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Total Results: 9,160 records

Showing results for "discussed".

381. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/47523/psn-pdf
     December 05, 2018 - A past Annual Perspective discussed how robust handoffs may improve safety outcomes.

382. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/45966/psn-pdf
     April 05, 2017 - A past WebM&M commentary discussed operating room fires and how to prevent them.

383. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/44742/psn-pdf
     January 06, 2016 - A previous PSNet interview discussed the second victim phenomenon.

384. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/45340/psn-pdf
     August 17, 2016 - A past PSNet Annual Perspective discussed safety and medical education.

385. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/47031/psn-pdf
     December 19, 2018 - A WebM&M commentary discussed an incident involving a patient-detected medication error.

386. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/36046/psn-pdf
     June 21, 2006 - Issues discussed include overcrowding, fragmentation of care, a shortage of on-call specialists, a lack

387. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/47187/psn-pdf
     September 05, 2018 - Albert Wu discussed ways that organizations can support second victims.

388. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/43644/psn-pdf
     April 22, 2015 - A past AHRQ WebM&M perspective discussed a widely-publicized incident involving a patient who died due

389. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/34075/psn-pdf
     December 23, 2008 - Another related past study discussed patients' and physicians' attitudes regarding the disclosure of

390. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/35934/psn-pdf
     February 24, 2011 - A past study discussed one of these methods, Morbidity and Mortality Conferences, as a place to discuss

391. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/38491/psn-pdf
     January 31, 2011 - An AHRQ WebM&M perspective discussed cognitive biases that lead to diagnostic error.

392. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/34993/psn-pdf
     June 22, 2009 - Each of these barriers is discussed with thoughtful perspective on both the associated historical and

393. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/45399/psn-pdf
     November 01, 2017 - also expressed concern about the greater number of handoffs, echoing the ongoing duty-hours debate discussed

394. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/47356/psn-pdf
     September 05, 2018 - A past WebM&M commentary discussed a task interruption due to texting.

395. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/45967/psn-pdf
     July 05, 2017 - A recent Annual Perspective discussed ongoing problems with the root cause analysis process and described

396. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/39895/psn-pdf
     September 21, 2011 - Mark Chassin, the president of the Joint Commission, discussed the organization's approach to improving

397. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/38543/psn-pdf
     April 27, 2010 - Two cases of preventable readmissions are discussed in this AHRQ WebM&M commentary.

398. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/45900/psn-pdf
     June 07, 2017 - An error associated with a mislabeled blood sample is discussed in a past WebM&M commentary.

399. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/41068/psn-pdf
     September 29, 2017 - A case of a misunderstood verbal order that led to a serious error is discussed in this AHRQ WebM&M

400. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/44818/psn-pdf
     February 24, 2018 - A PSNet perspective on the business case for patient safety discussed health care–associated infections