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psnet.ahrq.gov/web-mm/beeline-spine
March 01, 2014 - situation begs for a unified medical record [such as if the community-based primary care physician used an electronic … medical record (EMR) that was part of the hospital's network] or other methods for patient data to cross
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psnet.ahrq.gov/issue/guidelines-opioid-prescribing-children-and-adolescents-after-surgery-expert-panel-opinion
June 23, 2021 - September 7, 2022
Association of display of patient photographs in the electronic health … record with wrong-patient order entry errors.
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psnet.ahrq.gov/issue/retrospective-review-serious-surgical-incidents-5-large-uk-teaching-hospitals-system-based
May 26, 2021 - December 16, 2020
Improving allergy documentation: a retrospective electronic health … record system-wide patient safety initiative.
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psnet.ahrq.gov/issue/soft-factors-smooth-transport-role-safety-climate-and-team-processes-reducing-adverse-events
September 27, 2016 - Resource-based view on safety culture's influence on hospital performance: the moderating role of electronic … health record implementation.
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psnet.ahrq.gov/issue/medical-injuries-among-hospitalized-children
February 15, 2017 - December 21, 2014
Enhancing electronic health record usability in pediatric patient care
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psnet.ahrq.gov/node/49639/psn-pdf
November 01, 2011 - Near Miss with Bedside Medications
November 1, 2011
Wu AW. Near Miss with Bedside Medications. PSNet [internet]. 2011.
https://psnet.ahrq.gov/web-mm/near-miss-bedside-medications
Case Objectives
Understanding the definition of near miss—also known as close call.
Appreciate the importance of close calls in reducin…
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psnet.ahrq.gov/issue/safety-climate-and-its-association-office-type-and-team-involvement-primary-care
August 08, 2012 - May 1, 2024
Electronic health record usability contributions to patient safety and clinician
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psnet.ahrq.gov/issue/case-controlled-study-relatives-complaints-concerning-patients-who-died-hospital-role
November 16, 2022 - October 13, 2021
Association of electronic health record use above meaningful use thresholds
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psnet.ahrq.gov/primer/pharmacists-role-medication-safety
March 14, 2018 - in primary care practices in the United Kingdom tested an intervention bundle comprised of review of electronic … medical records, prescriber feedback, education on error reduction, and support for improving local
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psnet.ahrq.gov/issue/time-series-evaluation-improvement-interventions-reduce-alarm-notifications-paediatric
October 27, 2021 - October 27, 2021
Electronic medical record-based interventions to encourage opioid prescribing
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psnet.ahrq.gov/issue/medication-errors-pediatric-emergency-departments-systematic-review-and-recommendations
January 11, 2023 - WebM&M Cases
Weight and Height Juxtaposition in the Electronic … Medical Record Causing an Accidental Medication Overdose
October 31, 2023
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psnet.ahrq.gov/issue/deficiencies-provider-reported-interpreter-use-clinical-trial-comparing-telephonic-and-video
August 12, 2020 - 2021
Increasing naloxone prescribing in the emergency department through education and electronic … medical record work-aids.
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psnet.ahrq.gov/issue/registered-nurses-and-medical-doctors-experiences-patient-safety-health-information-exchange
July 22, 2020 - February 2, 2022
Emergency physician perceptions of electronic health record usability
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psnet.ahrq.gov/periodic-issue/periodic-issue-416
November 29, 2023 - Retrospective chart review is the standard for estimating prevalence of adverse events manual review of the electronic … health record (EHR) is resource intensive. … Retrospective chart review is the standard for estimating prevalence of adverse events manual review of the electronic … health record (EHR) is resource intensive.
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psnet.ahrq.gov/issue/identifying-and-characterizing-preventable-adverse-drug-events-prioritizing-pharmacist
July 15, 2010 - Implementation of a medication reconciliation risk stratification tool integrated within an electronic … health record: a case series of three academic medical centers.
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psnet.ahrq.gov/issue/hospitalwide-adverse-drug-events-and-after-limiting-weekly-work-hours-medical-residents-80
May 04, 2010 - August 4, 2021
Understanding differences in electronic health record (EHR) use: linking
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psnet.ahrq.gov/issue/effects-safety-checklists-medicine-systematic-review
December 07, 2011 - Review
The effects of safety checklists in medicine: a systematic review.
Citation Text:
Thomassen Ø, Storesund A, Søfteland E, et al. The effects of safety checklists in medicine: a systematic review. Acta Anaesthesiol Scand. 2014;58(1):5-18. doi:10.1111/aas.12207.
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psnet.ahrq.gov/node/49617/psn-pdf
January 01, 2011 - Failure to Reevaluate
December 1, 2010
Wong-Beringer A. Failure to Reevaluate. PSNet [internet]. 2010.
https://psnet.ahrq.gov/web-mm/failure-reevaluate
The Case
A 61-year-old woman receiving palliative chemotherapy for non–small-cell lung cancer at a community
hospital developed methicillin-resistant staphylococc…
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psnet.ahrq.gov/issue/center-excellence-improving-diagnosis
April 30, 2024 - Multi-use Website
Center of Excellence for Improving Diagnosis.
Citation Text:
Center of Excellence for Improving Diagnosis. Patient Safety Authority.
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psnet.ahrq.gov/issue/making-hospitals-accountable
December 09, 2020 - Newspaper/Magazine Article
Making hospitals accountable.
Citation Text:
Making hospitals accountable. Peters PG Jr.
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