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7781. Patient Self-Management | Agency for Healthcare Research and Quality
      www.ahrq.gov/topics/patient-self-management.html
      Topic: Patient Self-Management AHRQ has resources to help primary care clinicians and teams learn about and implement self-management support, which includes involving the whole care team in planning, carrying out, and following up on a patient visit; planning patient visits that focus on prevention and care manageme…

7782. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/44641/psn-pdf
      October 26, 2016 - Resident Safety Practices in Nursing Home Settings. October 26, 2016 Simmons S, Schnelle J, Slagle J, et al. Technical Brief No. 24. Rockville, MD: Agency for Healthcare Research and Quality; May 2016. AHRQ Publication No. 16-EHC022-EF. https://psnet.ahrq.gov/issue/resident-safety-practices-nursing-home-settings E…

7783. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/47241/psn-pdf
      October 10, 2018 - Impact of high-reliability education on adverse event reporting by registered nurses. October 10, 2018 McFarland DM, Doucette JN. Impact of High-Reliability Education on Adverse Event Reporting by Registered Nurses. J Nurs Care Qual. 2018;33(3):285-290. doi:10.1097/NCQ.0000000000000291. https://psnet.ahrq.gov/issu…

7784. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/44140/psn-pdf
      July 15, 2015 - Openness and Honesty When Things Go Wrong: the Professional Duty of Candour. July 15, 2015 London, UK: General Medical Council and the Nursing and Midwifery Council; June 29, 2015. https://psnet.ahrq.gov/issue/openness-and-honesty-when-things-go-wrong-professional-duty-candour Open and honest discussion with patie…

7785. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/50839/psn-pdf
      January 29, 2020 - Mid Staffs scandal: 10 years on, inquiry chair worries NHS staff too scared to speak up. January 29, 2020 Lintern S. The Independent. January 15, 2020. https://psnet.ahrq.gov/issue/mid-staffs-scandal-10-years-inquiry-chair-worries-nhs-staff-too-scared-speak The Francis report is a primary example of a large-scale …

7786. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/39605/psn-pdf
      December 17, 2010 - The effect of facility complexity on perceptions of safety climate in the operating room: size matters. December 17, 2010 Carney BT, West P, Neily J, et al. The effect of facility complexity on perceptions of safety climate in the operating room: size matters. Am J Med Qual. 2010;25(6):457-61. doi:10.1177/106286061…

7787. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/50891/psn-pdf
      February 12, 2020 - Nurses as antimicrobial stewards: recognition, confidence, and organizational factors across nine hospitals. February 12, 2020 Monsees E, Goldman J, Vogelsmeier A, et al. Nurses as antimicrobial stewards: Recognition, confidence, and organizational factors across nine hospitals. Am J Infect Control. 2020. doi:10.1…

7788. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/40772/psn-pdf
      November 23, 2011 - Improving perceptions of teamwork climate with the Veterans Health Administration medical team training program. November 23, 2011 Carney BT, West P, Neily J, et al. Improving perceptions of teamwork climate with the Veterans Health Administration medical team training program. Am J Med Qual. 2011;26(6):480-4. do…

7789. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/46352/psn-pdf
      October 15, 2018 - Optimal Resources for Surgical Quality and Safety. October 15, 2018 Hoyt DB, Ko CY, eds. Chicago, IL: American College of Surgeons; 2017. ISBN: 9780996826242. https://psnet.ahrq.gov/issue/optimal-resources-surgical-quality-and-safety Surgery is complex and involves a wide range of possibilities for error that can r…

7790. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/837431/psn-pdf
      June 15, 2022 - Anesthesiologist group says hospitals can prevent fatal errors like Vanderbilt's. June 15, 2022 Clark C. MedPage Today. June 2, 2022 https://psnet.ahrq.gov/issue/anesthesiologist-group-says-hospitals-can-prevent-fatal-errors-vanderbilts Transparency and discussion of errors is a hallmark of the culture needed to i…

7791. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/44265/psn-pdf
      January 22, 2016 - How surgical trainees handle catastrophic errors: a qualitative study. January 22, 2016 Balogun JA, Bramall AN, Bernstein M. How Surgical Trainees Handle Catastrophic Errors: A Qualitative Study. J Surg Educ. 2015;72(6):1179-84. doi:10.1016/j.jsurg.2015.05.003. https://psnet.ahrq.gov/issue/how-surgical-trainees-ha…

7792. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/50921/psn-pdf
      February 19, 2020 - How chaos at chain pharmacies is putting patients at risk. February 19, 2020 Gabler E. New York Times. January 31, 2020. https://psnet.ahrq.gov/issue/how-chaos-chain-pharmacies-putting-patients-risk Pharmacists are instrumental to safe medication use in the ambulatory setting. This news story discusses f…

7793. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/851454/psn-pdf
      July 19, 2023 - Preventing surgical site infections: implementing strategies throughout the perioperative continuum. July 19, 2023 Rosa R, Sposato K, Abbo LM. Preventing surgical site infections: implementing strategies throughout the perioperative continuum. AORN J. 2023;117(5):300-311. doi:10.1002/aorn.13913. https://psnet.ahrq…

7794. Exhibit 3.19. Major Factors that Facilitate Lean Success | Agency for Healthcare Research and Quality
      www.ahrq.gov/practiceimprovement/systemdesign/leancasestudies/lean-exhibit3-19.html
      November 01, 2014 - Improving Care Delivery Through Lean: Implementation Case Studies Exhibit 3.19. Major Factors that Facilitate Lean Success Previous Page Next Page Table of Contents Improving Care Delivery Through Lean: Implementation Case Studies Introduction to the Case Studies Case 1. Lakeview Healthcare Ca…

7795. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/44625/psn-pdf
      November 20, 2015 - State-of-the-art usage of simulation in anesthesia: skills and teamwork. November 20, 2015 Krage R, Erwteman M. State-of-the-art usage of simulation in anesthesia: skills and teamwork. Curr Opin Anaesthesiol. 2015;28(6):727-34. doi:10.1097/ACO.0000000000000257. https://psnet.ahrq.gov/issue/state-art-usage-simulati…

7796. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/38456/psn-pdf
      May 02, 2014 - Burden of difficult encounters in primary care: data from the Minimizing Error, Maximizing Outcomes Study. May 2, 2014 An PG, Rabatin JS, Manwell LB, et al. Burden of difficult encounters in primary care: data from the minimizing error, maximizing outcomes study. Arch Intern Med. 2009;169(4):410-4. doi:10.1001/arc…

7797. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/47213/psn-pdf
      June 20, 2018 - Are second victims getting the help they need? June 20, 2018 Headley M. Patient Saf Qual Healthc. May/June 2018. https://psnet.ahrq.gov/issue/are-second-victims-getting-help-they-need Clinicians can experience emotional stress, guilt, and insecurity after making a mistake. Organizations are increasingly building p…

7798. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/44803/psn-pdf
      January 27, 2016 - Examining the relationship among ambulatory surgical settings work environment, nurses' characteristics, and medication errors reporting. January 27, 2016 Farag AA, Anthony MK. Examining the Relationship Among Ambulatory Surgical Settings Work Environment, Nurses' Characteristics, and Medication Errors Reporting. …

7799. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/42681/psn-pdf
      December 13, 2013 - Medication reconciliation: reducing risk for medication misadventure during transition from hospital to assisted living. December 13, 2013 Fitzgibbon M, Lorenz R, Lach H. Medication reconciliation: reducing risk for medication misadventure during transition from hospital to assisted living. J Gerontol Nurs. 2013;3…

7800. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/47810/psn-pdf
      March 13, 2019 - Debriefing in the OR: a quality improvement project. March 13, 2019 Finch EP, Langston M, Erickson D, et al. Debriefing in the OR: A Quality Improvement Project. AORN J. 2019;109(3):336-344. doi:10.1002/aorn.12616. https://psnet.ahrq.gov/issue/debriefing-or-quality-improvement-project Debriefing has emerged as a s…