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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…
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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.
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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.
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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.
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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…
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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…
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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.
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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.
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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…
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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…
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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.
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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.
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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.
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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.
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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.
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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.
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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…
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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.
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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.
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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.
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