0b013e318206d26c. https://psnet.ahrq.gov/iss…

  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41969/psn-pdf
    July 02, 2014 - The creation and impact of a dedicated section on quality and patient safety in a clinical academic department. July 2, 2014 Boudreaux AM, Vetter TR. The Creation and Impact of a Dedicated Section on Quality and Patient Safety in a Clinical Academic Department. Academic Medicine. 2012;88(2). doi:10.1097/acm.0b013e3…

  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47145/psn-pdf
    July 23, 2018 - The elusive and illusive quest for diagnostic safety metrics. July 23, 2018 Schiff G, Ruan EL. The Elusive and Illusive Quest for Diagnostic Safety Metrics. J Gen Intern Med. 2018;33(7):983-985. doi:10.1007/s11606-018-4454-2. https://psnet.ahrq.gov/issue/elusive-and-illusive-quest-diagnostic-safety-metrics Measur…

  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/851462/psn-pdf
    July 19, 2023 - Broken Trust: Making Patient Safety More than Just a Promise. July 19, 2023 Manchester, UK: Parliamentary and Health Service Ombudsman; June 2023. ISBN: 9781528642446. https://psnet.ahrq.gov/issue/broken-trust-making-patient-safety-more-just-promise Lack of accountability for systemic contributions to failure degr…

  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47904/psn-pdf
    April 24, 2019 - Air pressure: human factors are the key to a safer flight environment. April 24, 2019 Erich J. EMS World. April 2019;48:26-31. https://psnet.ahrq.gov/issue/air-pressure-human-factors-are-key-safer-flight-environment Air transport service combines risks associated with both aviation and prehospital trauma care. Thi…

  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/34589/psn-pdf
    January 04, 2017 - John M. Eisenberg Patient Safety Awards. System innovation: Veterans Health Administration National Center for Patient Safety. January 4, 2017 Heget JR, Bagian JP, Lee CZ, et al. John M. Eisenberg Patient Safety Awards. System innovation: Veterans Health Administration National Center for Patient Safety. Jt Comm J…

  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44909/psn-pdf
    March 23, 2016 - Root Cause Analysis Workbook for Community/Ambulatory Pharmacy. March 23, 2016 Horsham, PA: Institute for Safe Medication Practices; 2013. https://psnet.ahrq.gov/issue/root-cause-analysis-workbook-communityambulatory-pharmacy Root cause analysis offers a structured way to detect and address system weaknesses. This…

  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45477/psn-pdf
    October 05, 2016 - Promoting safety through well-being: an experience in healthcare. October 5, 2016 Bruno A, Bracco F. Promoting Safety through Well-Being: An Experience in Healthcare. Front Psychol. 2016;7:1208. doi:10.3389/fpsyg.2016.01208. https://psnet.ahrq.gov/issue/promoting-safety-through-well-being-experience-healthcare Th…

  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42506/psn-pdf
    August 28, 2013 - Foundations for teaching surgeons to address the contributions of systems to operating room team conflict. August 28, 2013 Rogers DA, Lingard LA, Boehler ML, et al. Foundations for teaching surgeons to address the contributions of systems to operating room team conflict. Am J Surg. 2013;206(3):428-32. doi:10.1016/…

  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47378/psn-pdf
    February 22, 2019 - Taking the blame: appropriate responses to medical error. February 22, 2019 Tigard DW. Taking the blame: appropriate responses to medical error. J Med Ethics. 2019;45(2):101-105. doi:10.1136/medethics-2017-104687. https://psnet.ahrq.gov/issue/taking-blame-appropriate-responses-medical-error Balancing between expli…

  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43839/psn-pdf
    January 28, 2015 - Patient Safety. January 28, 2015 J Health Serv Res Policy. 2015;20(suppl 1):S1-S60. https://psnet.ahrq.gov/issue/patient-safety-11 Articles in this special supplement explore research commissioned by National Institute for Health Research in the United Kingdom to address four patient safety research gaps: how orga…

  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/836863/psn-pdf
    April 06, 2022 - Intrapersonal and institutional influences on overall perception of radiation safety among radiologic technologists. April 6, 2022 Moore QT, Walker DA, Frush DP, et al. Radiol Technol. 2022;93(3):255-267.  https://psnet.ahrq.gov/issue/intrapersonal-and-institutional-influences-overall-perception-radiation-saf…

  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/50894/psn-pdf
    February 12, 2020 - A professional development course improves unprofessional physician behavior. February 12, 2020 Swiggart WH, Bills JL, Penberthy JK, et al. A professional development course improves unprofessional physician behavior. Jt Comm J Qual Patient Saf. 2019;46(2). doi:10.1016/j.jcjq.2019.11.004. https://psnet.ahrq.gov/is…

  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/838636/psn-pdf
    October 19, 2022 - A qualitative survey of factors shaping the role of a safety professional. October 19, 2022 Van Wassenhove W, Foussard C, Dekker SWA, et al. A qualitative survey of factors shaping the role of a safety professional. Safety Sci. 2022;154:105835. doi:10.1016/j.ssci.2022.105835. https://psnet.ahrq.gov/issue/qualitati…

  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/73547/psn-pdf
    July 28, 2021 - Pharmacist and prescriber responsibilities for avoiding prescription drug misuse. July 28, 2021 Pharmacist and prescriber responsibilities for avoiding prescription drug misuse. AMA J Ethics. 2021;23(6):E471-479. doi:10.1001/amajethics.2021.471. https://psnet.ahrq.gov/issue/pharmacist-and-prescriber-responsibiliti…

  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41689/psn-pdf
    December 16, 2013 - Are health professionals' perceptions of patient safety related to figures on safety incidents? December 16, 2013 Martijn L, Harmsen M, Gaal S, et al. Are health professionals' perceptions of patient safety related to figures on safety incidents? J Eval Clin Pract. 2013;19(5):944-7. doi:10.1111/j.1365-2753.2012.018…

  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41565/psn-pdf
    December 21, 2014 - Pursuing professional accountability: an evidence-based approach to addressing residents with behavioral problems. December 21, 2014 Sanfey H, DaRosa DA, Hickson GB, et al. Pursuing professional accountability: an evidence-based approach to addressing residents with behavioral problems. Arch Surg. 2012;147(7):642-…
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