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psnet.ahrq.gov/perspective/key-issues-developing-successful-hospital-safety-program
July 01, 2006 - staff to grow in their understanding of safety, there must be a structure that will allow the open discussion … officer requires the ability to negotiate and influence, because cultural changes require a great deal of discussion
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psnet.ahrq.gov/perspective/rapid-response-teams-lessons-early-experience
November 01, 2005 - In the months since the IHI recommended nationwide adoption of RRTs, there has been considerable discussion … Can you talk about Rapid Response Teams specifically, and then broaden the discussion to the tension
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psnet.ahrq.gov/perspective/care-transitions
December 01, 2007 - the hospital's desire to clear the bed than by the availability of caregivers to participate in the discussion … health care professional community and the family caregiver advocacy community would benefit from a discussion
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psnet.ahrq.gov/perspective/role-health-literacy-patient-safety
March 22, 2009 - In general, health care encounters should promote discussion between the provider and patient, and patients … Individuals with limited health literacy are more likely to leave an informed consent discussion not
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psnet.ahrq.gov/node/36442/psn-pdf
July 23, 2023 - TeamSTEPPS: Strategies and Tools to Enhance
Performance and Patient Safety.
July 23, 2023
Department of Health and Human Services, Agency for Healthcare Research and Quality, Department of
Defense.
https://psnet.ahrq.gov/issue/teamstepps-strategies-and-tools-enhance-performance-and-patient-safety
Effective teamwo…
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psnet.ahrq.gov/node/842769/psn-pdf
January 18, 2023 - Production pressure and its relationship to safety: a
systematic review and future directions.
January 18, 2023
Hashemian SM, Triantis K. Production pressure and its relationship to safety: a systematic review and
future directions. Safety Sci. 2023;159:106045. doi:10.1016/j.ssci.2022.106045.
https://psnet.ahrq.go…
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psnet.ahrq.gov/node/33588/psn-pdf
March 15, 2025 - Second Victims: Support for Clinicians Involved in Errors
and Adverse Events
March 15, 2025
Second Victims: Support for Clinicians Involved in Errors and Adverse Events. PSNet [internet]. 2019.
https://psnet.ahrq.gov/primer/second-victims-support-clinicians-involved-errors-and-adverse-events
PSNet primers are regu…
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psnet.ahrq.gov/primer/disclosure-errors
September 15, 2024 - Disclosure of Errors
Citation Text:
Disclosure of Errors. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2019.
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Format:
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…
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psnet.ahrq.gov/web-mm/unintended-consequences-cpoe
September 01, 2004 - After a discussion, they decided to order the scan without intravenous contrast, out of concern for causing
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psnet.ahrq.gov/web-mm/nurse-staffing-ratios-crucible-money-policy-research-and-patient-care
June 01, 2003 - Commonly Used but Inadequate Options
The previous discussion focused on policies at the hospital level
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psnet.ahrq.gov/node/73365/psn-pdf
June 09, 2021 - Enhancing psychological safety in mental health services.
June 9, 2021
Hunt DF, Bailey J, Lennox BR, et al. Enhancing psychological safety in mental health services. Int J Ment
Health Syst. 2021;15(1):33. doi:10.1186/s13033-021-00439-1.
https://psnet.ahrq.gov/issue/enhancing-psychological-safety-mental-health-servi…
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psnet.ahrq.gov/web-mm/defensive-medicine-glowing-pain
November 01, 2012 - A full discussion of developing and employing practice guidelines is beyond the scope of this commentary
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psnet.ahrq.gov/web-mm/poor-prognosis
March 15, 2016 - Case & Commentary: Part 2
After further discussion, the family decided to withdraw care, because the
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psnet.ahrq.gov/web-mm/recurrent-hypoglycemia-care-transition-failure
December 23, 2020 - The family member might then call the nurse or doctor, prompting a bedside discussion of the patient's
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psnet.ahrq.gov/web-mm/medication-errors-retail-pharmacies-wrong-patient-wrong-instructions
March 19, 2019 - federally funded Medicaid programs, prospective drug use review of each prescription must be conducted and discussion
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psnet.ahrq.gov/node/864858/psn-pdf
March 20, 2024 - Remote assessment of real-world surgical safety
checklist performance using the OR Black Box: a multi-
institutional evaluation.
March 20, 2024
Riley MS, Etheridge J, Palter V, et al. Remote assessment of real-world surgical safety checklist
performance using the OR Black Box: a multi-Institutional evaluation. J A…
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psnet.ahrq.gov/node/33901/psn-pdf
August 01, 2023 - Patient Safety Indicators Overview.
August 1, 2023
Agency for Healthcare Research and Quality
https://psnet.ahrq.gov/issue/patient-safety-indicators-overview
The AHRQ Patient Safety Indicators (PSIs) represent quality measures that make use of a hospital's
available administrative data. The PSIs reflect the qualit…
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psnet.ahrq.gov/node/50907/psn-pdf
February 19, 2020 - Oral chemotherapy: a home safety educational framework
for healthcare providers, patients, and caregivers.
February 19, 2020
Huff C. Oral chemotherapy: A home safety educational framework for healthcare providers, patients, and
caregivers. Clin J Oncol Nurs. 2020;24(1):22-30. doi:10.1188/20.cjon.22-30.
https://psn…
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psnet.ahrq.gov/node/50799/psn-pdf
January 15, 2020 - The role of organizational and professional cultures in
medication safety: a scoping review of the literature.
January 15, 2020
Machen S, Jani Y, Turner S, et al. The role of organizational and professional cultures in medication safety:
a scoping review of the literature. Int J Health Care Qual. 2019;31(10):g146-g…
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psnet.ahrq.gov/web-mm/hemorrhagic-shock-after-elective-spine-surgery-failure-rescue-after-limited-response-nursing
April 27, 2022 - The case provides little discussion about what occurred overnight as the patient’s status continued to