-
psnet.ahrq.gov/node/73394/psn-pdf
June 16, 2021 - Advanced medication reconciliation: a systematic review
of the impact on medication errors and adverse drug
events associated with transitions of care.
June 16, 2021
Killin L, Hezam A, Anderson KK, et al. Advanced medication reconciliation: a systematic review of the
impact on medication errors and adverse drug ev…
-
psnet.ahrq.gov/node/72555/psn-pdf
December 09, 2020 - Development and validation of a deep learning model for
detection of allergic reactions using safety event reports
across hospitals.
December 9, 2020
Yang J, Wang L, Phadke NA, et al. Development and validation of a deep learning model for detection of
allergic reactions using safety event reports across hospitals…
-
psnet.ahrq.gov/node/73299/psn-pdf
May 19, 2021 - More can be done to alleviate errors associated with
pharmaceutical product labeling and packaging.
May 19, 2021
ISMP Medication Safety Alert! Acute Care Edition. May 6, 2021;26(9):1-4.
https://psnet.ahrq.gov/issue/more-can-be-done-alleviate-errors-associated-pharmaceutical-product-
labeling-and-packaging
Look-al…
-
psnet.ahrq.gov/node/60940/psn-pdf
September 23, 2020 - Impact of interoperability of smart infusion pumps and an
electronic medical record in critical care.
September 23, 2020
Joseph R, Lee SW, Anderson SV, et al. Impact of interoperability of smart infusion pumps and an electronic
medical record in critical care. Am J Health-System Pharm. 2020;77(15):1231-1236.
doi:1…
-
psnet.ahrq.gov/node/60732/psn-pdf
July 29, 2020 - Restructuring of a general surgery residency program in
an epicenter of the coronavirus disease 2019 pandemic:
lessons from New York City.
July 29, 2020
Juprasert JM, Gray KD, Moore MD, et al. Restructuring of a general surgery residency program in an
epicenter of the coronavirus disease 2019 pandemic: lessons fro…
-
psnet.ahrq.gov/node/48076/psn-pdf
July 24, 2019 - Simulation-based event analysis improves error
discovery and generates improved strategies for error
prevention.
July 24, 2019
Lobos A-T, Ward N, Farion KJ, et al. Simulation-based event analysis improves error discovery and
generates improved strategies for error prevention. Simul Healthc. 2019;14(4):209-216.
do…
-
psnet.ahrq.gov/node/34701/psn-pdf
January 04, 2017 - Making the business case for patient safety.
January 4, 2017
Weeks WB, Bagian JP. Making the business case for patient safety. Jt Comm J Qual Saf. 2003;29(1):51-4,
1.
https://psnet.ahrq.gov/issue/making-business-case-patient-safety
While the costs of medical error to patients are well appreciated, the direct costs…
-
psnet.ahrq.gov/node/44612/psn-pdf
October 28, 2015 - Transitional chaos or enduring harm? The EHR and the
disruption of medicine.
October 28, 2015
Rosenbaum L. Transitional Chaos or Enduring Harm? The EHR and the Disruption of Medicine. New Engl
J Med. 2015;373(17):1585-1588. doi:10.1056/NEJMp1509961.
https://psnet.ahrq.gov/issue/transitional-chaos-or-enduring-harm-…
-
psnet.ahrq.gov/node/34660/psn-pdf
December 24, 2008 - Building a learning organization.
December 24, 2008
Garvin DA. Building a learning organization. Harv Bus Rev. 1993;71(4):78-91.
https://psnet.ahrq.gov/issue/building-learning-organization
Garvin, a Harvard Business School professor, postulates that for organizations to truly improve over time
and succeed, they ne…
-
psnet.ahrq.gov/node/40184/psn-pdf
December 29, 2014 - Non-emergency patient transport: what are the quality
and safety issues? A systematic review.
December 29, 2014
Hains IM, Marks A, Georgiou A, et al. Non-emergency patient transport: what are the quality and safety
issues? A systematic review. Int J Qual Health Care. 2011;23(1):68-75. doi:10.1093/intqhc/mzq076.
ht…
-
psnet.ahrq.gov/node/38600/psn-pdf
October 03, 2017 - Assessment of transparency of cost estimates in
economic evaluations of patient safety programmes.
October 3, 2017
Fukuda H, Imanaka Y. Assessment of transparency of cost estimates in economic evaluations of patient
safety programmes. J Eval Clin Pract. 2009;15(3):451-9. doi:10.1111/j.1365-2753.2008.01033.x.
https…
-
psnet.ahrq.gov/node/36132/psn-pdf
May 27, 2011 - Motion study in surgery.
May 27, 2011
Gilbreth FB. Can J Med Surg. 1916:22-31.
https://psnet.ahrq.gov/issue/motion-study-surgery
This study was one of the first "time-motion" studies of physicians, and pioneered the application of human
factors engineering and industrial principles to medical practice. The authors…
-
psnet.ahrq.gov/node/42446/psn-pdf
May 19, 2014 - The Human Factors Analysis Classification System
(HFACS) applied to health care.
May 19, 2014
Diller T, Helmrich G, Dunning S, et al. The Human Factors Analysis Classification System (HFACS) applied
to health care. Am J Med Qual. 2014;29(3):181-190. doi:10.1177/1062860613491623.
https://psnet.ahrq.gov/issue/human-…
-
psnet.ahrq.gov/node/39185/psn-pdf
January 06, 2010 - Use of colour-coded labels for intravenous high-risk
medications and lines to improve patient safety.
January 6, 2010
Porat N, Bitan Y, Shefi D, et al. Use of colour-coded labels for intravenous high-risk medications and lines
to improve patient safety. Qual Saf Health Care. 2009;18(6):505-9. doi:10.1136/qshc.2007.…
-
psnet.ahrq.gov/node/34930/psn-pdf
April 06, 2011 - "Going solid": a model of system dynamics and
consequences for patient safety.
April 6, 2011
Cook R, Rasmussen J. "Going solid": a model of system dynamics and consequences for patient safety.
Qual Saf Health Care. 2005;14(2):130-4.
https://psnet.ahrq.gov/issue/going-solid-model-system-dynamics-and-consequences-pa…
-
psnet.ahrq.gov/node/836861/psn-pdf
April 06, 2022 - How health systems decide to use artificial intelligence
for clinical decision support.
April 6, 2022
Gonzalez-Smith J, Shen H, Singletary E, et al. How health systems decide to use artificial intelligence for
clinical decision support. NEJM Catal Innov Care Deliv. 2022;3(4). doi:10.1056/cat.21.0416.
https://psnet…
-
psnet.ahrq.gov/node/74007/psn-pdf
October 27, 2021 - The impact of hospital accreditation on the quality of
healthcare: a systematic literature review.
October 27, 2021
Hussein M, Pavlova M, Ghalwash M, et al. The impact of hospital accreditation on the quality of healthcare:
a systematic literature review. BMC Health Serv Res. 2021;21(1):1057. doi:10.1186/s12913-021…
-
psnet.ahrq.gov/node/837423/psn-pdf
June 15, 2022 - Evaluation and comparison of errors on nursing notes
created by online and offline speech recognition
technology and handwritten: an interventional study.
June 15, 2022
Peivandi S, Ahmadian L, Farokhzadian J, et al. Evaluation and comparison of errors on nursing notes
created by online and offline speech recogniti…
-
psnet.ahrq.gov/node/837148/psn-pdf
May 18, 2022 - Assessing quality of older persons' emergency
transitions between long-term and acute care settings: a
proof-of-concept study.
May 18, 2022
Tate K, McLane P, Reid C, et al. Assessing quality of older persons’ emergency transitions between long-
term and acute care settings: a proof-of-concept study. BMJ Open Qual.…
-
psnet.ahrq.gov/node/851193/psn-pdf
July 05, 2023 - Overlapping surgery in arthroplasty - a systematic review
and meta-analysis.
July 5, 2023
Kim RG, An VVG, Lee SLK, et al. Overlapping surgery in arthroplasty – a systematic review and meta-
analysis. Orthop Traumatol Surg Res. 2023;109(4):103299. doi:10.1016/j.otsr.2022.103299.
https://psnet.ahrq.gov/issue/overlap…