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  1. psnet.ahrq.gov/issue/crossing-quality-chasm-new-health-system-21st-century
    July 08, 2016 - Book/Report Classic Crossing the Quality Chasm: A New Health System for the 21st Century. Citation Text: Crossing the Quality Chasm: A New Health System for the 21st Century. Committee on Quality of Health Care in America, Institute of Medicine. Washington DC: N…
  2. psnet.ahrq.gov/issue/organizational-learning-framework-patient-safety
    November 28, 2018 - Commentary An organizational learning framework for patient safety. Citation Text: Edwards MT. An Organizational Learning Framework for Patient Safety. Am J Med Qual. 2016;32(2):148-155. doi:10.1177/1062860616632295. Copy Citation Format: DOI Google Scholar BibTeX EndNote X…
  3. psnet.ahrq.gov/issue/patient-safety-and-quality-improvement-act-2005
    March 29, 2023 - Legislation/Case Law Classic Patient Safety and Quality Improvement Act of 2005. Citation Text: Patient Safety and Quality Improvement Act of 2005. Pub L No. 109-41.  Copy Citation Save Save to your library Print Download…
  4. psnet.ahrq.gov/issue/independent-double-checks-worth-effort-if-used-judiciously-and-properly
    January 23, 2019 - Newspaper/Magazine Article Independent double checks: worth the effort if used judiciously and properly. Citation Text: Independent double checks: worth the effort if used judiciously and properly. ISMP Medication Safety Alert! Acute Care Edition. June 6, 2019;24:1-7. Copy Citation …
  5. psnet.ahrq.gov/issue/building-culture-patient-safety-report-commission-patient-safety-and-quality-assurance
    November 10, 2011 - Book/Report Building a Culture of Patient Safety: Report of the Commission on Patient Safety and Quality Assurance. Citation Text: Building a Culture of Patient Safety: Report of the Commission on Patient Safety and Quality Assurance. Dublin, Ireland: Department of Health & Childre…
  6. psnet.ahrq.gov/issue/preventing-errors-when-preparing-and-administering-medications-enteral-feeding-tubes
    November 30, 2016 - Newspaper/Magazine Article Preventing errors when preparing and administering medications via enteral feeding tubes. Citation Text: Preventing errors when preparing and administering medications via enteral feeding tubes. ISMP Medication Safety Alert! Acute care edition. November 17, 202…
  7. psnet.ahrq.gov/issue/educational-opportunities-postevent-debriefing
    May 28, 2015 - Commentary Educational opportunities with postevent debriefing. Citation Text: Mullan PC, Kessler DO, Cheng A. Educational opportunities with postevent debriefing. JAMA. 2014;312(22):2333-4. doi:10.1001/jama.2014.15741. Copy Citation Format: DOI Google Scholar PubMed BibTeX…
  8. psnet.ahrq.gov/issue/using-medical-malpractice-closed-claims-data-reduce-surgical-risk-and-improve-patient-safety
    December 01, 2010 - Commentary Using medical malpractice closed claims data to reduce surgical risk and improve patient safety. Citation Text: Manuel BM, Greenwald LM. Using medical malpractice closed claims data to reduce surgical risk and improve patient safety. Bull Am Coll Surg. 2007;92(3):27-30. Copy…
  9. psnet.ahrq.gov/issue/partnership-patients-pfp-hospital-engagement-network-hen-20-final-report
    May 06, 2015 - Book/Report Partnership for Patients (PfP) Hospital Engagement Network (HEN) 2.0 Final Report. Citation Text: Partnership for Patients (PfP) Hospital Engagement Network (HEN) 2.0 Final Report. Chicago, IL: American Hospital Association and Health Research & Educational Trust; September 2…
  10. psnet.ahrq.gov/issue/selected-medication-safety-risks-manage-2016-might-otherwise-fall-radar-screen-part-1-and
    March 09, 2016 - Newspaper/Magazine Article Selected medication safety risks to manage in 2016 that might otherwise fall off the radar screen—part 1 and part 2. Citation Text: Selected medication safety risks to manage in 2016 that might otherwise fall off the radar screen—part 1 and part 2. ISMP Medicat…
  11. psnet.ahrq.gov/issue/mix-ups-between-influenza-flu-vaccine-and-covid-19-vaccines
    October 21, 2020 - Newspaper/Magazine Article Mix-ups between the influenza (Flu) vaccine and COVID-19 vaccines. Citation Text: Mix-ups between the influenza (Flu) vaccine and COVID-19 vaccines. ISMP Medication Safety Alert! Acute care edition. October 7, 2021;26(20):1-4. Copy Citation Sa…
  12. psnet.ahrq.gov/issue/alarm-management-promoting-safety-and-establishing-guidelines
    May 24, 2017 - Commentary Alarm management: promoting safety and establishing guidelines. Citation Text: Criscitelli T. Alarm Management: Promoting Safety and Establishing Guidelines. AORN J. 2016;103(5):518-21. doi:10.1016/j.aorn.2016.03.008. Copy Citation Format: DOI Google Scholar PubM…
  13. psnet.ahrq.gov/issue/errors-omission-missed-nursing-care
    September 27, 2017 - Review Errors of omission: missed nursing care. Citation Text: Kalisch BJ, Xie B. Errors of Omission: Missed Nursing Care. West J Nurs Res. 2014;36(7):875-890. doi:10.1177/0193945914531859. Copy Citation Format: DOI Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML …
  14. psnet.ahrq.gov/issue/impact-teamwork-missed-nursing-care
    September 27, 2017 - Study The impact of teamwork on missed nursing care. Citation Text: Kalisch BJ, Lee KH. The impact of teamwork on missed nursing care. Nurs Outlook. 2010;58(5):233-41. doi:10.1016/j.outlook.2010.06.004. Copy Citation Format: DOI Google Scholar PubMed BibTeX EndNote X3 XML E…
  15. psnet.ahrq.gov/issue/overcoming-barriers-patient-safety
    September 24, 2016 - Commentary Overcoming barriers to patient safety. Citation Text: Kalisch BJ, Aebersold M. Overcoming barriers to patient safety. Nurs Econ. 2006;24(3):143-8, 155, 123; quiz 149. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged…
  16. psnet.ahrq.gov/issue/advancing-maternal-health-equity-and-reducing-maternal-mortality-workshop
    May 19, 2021 - Meeting/Conference Proceedings Advancing Maternal Health Equity and Reducing Maternal Mortality Workshop. Citation Text: Advancing Maternal Health Equity and Reducing Maternal Mortality Workshop. National Academies of Sciences, Engineering, and Medicine. June 7-8, 2021. Copy Citatio…
  17. psnet.ahrq.gov/issue/acog-committee-opinion-590-preparing-clinical-emergencies-obstetrics-and-gynecology
    May 22, 2019 - Commentary ACOG Committee Opinion #590: preparing for clinical emergencies in obstetrics and gynecology. Citation Text: Improvement AC of O and GC on PS and Q. Committee opinion no. 590: preparing for clinical emergencies in obstetrics and gynecology. Obstet Gynecol. 2014;123(3):722-5. d…
  18. psnet.ahrq.gov/issue/improving-patient-safety-radiotherapy-learning-near-misses-incidents-and-errors
    July 10, 2017 - Commentary Improving patient safety in radiotherapy by learning from near misses, incidents and errors. Citation Text: Williams M. Improving patient safety in radiotherapy by learning from near misses, incidents and errors. Br J Radiol. 2007;80(953):297-301. Copy Citation Format:…
  19. psnet.ahrq.gov/issue/how-insight-contributes-diagnostic-excellence
    June 08, 2022 - Commentary How insight contributes to diagnostic excellence. Citation Text: Shimizu T, Graber ML. How insight contributes to diagnostic excellence. Diagnosis (Berl). 2022;9(3):311-315. doi:10.1515/dx-2022-0007. Copy Citation Format: DOI Google Scholar BibTeX EndNote X3 XML …
  20. psnet.ahrq.gov/issue/obstacles-research-effects-interruptions-healthcare
    April 19, 2017 - Commentary Obstacles to research on the effects of interruptions in healthcare. Citation Text: Grundgeiger T, Dekker SWA, Sanderson P, et al. Obstacles to research on the effects of interruptions in healthcare. BMJ Qual Saf. 2016;25(6):392-5. doi:10.1136/bmjqs-2015-004083. Copy Citatio…

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