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psnet.ahrq.gov/web-mm/tough-call-addressing-errors-previous-providers
July 17, 2024 - Describe two examples of well-defined processes to identify individual accountability for adverse events … practice-based learning.( 9 ) Organizations can reinforce these professional duties by: (i) developing well-defined … diagnostic errors, such as a standardized review of all readmissions for the same diagnosis within a defined … After a suspected diagnostic error, there should be a standardized-review process with well-defined means … Reason's Unsafe Acts Algorithm and the Professional Accountability Pyramid are two well-defined tools
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psnet.ahrq.gov/issue/ahrq-funded-patient-safety-project-highlights-improving-patient-safety-enhancing-care
August 07, 2024 - Care coordination is defined as the process of organizing patient care activities and sharing information
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psnet.ahrq.gov/primer/measurement-patient-safety
September 15, 2024 - Framework for Measuring Patient Safety In the 1960s, health services researcher Avedis Donabedian defined … Retrospective chart review using trigger tools or well-defined specific adverse events is often used … reliable measurement strategies , and studies have shown that variation in how medication errors are defined
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psnet.ahrq.gov/node/60641/psn-pdf
July 01, 2020 - literature, this systematic review explored predictors and
triggers of incivility in medical teams (defined
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psnet.ahrq.gov/node/73066/psn-pdf
March 24, 2021 - The authors suggest risk reduction strategies
including defined clinician roles for medication reconciliation
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psnet.ahrq.gov/node/50741/psn-pdf
December 18, 2019 - potentially-inappropriate-medication-use-hospitalized-elders
https://psnet.ahrq.gov/issue/potentially-inappropriate-medications-defined-stopp-criteria-and-risk-adverse-drug-events
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psnet.ahrq.gov/node/853621/psn-pdf
September 20, 2023 - do-not-pimp-my-nursing-home-ride-impact-potentially-inappropriate-medications-prescribing
https://psnet.ahrq.gov/issue/potentially-inappropriate-medications-defined-stopp-criteria-and-risk-adverse-drug-events
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psnet.ahrq.gov/node/33591/psn-pdf
March 15, 2025 - Well-defined, specific triggers like this also
lend themselves to automated electronic detection, making … Use of the trigger tool involves screening a
defined sample of medical records by two independent clinicians
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psnet.ahrq.gov/node/41593/psn-pdf
August 15, 2012 - facility-level-variation-potentially-inappropriate-prescribing-older-veterans
https://psnet.ahrq.gov/issue/potentially-inappropriate-medications-defined-stopp-criteria-and-risk-adverse-drug-events
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psnet.ahrq.gov/node/864368/psn-pdf
March 13, 2024 - Diseases (ICD) subclass Misadventures to Patients During Surgical and
Medical Care, where the authors defined
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psnet.ahrq.gov/issue/defining-and-measuring-diagnostic-uncertainty-medicine-systematic-review
June 21, 2018 - Review
Classic
Defining and measuring diagnostic uncertainty in medicine: a systematic review.
Citation Text:
Bhise V, Rajan SS, Sittig DF, et al. Defining and Measuring Diagnostic Uncertainty in Medicine: A Systematic Review. J Gen Intern Med. 2018;33(1):103-11…
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psnet.ahrq.gov/issue/defining-attributes-patient-safety-through-concept-analysis
May 08, 2013 - Review
Defining attributes of patient safety through a concept analysis.
Citation Text:
Kim L, Lyder CH, McNeese-Smith D, et al. Defining attributes of patient safety through a concept analysis. J Adv Nurs. 2015;71(11):2490-503. doi:10.1111/jan.12715.
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Format:
…
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psnet.ahrq.gov/issue/defining-technical-errors-laparoscopic-surgery-systematic-review
September 11, 2013 - Review
Defining technical errors in laparoscopic surgery: a systematic review.
Citation Text:
Bonrath EM, Dedy NJ, Zevin B, et al. Defining technical errors in laparoscopic surgery: a systematic review. Surg Endosc. 2013;27(8):2678-91. doi:10.1007/s00464-013-2827-5.
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…
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psnet.ahrq.gov/issue/science-simulation-healthcare-defining-and-developing-clinical-expertise
November 02, 2011 - Meeting/Conference Proceedings
The Science of Simulation in Healthcare: Defining and Developing Clinical Expertise.
Citation Text:
The Science of Simulation in Healthcare: Defining and Developing Clinical Expertise. Kaji AH, Cone DC, eds. Acad Emerg Med. 2008;15:971-1222.
…
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psnet.ahrq.gov/issue/safety-management-systems-introduction-healthcare
February 14, 2024 - the core safety elements of an SMS (policy, risk management, assurance, and promotion), how they are defined
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psnet.ahrq.gov/node/850916/psn-pdf
June 21, 2023 - transparency, lack of standardization regarding how race and social determinants
are collected and defined
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psnet.ahrq.gov/node/74139/psn-pdf
December 01, 2021 - This narrative review
explored how situation awareness has been defined and studied in healthcare, with
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psnet.ahrq.gov/node/41861/psn-pdf
September 27, 2017 - surgeon-commitment-trauma-care-decreases-missed-injuries
Full-time trauma surgeons had a lower incidence of diagnostic errors (defined
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psnet.ahrq.gov/node/37558/psn-pdf
July 05, 2013 - implementation of portions of the Patient Safety and Quality
Improvement Act of 2005 including how entities are defined
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psnet.ahrq.gov/node/40569/psn-pdf
June 29, 2011 - inappropriate-medications-elderly-icu-survivors-where-intervene
https://psnet.ahrq.gov/issue/potentially-inappropriate-medications-defined-stopp-criteria-and-risk-adverse-drug-events