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Unplanned transfers to a medical intensive care unit: causes and relationship to preventable errors in care. | PSNet

psnet.ahrq.gov/issue/unplanned-transfers-medical-intensive-care-unit-causes-and-relationship-preventable-errors

July 19, 2023 - Study Unplanned transfers to a medical intensive care unit: causes and relationship to preventable errors in care. Citation Text: Bapoje SR, Gaudiani JL, Narayanan V, et al. Unplanned transfers to a medical intensive care unit: causes and relationship to preventable errors in care. J …

Validation of a reduced set of high-performance triggers for identifying patient safety incidents with harm in primary care. | PSNet

psnet.ahrq.gov/issue/validation-reduced-set-high-performance-triggers-identifying-patient-safety-incidents-harm

May 17, 2023 - Study Validation of a reduced set of high-performance triggers for identifying patient safety incidents with harm in primary care. Citation Text: Garzón González G, Alonso Safont T, Conejos Míquel D, et al. Validation of a reduced set of high-performance triggers for identifying patient …

Associations between stopping prescriptions for opioids, length of opioid treatment, and overdose or suicide deaths in US veterans: observational evaluation. | PSNet

psnet.ahrq.gov/issue/associations-between-stopping-prescriptions-opioids-length-opioid-treatment-and-overdose-or

April 05, 2017 - Study Classic Associations between stopping prescriptions for opioids, length of opioid treatment, and overdose or suicide deaths in US veterans: observational evaluation. Citation Text: Oliva EM, Bowe T, Manhapra A, et al. Associations between stopping prescrip…

Identifying health information technology usability issues contributing to medication errors across medication process stages. | PSNet

psnet.ahrq.gov/issue/identifying-health-information-technology-usability-issues-contributing-medication-errors

November 03, 2021 - Study Identifying health information technology usability issues contributing to medication errors across medication process stages. Citation Text: Adams KT, Pruitt Z, Kazi S, et al. Identifying health information technology usability issues contributing to medication errors across medic…

Safety competency: exploring the impact of environmental and personal factors on the nurse's ability to deliver safe care. | PSNet

psnet.ahrq.gov/issue/safety-competency-exploring-impact-environmental-and-personal-factors-nurses-ability-deliver

September 14, 2022 - Study Safety competency: exploring the impact of environmental and personal factors on the nurse's ability to deliver safe care. Citation Text: Dillon-Bleich K, Dolansky MA, Burant CJ, et al. Safety competency: exploring the impact of environmental and personal factors on the nurse's abi…

Applicability of Healthcare Failure Mode and Effects Analysis to healthcare epidemiology: evaluation of the sterilization and use of surgical instruments. | PSNet

psnet.ahrq.gov/issue/applicability-healthcare-failure-mode-and-effects-analysis-healthcare-epidemiology-evaluation

October 19, 2022 - Study Applicability of Healthcare Failure Mode and Effects Analysis to healthcare epidemiology: evaluation of the sterilization and use of surgical instruments. Citation Text: Weinstein RA, Linkin DR, Sausman C, et al. Applicability of Healthcare Failure Mode and Effects Analysis to Heal…

Using a pediatric trigger tool to estimate total harm burden hospital-acquired conditions represent. | PSNet

psnet.ahrq.gov/issue/using-pediatric-trigger-tool-estimate-total-harm-burden-hospital-acquired-conditions

July 03, 2016 - Study Using a pediatric trigger tool to estimate total harm burden hospital-acquired conditions represent. Citation Text: Stockwell DC, Landrigan CP, Schuster MA, et al. Using a Pediatric Trigger Tool to Estimate Total Harm Burden Hospital-acquired Conditions Represent. Pediatr Qual Saf.…

Evaluation of an electronic health record structured discharge summary to provide real time adverse event reporting in thoracic surgery. | PSNet

psnet.ahrq.gov/issue/evaluation-electronic-health-record-structured-discharge-summary-provide-real-time-adverse

December 29, 2014 - Study Evaluation of an electronic health record structured discharge summary to provide real time adverse event reporting in thoracic surgery. Citation Text: Graham AJ, Ocampo W, Southern DA, et al. Evaluation of an electronic health record structured discharge summary to provide real ti…

Risk-adjusted survival for adults following in-hospital cardiac arrest by day of week and time of day: observational cohort study. | PSNet

psnet.ahrq.gov/issue/risk-adjusted-survival-adults-following-hospital-cardiac-arrest-day-week-and-time-day

July 01, 2017 - Study Risk-adjusted survival for adults following in-hospital cardiac arrest by day of week and time of day: observational cohort study. Citation Text: Robinson EJ, Smith GB, Power GS, et al. Risk-adjusted survival for adults following in-hospital cardiac arrest by day of week and time o…

Repeat prescribing of medications: a system-centred risk management model for primary care organisations. | PSNet

psnet.ahrq.gov/issue/repeat-prescribing-medications-system-centred-risk-management-model-primary-care

January 20, 2016 - Study Repeat prescribing of medications: a system-centred risk management model for primary care organisations. Citation Text: Price J, Man SL, Bartlett S, et al. Repeat prescribing of medications: A system-centred risk management model for primary care organisations. J Eval Clin Pract. …

Exploring relationships between hospital patient safety culture and Consumer Reports safety scores. | PSNet

psnet.ahrq.gov/issue/exploring-relationships-between-hospital-patient-safety-culture-and-consumer-reports-safety

July 21, 2016 - Study Exploring relationships between hospital patient safety culture and Consumer Reports safety scores. Citation Text: Smith SA, Yount N, Sorra J. Exploring relationships between hospital patient safety culture and Consumer Reports safety scores. BMC Health Serv Res. 2017;17(1):143. do…

What is the return on investment for implementation of a crew resource management program at an academic medical center? | PSNet

psnet.ahrq.gov/issue/what-return-investment-implementation-crew-resource-management-program-academic-medical

April 24, 2018 - Study What is the return on investment for implementation of a crew resource management program at an academic medical center? Citation Text: Moffatt-Bruce SD, Hefner JL, Mekhjian H, et al. What Is the Return on Investment for Implementation of a Crew Resource Management Program at an Ac…

Adherence to Surgical Care Improvement Project measures and the association with postoperative infections. | PSNet

psnet.ahrq.gov/issue/adherence-surgical-care-improvement-project-measures-and-association-postoperative-infections

November 25, 2020 - Study Classic Adherence to Surgical Care Improvement Project measures and the association with postoperative infections. Citation Text: Stulberg JJ, Delaney CP, Neuhauser D, et al. Adherence to surgical care improvement project measures and the association wit…

The I-READI quality and safety framework: a health system’s response to airway complications in mechanically ventilated patients with Covid-19. | PSNet

psnet.ahrq.gov/issue/i-readi-quality-and-safety-framework-health-systems-response-airway-complications

June 09, 2021 - Commentary The I-READI quality and safety framework: a health system’s response to airway complications in mechanically ventilated patients with Covid-19. Citation Text: Ginestra JC, Atkins JH, Mikkelsen ME, et al. The I-READI Quality and Safety Framework: a health system’s response to a…

Design and implementation of an automated email notification system for results of tests pending at discharge. | PSNet

psnet.ahrq.gov/issue/design-and-implementation-automated-email-notification-system-results-tests-pending-discharge

March 04, 2015 - Study Design and implementation of an automated email notification system for results of tests pending at discharge. Citation Text: Dalal A, Schnipper JL, Poon EG, et al. Design and implementation of an automated email notification system for results of tests pending at discharge. J Am M…

Analysis of hospital-level readmission rates and variation in adverse events among patients with pneumonia in the United States. | PSNet

psnet.ahrq.gov/issue/analysis-hospital-level-readmission-rates-and-variation-adverse-events-among-patients

August 25, 2021 - Study Analysis of hospital-level readmission rates and variation in adverse events among patients with pneumonia in the United States. Citation Text: Wang Y, Eldridge N, Metersky ML, et al. Analysis of hospital-level readmission rates and variation in adverse events among patients with p…

A descriptive study of morbidity and mortality conferences and their conformity to medical incident analysis models: results of the morbidity and mortality conference improvement study, phase 1. | PSNet

psnet.ahrq.gov/issue/descriptive-study-morbidity-and-mortality-conferences-and-their-conformity-medical-incident

September 28, 2010 - Study A descriptive study of morbidity and mortality conferences and their conformity to medical incident analysis models: results of the morbidity and mortality conference improvement study, phase 1. Citation Text: Aboumatar HJ, Blackledge CG, Dickson C, et al. A descriptive study of …

Diagnostic uncertainty among critically ill children admitted to the PICU: a multicenter study. | PSNet

psnet.ahrq.gov/issue/diagnostic-uncertainty-among-critically-ill-children-admitted-picu-multicenter-study

June 14, 2023 - Study Diagnostic uncertainty among critically ill children admitted to the PICU: a multicenter study. Citation Text: Cifra CL, Custer JW, Smith CM, et al. Diagnostic uncertainty among critically ill children admitted to the PICU: a multicenter study. Crit Care Med. 2025;53(2):e294-e307. …

Communication with patients and families regarding health care-associated exposure to coronavirus 2019: a checklist to facilitate disclosure. | PSNet

psnet.ahrq.gov/issue/communication-patients-and-families-regarding-health-care-associated-exposure-coronavirus

June 24, 2020 - Commentary Communication with patients and families regarding health care-associated exposure to coronavirus 2019: a checklist to facilitate disclosure. Citation Text: Sivashanker K, Mendu ML, Wickner PG, et al. Communication with patients and families regarding health care-associated ex…

Evaluation of an evidence-based, nurse-driven checklist to prevent hospital-acquired catheter-associated urinary tract infections in intensive care units. | PSNet

psnet.ahrq.gov/issue/evaluation-evidence-based-nurse-driven-checklist-prevent-hospital-acquired-catheter

June 03, 2013 - Study Evaluation of an evidence-based, nurse-driven checklist to prevent hospital-acquired catheter-associated urinary tract infections in intensive care units. Citation Text: Fuchs MA, Sexton DJ, Thornlow D, et al. Evaluation of an evidence-based, nurse-driven checklist to prevent hos…

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