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  1. psnet.ahrq.gov/issue/comprehensive-healthcare-inspection-summary-report-evaluation-care-coordination-veterans
    July 27, 2022 - Book/Report Comprehensive Healthcare Inspection Summary Report: Evaluation of Care Coordination in Veterans Health Administration Facilities, Fiscal Year 2021. Citation Text: Comprehensive Healthcare Inspection Summary Report: Evaluation of Care Coordination in Veterans Health Administra…
  2. psnet.ahrq.gov/issue/call-safety-anticipating-and-mitigating-risk-across-obstetrics-and-gynecology-service-line
    February 24, 2016 - Commentary A call for safety: anticipating and mitigating risk across an obstetrics and gynecology service line. Citation Text: Combs A, Klein VR. A call for safety: anticipating and mitigating risk across an obstetrics and gynecology service line. J Healthc Risk Manag. 2023;43(1):38-42.…
  3. psnet.ahrq.gov/issue/unintentionally-retained-foreign-objects-descriptive-study-308-sentinel-events-and
    March 20, 2019 - Study Emerging Classic Unintentionally retained foreign objects: a descriptive study of 308 sentinel events and contributing factors. Citation Text: Steelman VM, Shaw C, Shine L, et al. Unintentionally Retained Foreign Objects: A Descriptive Study of 308 Sentine…
  4. psnet.ahrq.gov/issue/ensuring-safe-and-equitable-discharge-quality-improvement-initiative-individuals-hypertensive
    October 19, 2022 - Study Ensuring safe and equitable discharge: a quality improvement initiative for individuals with hypertensive disorders of pregnancy. Citation Text: Zacherl KM, Sterrett EC, Hughes BL, et al. Ensuring safe and equitable discharge: a quality improvement initiative for individuals with h…
  5. psnet.ahrq.gov/issue/language-discordance-and-patient-care-babel
    October 30, 2024 - Commentary Language discordance and patient care-Babel. Citation Text: Huson TA. Language discordance and patient care-Babel. JAMA Intern Med. 2024;184(11):1287-1288. doi:10.1001/jamainternmed.2024.4273. Copy Citation Format: DOI Google Scholar BibTeX EndNote X3 XML EndNote…
  6. psnet.ahrq.gov/issue/pathology-oversight-failures-veterans-health-care-system-ozarks-fayetteville-arkansas-va
    July 14, 2021 - Book/Report Pathology Oversight Failures at the Veterans Health Care System of the Ozarks in Fayetteville, Arkansas VA. Citation Text: Pathology Oversight Failures at the Veterans Health Care System of the Ozarks in Fayetteville, Arkansas VA. Office of Inspector General. June 2, 202…
  7. psnet.ahrq.gov/issue/guided-reflection-interventions-show-no-effect-diagnostic-accuracy-medical-students
    September 20, 2016 - Study Guided reflection interventions show no effect on diagnostic accuracy in medical students. Citation Text: Lambe KA, Hevey D, Kelly BD. Guided Reflection Interventions Show No Effect on Diagnostic Accuracy in Medical Students. Front Psychol. 2018;9:2297. doi:10.3389/fpsyg.2018.02297…
  8. psnet.ahrq.gov/issue/use-checklist-pediatric-oncology-clinic
    April 24, 2019 - Study The use of a checklist in a pediatric oncology clinic. Citation Text: McLean TW, White GM, Bagliani AF, et al. The use of a checklist in a pediatric oncology clinic. Pediatr Blood Cancer. 2013;60(11):1855-9. doi:10.1002/pbc.24657. Copy Citation Format: DOI Google Sch…
  9. psnet.ahrq.gov/issue/evaluation-registered-nurse-competency-processes-veterans-health-administration-facilities
    April 26, 2006 - Book/Report Evaluation of Registered Nurse Competency Processes in Veterans Health Administration Facilities. Citation Text: Evaluation of Registered Nurse Competency Processes in Veterans Health Administration Facilities. Washington, DC: VA Office of Inspector General; April 20, 201…
  10. psnet.ahrq.gov/issue/health-care-worker-perspectives-their-motivation-reduce-health-care-associated-infections
    June 02, 2019 - Study Health care worker perspectives of their motivation to reduce health care–associated infections. Citation Text: McClung L, Obasi C, Knobloch MJ, et al. Health care worker perspectives of their motivation to reduce health care-associated infections. Am J Infect Control. 2017;45(10):…
  11. psnet.ahrq.gov/issue/quality-and-health-system-becoming-high-reliability-organization
    November 16, 2022 - Review Quality and the health system: becoming a high reliability organization. Citation Text: Gaw M, Rosinia F, Diller T. Quality and the health system: becoming a high reliability organization. Anesthesiol Clin. 2018;36(2):217-226. doi:10.1016/j.anclin.2018.01.010. Copy Citation …
  12. psnet.ahrq.gov/issue/anatomy-and-pathophysiology-errors-occurring-clinical-radiology-practice
    February 01, 2011 - Patient Safety Innovations Ambulatory Safety Nets to Reduce Missed and Delayed Diagnoses … October 31, 2014 Fool me twice: delayed diagnoses in radiology with emphasis on perpetuated
  13. psnet.ahrq.gov/issue/recommendations-quality-assurance-and-improvement-surgical-and-autopsy-pathology
    September 29, 2010 - Download Citation Related Resources From the Same Author(s) Critical diagnoses … August 26, 2011 Critical diagnoses (critical values) in anatomic pathology.
  14. psnet.ahrq.gov/issue/beyond-negligence-avoidability-and-medical-injury-compensation
    February 17, 2011 - April 21, 2015 Missed and delayed diagnoses in the ambulatory setting: a study of closed … March 2, 2011 Missed and delayed diagnoses in the emergency department: a study of closed
  15. psnet.ahrq.gov/issue/understanding-medication-safety-healthcare-settings-critical-review-conceptual-models
    September 27, 2016 - 2011 Autopsy interrogation of emergency medicine dispute cases: how often are clinical diagnoses … May 6, 2020 Evaluation and accurate diagnoses of pediatric diseases using artificial
  16. psnet.ahrq.gov/issue/covid-19-delaying-routine-care-chronic-disease-startups-brace-slew-complications
    May 02, 2018 - December 4, 2019 Using telehealth to revolutionize the speed of making rare disease diagnoses … September 16, 2020 Missed and delayed diagnoses of non-COVID conditions--collateral harm
  17. psnet.ahrq.gov/issue/pathology-and-patient-safety-critical-role-pathology-informatics-error-reduction-and-quality
    July 20, 2009 - March 28, 2012 Clinical impact and frequency of anatomic pathology errors in cancer diagnoses … October 27, 2010 The "Big Dog" effect: variability assessing the causes of error in diagnoses
  18. psnet.ahrq.gov/issue/using-medical-malpractice-closed-claims-data-reduce-surgical-risk-and-improve-patient-safety
    December 01, 2010 - July 3, 2014 Missed and delayed diagnoses in the emergency department: a study of closed … October 26, 2010 Critical diagnoses (critical values) in anatomic pathology.
  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44161/psn-pdf
    December 19, 2018 - issue/among-elderly-many-mental-illnesses-go-undiagnosed This commentary spotlights missed and delayed diagnosis … physician-patient-communication-failure-facilitates-medication-errors-older-polymedicated https://psnet.ahrq.gov/issue/confirmation-bias-why-psychiatrists-stick-wrong-preliminary-diagnoses
  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45018/psn-pdf
    November 18, 2016 - identifying-risk-use-tumor-markers-improve-patient-safety Inappropriate use of laboratory tests can contribute to missed and delayed diagnosis … identifying-risk-use-tumor-markers-improve-patient-safety https://psnet.ahrq.gov/primer/diagnostic-errors https://psnet.ahrq.gov/issue/missed-and-delayed-diagnoses-ambulatory-setting-study-closed-malpractice-claims

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