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psnet.ahrq.gov/issue/debrief-it-all-tool-inclusion-safety-ii
June 08, 2022 - Study
Debrief it all: a tool for inclusion of Safety-II.
Citation Text:
Bentley SK, McNamara S, Meguerdichian MJ, et al. Debrief it all: a tool for inclusion of Safety-II. Adv Simul (Lond). 2021;6(1):9. doi:10.1186/s41077-021-00163-3.
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DOI Google Schola…
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psnet.ahrq.gov/training-catalog
March 03, 2025 - Training Catalog
The AHRQ PSNet Training Catalog is an easy to use resource for healthcare professionals across all settings of care and specialties looking for education opportunities to further their knowledge of patient safety practices and principles. Some training opportunities are available as in-person meeting…
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psnet.ahrq.gov/issue/challenges-making-diagnosis-outpatient-setting-multi-site-survey-primary-care-physicians
March 11, 2020 - Study
Challenges of making a diagnosis in the outpatient setting: a multi-site survey of primary care physicians.
Citation Text:
Sarkar U, Bonacum D, Strull W, et al. Challenges of making a diagnosis in the outpatient setting: a multi-site survey of primary care physicians. BMJ Qual Sa…
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psnet.ahrq.gov/issue/benefits-and-risks-using-smart-pumps-reduce-medication-error-rates-systematic-review
July 16, 2019 - Review
Benefits and risks of using smart pumps to reduce medication error rates: a systematic review.
Citation Text:
Ohashi K, Dalleur O, Dykes PC, et al. Benefits and risks of using smart pumps to reduce medication error rates: a systematic review. Drug Saf. 2014;37(12):1011-1020. doi:1…
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psnet.ahrq.gov/issue/system-factors-affecting-patient-safety-or-analysis-safety-threats-and-resiliency
August 31, 2022 - Study
System factors affecting patient safety in the OR: an analysis of safety threats and resiliency.
Citation Text:
Adams-McGavin RC, Jung JJ, van Dalen ASHM, et al. System factors affecting patient safety in the OR: an analysis of safety threats and resiliency. Ann Surg. 2021;274(1):…
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psnet.ahrq.gov/print/pdf/node/867658
January 26, 2022 - PSNet
Curated Library
AHRQ: Agency for Healthcare Research and Quality
Opioid Stewardship
Curated Library
Primers
Pharmacist's Role in Medication Safety
UC Davis PSNet Editorial Team | December, 15 2024
Pharmacists in all settings play a crucial role in medication safety.
Opioid Safety
UC Davis PSNet Editoria…
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psnet.ahrq.gov/issue/misdiagnosis-and-failure-diagnose-emergency-care-causes-and-empathy-solution
August 04, 2021 - Commentary
Misdiagnosis and failure to diagnose in emergency care: causes and empathy as a solution.
Citation Text:
Pelaccia T, Messman AM, Kline JA. Misdiagnosis and failure to diagnose in emergency care: causes and empathy as a solution. Patient Edu Couns. 2020;103(8):1650-1656. doi:10…
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psnet.ahrq.gov/issue/2019-novel-coronavirus-covid-19-pandemic-built-environment-considerations-reduce-transmission
January 12, 2022 - Commentary
2019 Novel Coronavirus (COVID-19) pandemic: built environment considerations to reduce transmission.
Citation Text:
Dietz L, Horve PF, Coil DA, et al. 2019 Novel Coronavirus (COVID-19) pandemic: built environment considerations to reduce transmission. mSystems. 2020;5(2):e0024…
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psnet.ahrq.gov/web-mm/two-cases-retained-vaginal-packing-when-writing-order-not-enough
September 01, 2003 - Risk management was notified, and a disclosure discussion was held with the patient. … The physician was notified, and a disclosure discussion was held with the patient.
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psnet.ahrq.gov/perspective/evolution-patient-safety-surgery
August 01, 2017 - Today, this question would be viewed through the lens of competency assessment, accompanied by a discussion … correlated with surgical technique (as judged by peer reviews of intraoperative videos) has led to much discussion
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psnet.ahrq.gov/perspective/conversation-withpeter-j-pronovost-md-phd
June 01, 2005 - Rather than attempting to compress this comprehensive series into a brief commentary, the discussion … this relatively poor agreement, how does one assign the final outcome for each case—majority rules or discussion
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psnet.ahrq.gov/perspective/building-safety-program-vast-health-care-network
March 01, 2019 - The second thing that we developed was a pre-affiliation discussion guide . … The questions in the pre-affiliation discussion guide are helpful.
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psnet.ahrq.gov/web-mm/collegiality-vs-competence
August 28, 2024 - However, the focus of this case discussion is on the hospital’s responsibility to protect patients through
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psnet.ahrq.gov/perspective/safety-across-board
August 31, 2020 - The discussion lands on the fact that Cindy is a ‘person.’
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psnet.ahrq.gov/node/33602/psn-pdf
March 15, 2025 - Individual Clinician Performance Issues
March 15, 2025
Individual Clinician Performance Issues. PSNet [internet]. 2019.
https://psnet.ahrq.gov/primer/individual-clinician-performance-issues
PSNet primers are regularly reviewed and updated by the UC Davis PSNet Editorial Team to ensure that
they reflect current res…
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psnet.ahrq.gov/web-mm/getting-diagnosis-both-right-and-wrong
May 29, 2024 - This can be accomplished through systematized discharge summary routing between providers, discussion
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psnet.ahrq.gov/print/pdf/node/865864
January 01, 2024 - PSNet
Curated Library
AHRQ: Agency for Healthcare Research and Quality
Diagnostic Error
Curated Library
Incidence of Diagnostic Errors
25-Year summary of US malpractice claims for diagnostic errors 1986–2010: an analysis from the
National Practitioner Data Bank.
Tehrani ASS, Lee HW, Mathews SC, et al. BMJ Qua…
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psnet.ahrq.gov/clinical-areas
March 24, 2025 - Clinical Areas
Scroll down to search or browse using Clinical Area if you would like to explore PSNet by the healthcare profession, such as the nurse care or medical specialty, featured in the resources.
Latest by Clinical Areas
In Conversation with Edwin Boudreaux about S…
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psnet.ahrq.gov/issue/report-mid-staffordshire-nhs-foundation-trust-public-inquiry
November 06, 2015 - Book/Report
Report of the Mid Staffordshire NHS Foundation Trust: Public Inquiry.
Citation Text:
Report of the Mid Staffordshire NHS Foundation Trust: Public Inquiry. Francis R. London, UK: The Stationary Office; 2013. ISBN: 9780102981469.
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psnet.ahrq.gov/issue/physician-burnout
May 01, 2017 - Book/Report
Physician Burnout.
Citation Text:
Physician Burnout. Rockville, MD: Agency for Healthcare Research and Quality; July 2017. AHRQ Publication No. 17-M018-1-EF.
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