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psnet.ahrq.gov/issue/hospitals-two-states-denied-abortion-miscarrying-patient-investigators-say-they-broke-federal
September 20, 2023 - Newspaper/Magazine Article
Hospitals in two states denied an abortion to a miscarrying patient. Investigators say they broke federal law.
Citation Text:
Hospitals in two states denied an abortion to a miscarrying patient. Investigators say they broke federal law. Surana K. Pro Publica. M…
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psnet.ahrq.gov/issue/assessing-residents-communication-skills-disclosure-adverse-event-standardized-patient
December 21, 2016 - Study
Assessing residents' communication skills: disclosure of an adverse event to a standardized patient.
Citation Text:
Posner G, Nakajima A. Assessing residents' communication skills: disclosure of an adverse event to a standardized patient. J Obstet Gynaecol Can. 2011;33(3):262-26…
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psnet.ahrq.gov/issue/improving-patient-safety-practicing-just-culture
June 14, 2017 - Commentary
Improving patient safety by practicing in a just culture.
Citation Text:
Duffy W. Improving Patient Safety by Practicing in a Just Culture. AORN J. 2017;106(1):66-68. doi:10.1016/j.aorn.2017.05.005.
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psnet.ahrq.gov/issue/technologists-role-patient-safety-and-quality-medical-imaging
May 15, 2024 - Commentary
The technologist's role in patient safety and quality in medical imaging.
Citation Text:
Watson L, Odle TG. The technologist's role in patient safety and quality in medical imaging. Radiol Technol. 2013;84(5):536-41.
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psnet.ahrq.gov/issue/human-factors-and-systems-engineering-approach-patient-safety-radiotherapy
August 07, 2013 - Commentary
Human factors and systems engineering approach to patient safety for radiotherapy.
Citation Text:
Human factors and systems engineering approach to patient safety for radiotherapy. Rivera AJ, Karsh B-T. Int J Radiat Oncol Biol Phys. 2008;71:S174-S177.
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psnet.ahrq.gov/issue/taking-risky-business-out-mri-suite
September 12, 2016 - Newspaper/Magazine Article
Taking risky business out of the MRI suite.
Citation Text:
Rozovsky FA, Gilk TB, Latina RJ. Managing liability exposure and safety. Taking risky business out of the MRI suite. Materials management in health care. 2006;15(1):18-23.
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psnet.ahrq.gov/issue/fda-public-health-notification-unretrieved-device-fragments
June 02, 2021 - Press Release/Announcement
FDA public health notification: unretrieved device fragments.
Citation Text:
FDA public health notification: unretrieved device fragments. Silver Spring MD, Center for Devices and Radiological Health, US Food and Drug Administration; January 15, 2008.
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psnet.ahrq.gov/issue/identity-crisis-examination-costs-and-benefits-unique-patient-identifier-us-health-care
May 21, 2014 - Book/Report
Identity Crisis: An Examination of the Costs and Benefits of a Unique Patient Identifier for the US Health Care System.
Citation Text:
Identity Crisis: An Examination of the Costs and Benefits of a Unique Patient Identifier for the US Health Care System. Hillestad R, Bigelow …
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psnet.ahrq.gov/issue/assessment-national-patient-safety-initiative-context-and-baseline-evaluation-report-1
May 21, 2014 - Book/Report
Assessment of the National Patient Safety Initiative: Context and Baseline Evaluation Report 1.
Citation Text:
Assessment of the National Patient Safety Initiative: Context and Baseline Evaluation Report 1. Santa Monica, CA: RAND Corporation; 2005. ISBN 0833037870.
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psnet.ahrq.gov/issue/saving-lives-saving-money-imperative-computerized-physician-order-entry-massachusetts
November 18, 2011 - Book/Report
Saving Lives, Saving Money: The Imperative for Computerized Physician Order Entry in Massachusetts Hospitals.
Citation Text:
Saving Lives, Saving Money: The Imperative for Computerized Physician Order Entry in Massachusetts Hospitals. Adams M, Bates D, Coffman G, et al. Bosto…
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psnet.ahrq.gov/issue/adverse-events-hospitals-methods-identifying-events
February 18, 2009 - Book/Report
Adverse Events in Hospitals: Methods for Identifying Events.
Citation Text:
Adverse Events in Hospitals: Methods for Identifying Events. Levinson DR. Washington, DC: US Department of Health and Human Services, Office of the Inspector General; March 2010. Report No. OEI-06…
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psnet.ahrq.gov/issue/adverse-events-toolkit-clinical-guidance-identifying-harm
July 26, 2023 - Tools/Toolkit
Adverse Events Toolkit: Clinical Guidance for Identifying Harm
Citation Text:
Adverse Events Toolkit: Clinical Guidance for Identifying Harm Maxwell A. Washington, DC: US Department of Health and Human Services, Office of the Inspector General; July 2023. Report n…
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psnet.ahrq.gov/issue/safety-maternity-services-england
February 04, 2015 - Book/Report
The Safety of Maternity Services in England.
Citation Text:
The Safety of Maternity Services in England. Fourth Report of Session 2021–22. House of Commons Health Committee. London, England: The Stationery Office; July 6, 2021. Publication HC 19.
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psnet.ahrq.gov/issue/patient-safety-act
November 09, 2011 - Book/Report
Patient Safety Act.
Citation Text:
Patient Safety Act. Washington, DC: United States Government Accountability Office; January 28, 2010. Publication GAO-10-281.
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psnet.ahrq.gov/issue/improving-safety-throughout-medication-use-process-neonatal-intensive-care-unit
January 27, 2012 - Commentary
Improving safety throughout the medication use process in a neonatal intensive care unit.
Citation Text:
Asdigha MN. Improving Safety Throughout the Medication Use Process in a Neonatal Intensive Care Unit. Hosp Pharm. 2010;41(11):1067-1075. doi:10.1310/hpj4111-1067.
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psnet.ahrq.gov/issue/failure-weigh-patients-hospital-medication-safety-risk
April 22, 2015 - Study
Failure to weigh patients in hospital: a medication safety risk.
Citation Text:
Hilmer SN, Rangiah C, Bajorek B, et al. Failure to weigh patients in hospital: a medication safety risk. Intern Med J. 2007;37(9):647-50.
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psnet.ahrq.gov/issue/safety-considerations-mitigate-risks-misconnections-small-bore-connectors-intended-enteral
June 02, 2021 - Regulation
Safety considerations to mitigate the risks of misconnections with small-bore connectors intended for enteral applications.
Citation Text:
Safety considerations to mitigate the risks of misconnections with small-bore connectors intended for enteral applications. Rockville, MD:…
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psnet.ahrq.gov/issue/enhancing-surgical-team-communication-sops-and-teamstepps-action
August 01, 2012 - Meeting/Conference Proceedings
Enhancing Surgical Team Communication: SOPS and TeamSTEPPS in Action.
Citation Text:
Enhancing Surgical Team Communication: SOPS and TeamSTEPPS in Action. Agency for Healthcare Research and Quality. July 25, 2024.
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psnet.ahrq.gov/issue/addressing-electronic-health-record-contributions-diagnostic-error
July 29, 2009 - Newspaper/Magazine Article
Addressing electronic health record contributions to diagnostic error.
Citation Text:
Addressing electronic health record contributions to diagnostic error. Ratwani RM, Bates DW, Gold J. Health Affairs Forefront. April 25, 2024.
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psnet.ahrq.gov/issue/cyberattack-led-harrowing-lapses-ascension-hospitals-clinicians-say
March 06, 2024 - Newspaper/Magazine Article
Cyberattack led to harrowing lapses at Ascension hospitals, clinicians say.
Citation Text:
Cyberattack led to harrowing lapses at Ascension hospitals, clinicians say. Pradhan R, Wells K. KFF Health News and Morning Edition, Michigan Public Radio: June 19, 2024.…