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Paying the piper: investing in infrastructure for patient safety. | PSNet

psnet.ahrq.gov/issue/paying-piper-investing-infrastructure-patient-safety

July 01, 2017 - Commentary Classic Paying the piper: investing in infrastructure for patient safety. Citation Text: Pronovost P, Rosenstein BJ, Paine LA, et al. Paying the piper: investing in infrastructure for patient safety. Jt Comm J Qual Patient Saf. 2008;34(6):342-8. Co…

FDA Safety Communication: update--robotically-assisted surgical devices in mastectomy. | PSNet

psnet.ahrq.gov/issue/fda-safety-communication-caution-when-using-robotically-assisted-surgical-devices-womens

September 01, 2021 - Press Release/Announcement FDA Safety Communication: update--robotically-assisted surgical devices in mastectomy. Citation Text: FDA Safety Communication: update--robotically-assisted surgical devices in mastectomy. MedWatch Safety Alert. Silver Spring, MD: US Food and Drug Administratio…

Does an app a day keep the doctor away? AI symptom checker applications, entrenched bias, and professional responsibility. | PSNet

psnet.ahrq.gov/issue/does-app-day-keep-doctor-away-ai-symptom-checker-applications-entrenched-bias-and

March 14, 2018 - Commentary Does an app a day keep the doctor away? AI symptom checker applications, entrenched bias, and professional responsibility. Citation Text: Zawati M'n H, Lang M. Does an app a day keep the doctor away? AI symptom checker applications, entrenched bias, and professional responsibi…

Adverse events in healthcare: learning from mistakes. | PSNet

psnet.ahrq.gov/issue/adverse-events-healthcare-learning-mistakes

February 08, 2017 - Commentary Adverse events in healthcare: learning from mistakes. Citation Text: Rafter N, Hickey A, Condell S, et al. Adverse events in healthcare: learning from mistakes. QJM. 2015;108(4):273-7. doi:10.1093/qjmed/hcu145. Copy Citation Format: DOI Google Scholar PubMed BibT…

The doctor was rude, the toilets are dirty. Utilizing 'soft signals' in the regulation of patient safety. | PSNet

psnet.ahrq.gov/issue/doctor-was-rude-toilets-are-dirty-utilizing-soft-signals-regulation-patient-safety

October 06, 2021 - Study The doctor was rude, the toilets are dirty. Utilizing 'soft signals' in the regulation of patient safety. Citation Text: Kok J, Wallenburg I, Leistikow I, et al. The doctor was rude, the toilets are dirty. Utilizing ‘soft signals’ in the regulation of patient safety. Safety Sci. 20…

Meta-analysis: effect of interactive communication between collaborating primary care physicians and specialists. | PSNet

psnet.ahrq.gov/issue/meta-analysis-effect-interactive-communication-between-collaborating-primary-care-physicians

September 20, 2011 - Review Meta-analysis: effect of interactive communication between collaborating primary care physicians and specialists. Citation Text: Foy R, Hempel S, Rubenstein L, et al. Meta-analysis: effect of interactive communication between collaborating primary care physicians and specialists…

The effect of executive walk rounds on nurse safety climate attitudes: a randomized trial of clinical units. | PSNet

psnet.ahrq.gov/issue/effect-executive-walk-rounds-nurse-safety-climate-attitudes-randomized-trial-clinical-units

June 16, 2011 - Study Classic The effect of executive walk rounds on nurse safety climate attitudes: a randomized trial of clinical units. Citation Text: Thomas EJ, Sexton B, Neilands TB, et al. The effect of executive walk rounds on nurse safety climate attitudes: a randomiz…

Closing the loop: follow-up and feedback in a patient safety program. | PSNet

psnet.ahrq.gov/issue/closing-loop-follow-and-feedback-patient-safety-program

January 04, 2017 - Study Closing the loop: follow-up and feedback in a patient safety program. Citation Text: Gandhi TK, Graydon-Baker E, Huber CN, et al. Closing the loop: follow-up and feedback in a patient safety program. Jt Comm J Qual Patient Saf. 2005;31(11):614-21. Copy Citation Format: …

Randomized trial of a warfarin communication protocol for nursing homes: an SBAR-based approach. | PSNet

psnet.ahrq.gov/issue/randomized-trial-warfarin-communication-protocol-nursing-homes-sbar-based-approach

November 21, 2012 - Study Randomized trial of a warfarin communication protocol for nursing homes: an SBAR-based approach. Citation Text: Field T, Tjia J, Mazor KM, et al. Randomized trial of a warfarin communication protocol for nursing homes: an SBAR-based approach. Am J Med. 2011;124(2):179.e1-7. doi:1…

Systems errors versus physicians' errors: finding the balance in medical education. | PSNet

psnet.ahrq.gov/issue/systems-errors-versus-physicians-errors-finding-balance-medical-education

October 12, 2012 - Commentary Systems errors versus physicians' errors: finding the balance in medical education. Citation Text: Casarett D, Helms C. Systems errors versus physicians' errors: finding the balance in medical education. Acad Med. 1999;74(1):19-22. Copy Citation Format: Google …

'It depends': The complexity of allowing residents to fail from the perspective of clinical supervisors. | PSNet

psnet.ahrq.gov/issue/it-depends-complexity-allowing-residents-fail-perspective-clinical-supervisors

December 14, 2022 - Study 'It depends': The complexity of allowing residents to fail from the perspective of clinical supervisors. Citation Text: Klasen JM, Teunissen PW, Driessen EW, et al. ‘It depends’: the complexity of allowing residents to fail from the perspective of clinical supervisors. Med Teach. 2…

Outcomes of a quality improvement project for educating nurses on medication administration and errors in nursing homes. | PSNet

psnet.ahrq.gov/issue/outcomes-quality-improvement-project-educating-nurses-medication-administration-and-errors

April 24, 2018 - Study Outcomes of a quality improvement project for educating nurses on medication administration and errors in nursing homes. Citation Text: Tenhunen ML, Tanner EK, Dahlen R. Outcomes of a quality improvement project for educating nurses on medication administration and errors in nursin…

Can the standard configuration of a cardiac monitor lead to medical errors under a stress induction? | PSNet

psnet.ahrq.gov/issue/can-standard-configuration-cardiac-monitor-lead-medical-errors-under-stress-induction

May 19, 2021 - Study Can the standard configuration of a cardiac monitor lead to medical errors under a stress induction? Citation Text: Dzisko M, Lewandowska A, Wudarska B. Can the standard configuration of a cardiac monitor lead to medical errors under a stress induction? Sensors (Basel). 2022;22(9):…

The safety of warfarin therapy in the nursing home setting. | PSNet

psnet.ahrq.gov/issue/safety-warfarin-therapy-nursing-home-setting

March 11, 2011 - Study The safety of warfarin therapy in the nursing home setting. Citation Text: Gurwitz JH, Field T, Radford MJ, et al. The safety of warfarin therapy in the nursing home setting. Am J Med. 2007;120(6):539-44. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3…

Increasing trainee reporting of adverse events with monthly, trainee-directed review of adverse events. | PSNet

psnet.ahrq.gov/issue/increasing-trainee-reporting-adverse-events-monthly-trainee-directed-review-adverse-events

July 01, 2017 - Study Increasing trainee reporting of adverse events with monthly, trainee-directed review of adverse events. Citation Text: Smith A, Hatoun J, Moses J. Increasing Trainee Reporting of Adverse Events With Monthly Trainee-Directed Review of Adverse Events. Acad Pediatr. 2017;17(8):902-906…

Improving clinician well-being and patient safety through human-centered design. | PSNet

psnet.ahrq.gov/issue/improving-clinician-well-being-and-patient-safety-through-human-centered-design

April 29, 2018 - Commentary Improving clinician well-being and patient safety through human-centered design. Citation Text: Benishek LE, Kachalia A, Daugherty Biddison L. Improving clinician well-being and patient safety through human-centered design. JAMA. 2023;329(14):1149-1150. doi:10.1001/jama.2023.2…

Less is more: a project to reduce the number of PIMs (potentially inappropriate medications) on an elderly care ward. | PSNet

psnet.ahrq.gov/issue/less-more-project-reduce-number-pims-potentially-inappropriate-medications-elderly-care-ward

September 27, 2017 - Commentary Less is more: a project to reduce the number of PIMs (potentially inappropriate medications) on an elderly care ward. Citation Text: Aung TH, Beck AJ, Siese T, et al. Less is more: a project to reduce the number of PIMs (potentially inappropriate medications) on an elderly car…

Fifteen years after To Err Is Human: a success story to learn from. | PSNet

psnet.ahrq.gov/issue/fifteen-years-after-err-human-success-story-learn

August 04, 2021 - Commentary Fifteen years after To Err Is Human: a success story to learn from. Citation Text: Pronovost P, Cleeman JI, Wright D, et al. Fifteen years after To Err is Human: a success story to learn from. BMJ Qual Saf. 2016;25(6):396-9. doi:10.1136/bmjqs-2015-004720. Copy Citation F…

System factors affecting intraoperative risk and resilience: applying a novel integrated approach to study surgical performance and patient safety. | PSNet

psnet.ahrq.gov/issue/system-factors-affecting-intraoperative-risk-and-resilience-applying-novel-integrated

August 25, 2021 - Study Emerging Classic System factors affecting intraoperative risk and resilience: applying a novel integrated approach to study surgical performance and patient safety. Citation Text: Kolodzey L, Trbovich PL, Kashfi A, et al. System Factors Affecting Intraope…

Cause and effect analysis of closed claims in obstetrics and gynecology. | PSNet

psnet.ahrq.gov/issue/cause-and-effect-analysis-closed-claims-obstetrics-and-gynecology

April 05, 2017 - Study Cause and effect analysis of closed claims in obstetrics and gynecology. Citation Text: White AA, Pichert JW, Bledsoe SH, et al. Cause and effect analysis of closed claims in obstetrics and gynecology. Obstet Gynecol. 2005;105(5 Pt 1):1031-1038. Copy Citation Format: …

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