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psnet.ahrq.gov/node/33720/psn-pdf
November 01, 2011 - years to change, changing the
culture of the health care industry will require a new generation of doctors
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psnet.ahrq.gov/perspective/conversation-paul-g-shekelle-md-mph-phd
February 26, 2025 - large body of information about the physiology of the condition and about the kinds of things medical doctors
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psnet.ahrq.gov/primer/debriefing-clinical-learning
September 15, 2024 - Stories doctors tell.
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psnet.ahrq.gov/web-mm/another-fall
June 01, 2010 - however, frequently challenging to implement because it is perceived as making tasks more difficult for doctors
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psnet.ahrq.gov/web-mm/managing-complexity-diagnosis-life-threatening-complications-after-gastric-bypass-surgery
September 25, 2019 - Implicit and explicit anti-fat bias among a large sample of medical doctors by BMI, race/ethnicity and
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psnet.ahrq.gov/web-mm/crushing-chest-pain-missed-opportunity
February 01, 2007 - Author(s)
Perspective
Diagnostic Errors in Medicine: What Do Doctors
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psnet.ahrq.gov/issue/effort-human-factors-performance-and-decision-making
August 31, 2022 - Commentary
Effort in human factors performance and decision making.
Citation Text:
Wickens CD. Effort in human factors performance and decision making. Hum Factors. 2014;56(8):1329-36.
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psnet.ahrq.gov/issue/promoting-patient-safety-one-companys-example
April 05, 2017 - Commentary
Promoting patient safety: one company's example.
Citation Text:
Babaie K. Promoting patient safety: one company's example. Case Manager. 2006;17(6):54-9.
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psnet.ahrq.gov/issue/teamwork-and-legal-and-ethical-responsibility-anaesthetist
February 14, 2024 - Review
Teamwork and the legal and ethical responsibility of the anaesthetist.
Citation Text:
Booij LHDJ, van Leeuwen E. Teamwork and the legal and ethical responsibility of the anaesthetist. Curr Opin Anaesthesiol. 2008;21(2):178-82. doi:10.1097/ACO.0b013e3282f5ff87.
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psnet.ahrq.gov/issue/patient-safety-and-surgeons-why-resistance
September 23, 2020 - Commentary
Patient safety and surgeons: why the resistance?
Citation Text:
Hoover EL. Patient safety and surgeons: why the resistance? Arch Surg. 2007;142(12):1127-8.
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psnet.ahrq.gov/node/49512/psn-pdf
May 01, 2006 - Right? Left? Neither!
May 1, 2006
Chassin MR, Howell EA. Right? Left? Neither!. PSNet [internet]. 2006.
https://psnet.ahrq.gov/web-mm/right-left-neither
Case Objectives
Appreciate the role of Reason's Swiss Cheese Model in medical errors
Understand the process of analyzing a single error
Provide suggestions for …
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psnet.ahrq.gov/web-mm/2-week-itch
June 16, 2019 - The 2-Week Itch
Citation Text:
Cohen MR. The 2-Week Itch. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2003.
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…
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psnet.ahrq.gov/web-mm/two-pills-same-drug
May 27, 2011 - Two Pills, Same Drug
Citation Text:
Horsky J, Patel VL. Two Pills, Same Drug. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2005.
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psnet.ahrq.gov/node/49433/psn-pdf
June 23, 2021 - Environmental Safety in the OR
February 1, 2004
Linkin DR, Lautenbach E. Environmental Safety in the OR . PSNet [internet]. 2004.
https://psnet.ahrq.gov/web-mm/environmental-safety-or
The Case
The infection control department of a hospital noticed a marked increase in the rates of post-operative
sternal wound inf…
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psnet.ahrq.gov/web-mm/adverse-event-during-intrahospital-transport
June 16, 2021 - Adverse Event During Intrahospital Transport
Citation Text:
Bergman L, Chaboyer W. Adverse Event During Intrahospital Transport. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2019.
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psnet.ahrq.gov/web-mm/hip-fractures-older-patients-case-geriatrics-comanagement
July 01, 2004 - Hip Fractures in Older Patients: the Case for Geriatrics Comanagement
Citation Text:
Rogers S, Ward D. Hip Fractures in Older Patients: the Case for Geriatrics Comanagement. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2019.
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psnet.ahrq.gov/web-mm/mistaken-identity
December 18, 2014 - Mistaken Identity
Citation Text:
Hall LW. Mistaken Identity. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2008.
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…
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psnet.ahrq.gov/node/49417/psn-pdf
October 01, 2003 - Lost in the Black Hole
October 1, 2003
Wachter R. Lost in the Black Hole. PSNet [internet]. 2003.
https://psnet.ahrq.gov/web-mm/lost-black-hole
The Case
A 38-year-old married, monogamous female came to the emergency department with aseptic meningitis.
She had a remote history of gonorrhea, no environmental exposu…
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.350_slideshow.ppt
June 01, 2015 - PowerPoint Presentation
Spotlight
Anchoring Bias With Critical Implications
1
This presentation is based on the June 2015
AHRQ WebM&M Spotlight Case
See the full article at http://webmm.ahrq.gov
CME credit is available
Commentary by: Edward Etchells, MD, MSc, Division of General Internal Medicine, Centre for Q…
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psnet.ahrq.gov/node/838972/psn-pdf
October 27, 2022 - The Unhappy Patient Leaves Against Medical Advice.
October 27, 2022
Nichols A. The Unhappy Patient Leaves Against Medical Advice. PSNet [internet]. 2022.
https://psnet.ahrq.gov/web-mm/unhappy-patient-leaves-against-medical-advice
The Case
A 61-year-old woman was placed on bedrest following major surgery. Her posto…