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psnet.ahrq.gov/web-mm/doctor-dont-treat-thyself
August 21, 2024 - diagnostic and treatment plans in detail: do not assume that a physician's professional knowledge makes such discussion
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psnet.ahrq.gov/curated-library/opioid-stewardship
December 15, 2024 - Breadcrumb
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Opioid Stewardship
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Created By: AHRQ
Date Created: January 24, 2025
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psnet.ahrq.gov/node/867004/psn-pdf
October 30, 2024 - innovation consists of a four-step process: 1) informing the patient of the finding and
documenting the discussion
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psnet.ahrq.gov/node/867651/psn-pdf
February 26, 2025 - However, any discussion of Safety I/II should be placed in the
context of safety science and patient … is called
Safety I.4,5 Dekker described periods of thinking on safety science (Table 1), but full discussion
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psnet.ahrq.gov/primer/safety-i-safety-ii-and-new-views-safety
October 02, 2024 - However, any discussion of Safety I/II should be placed in the context of safety science and patient … called Safety I. 4,5 Dekker described periods of thinking on safety science ( Table 1 ), but full discussion
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psnet.ahrq.gov/webmm-case-studies
March 25, 2025 - WebM&M: Case Studies
WebM&M (Morbidity & Mortality Rounds on the Web) features expert analysis of medical errors reported anonymously by our readers. Spotlight Cases include interactive learning modules available for CME/CPE . Commentaries are written by patient safety experts and published monthly. Have you encou…
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psnet.ahrq.gov/perspective/annual-perspective-psychological-safety-healthcare-staff
November 16, 2022 - meetings designed to address questions that are frequently unanswered or unanswerable to generate open discussion
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psnet.ahrq.gov/web-mm/pains-chronic-opioid-usage
April 04, 2018 - or discontinuation of opioids after initial treatment of 8 to 12 weeks.( 20 ) In the present case discussion … Discussion paper based on a scientific workshop. January 18–19 2011; UNODC, Vienna, Austria.
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psnet.ahrq.gov/node/36889/psn-pdf
May 28, 2024 - Surveys on Patient Safety Culture.
May 28, 2024
Rockville MD: Agency for Healthcare Research and Quality
https://psnet.ahrq.gov/issue/surveys-patient-safety-culture
Safety culture has been described as a key to establishing high reliability organizations. The National
Quality Forum's Safe Practices for Healthcare …
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psnet.ahrq.gov/node/60156/psn-pdf
March 25, 2020 - The cognitive health system.
March 25, 2020
Coiera E. The cognitive health system. Lancet. 2020;395(10222):463-466. doi:10.1016/s0140-
6736(19)32987-3.
https://psnet.ahrq.gov/issue/cognitive-health-system
This article discusses the influence of artificial intelligence tools and cyber-social systems on human
decis…
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psnet.ahrq.gov/node/60634/psn-pdf
January 01, 2021 - Quality & safety in the time of coronavirus--design better,
learn faster.
July 1, 2020
Fitzsimons J. Quality and safety in the time of Coronavirus: design better, learn faster. Int J Qual Health
Care. 2021;33(1):mzaa051. doi:10.1093/intqhc/mzaa051.
https://psnet.ahrq.gov/issue/quality-safety-time-coronavirus-desig…
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psnet.ahrq.gov/web-mm/code-status-vs-care-status
September 30, 2020 - After the patient’s death, a discussion was held between the neurosurgical teams(the patient’s primary
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psnet.ahrq.gov/primer/digital-health-literacy
August 30, 2023 - December 20, 2023
Rethinking Patient Safety: A Discussion Guide for Patients, Healthcare
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psnet.ahrq.gov/issue/medical-diagnoses-commonly-associated-pediatric-malpractice-lawsuits-united-states
November 16, 2022 - Study
Medical diagnoses commonly associated with pediatric malpractice lawsuits in the United States.
Citation Text:
McAbee GN, Donn SM, Mendelson RA, et al. Medical diagnoses commonly associated with pediatric malpractice lawsuits in the United States. Pediatrics. 2008;122(6):e1282-e1…
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psnet.ahrq.gov/cme
February 26, 2025 - Misdiagnosis of Small Bowel Obstruction in the Setting of Previous Abdominal Operations A man with a history of prior umbilical hernia repair presented to the emergency department (ED) with abdominal pain and was initially diagnosed with cholelithiasis before being discharged home. However, the next day he returned to …
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psnet.ahrq.gov/web-mm/polypharmacy
March 01, 2007 - However, the focus of this discussion centers upon errors associated with an incomplete medication profile
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psnet.ahrq.gov/node/60763/psn-pdf
August 05, 2020 - Supporting the emotional well-being of health care
workers during the COVID-19 pandemic.
August 5, 2020
Wu AW, Buckle P, Haut ER, et al. Supporting the emotional well-being of health care workers during the
COVID-19 pandemic. J Patient Saf Risk Manag. 2020;25(3):93-96. doi:10.1177/2516043520931971.
https://psnet.a…
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psnet.ahrq.gov/classics
August 01, 2023 - Classics and Emerging Classics
To help our readers navigate the tremendous breadth of the PSNet Collection, AHRQ PSNet editors and advisors have given the designation of “Classic” to review articles, empirical studies, government and stakeholder reports, commentaries, and books of lasting importance to the patient sa…
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psnet.ahrq.gov/web-mm/case-mistaken-intubation
July 01, 2016 - SPOTLIGHT CASE
The Case of Mistaken Intubation
Citation Text:
Silveira MJ. The Case of Mistaken Intubation. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2016.
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Format:
Google Scholar BibTeX End…
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psnet.ahrq.gov/node/33600/psn-pdf
June 16, 2024 - Patient Safety 101
June 16, 2024
Patient Safety 101. PSNet [internet]. 2019.
https://psnet.ahrq.gov/primer/patient-safety-101
PSNet primers are regularly reviewed and updated by the UC Davis PSNet Editorial Team to ensure that
they reflect current research and practice in the patient safety field. Last reviewed in…