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psnet.ahrq.gov/node/46244/psn-pdf
June 28, 2017 - Changing the narratives for patient safety.
June 28, 2017
Pronovost P, Sutcliffe K, Basu L, et al. Changing the narratives for patient safety. Bull World Health Organ.
2017;95(6):478-480. doi:10.2471/BLT.16.178392.
https://psnet.ahrq.gov/issue/changing-narratives-patient-safety
Mental models represent established …
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psnet.ahrq.gov/node/45986/psn-pdf
March 29, 2017 - Pediatric prehospital medication dosing errors: a national
survey of paramedics.
March 29, 2017
Hoyle JD, Crowe RP, Bentley MA, et al. Pediatric prehospital medication dosing errors: a national survey of
paramedics. Prehosp Emerg Care. 2017;21(2):185-191. doi:10.1080/10903127.2016.1227001.
https://psnet.ahrq.gov/i…
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psnet.ahrq.gov/node/44445/psn-pdf
September 16, 2015 - Understanding nurses' and physicians' fear of
repercussions for reporting errors: clinician
characteristics, organization demographics, or leadership
factors?
September 16, 2015
Castel ES, Ginsburg LR, Zaheer S, et al. Understanding nurses' and physicians' fear of repercussions for
reporting errors: clinician cha…
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psnet.ahrq.gov/node/47462/psn-pdf
October 31, 2018 - Emergency department checklist: an innovation to
improve safety in emergency care.
October 31, 2018
Redfern E, Hoskins R, Gray J, et al. Emergency department checklist: an innovation to improve safety in
emergency care. BMJ Open Qual. 2018;7(3):e000325. doi:10.1136/bmjoq-2018-000325.
https://psnet.ahrq.gov/issue/e…
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psnet.ahrq.gov/node/43672/psn-pdf
November 12, 2014 - Is a tired doctor a safe doctor?
November 12, 2014
Goldman B. "White Coat, Black Art." CBC Radio. October 31, 2014.
https://psnet.ahrq.gov/issue/tired-doctor-safe-doctor
This radio segment explores whether sleep deprivation affects the safety of care delivery. Panelists discuss
sleep deprivation in health care, th…
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psnet.ahrq.gov/node/60604/psn-pdf
June 17, 2020 - The limits of current A.I. in health care: patient safety
policing in hospitals.
June 17, 2020
Furrow BR. NE Univ Law Rev. 2020;12(1):1-55.
https://psnet.ahrq.gov/issue/limits-current-ai-health-care-patient-safety-policing-hospitals
Artificial intelligence (AI) has the potential to improve the use of big data to e…
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psnet.ahrq.gov/node/47310/psn-pdf
September 19, 2018 - Use of simulation to test systems and prepare staff for a
new hospital transition.
September 19, 2018
Adler MD, Mobley BL, Eppich W, et al. Use of Simulation to Test Systems and Prepare Staff for a New
Hospital Transition. J Patient Saf. 2018;14(3):143-147. doi:10.1097/PTS.0000000000000184.
https://psnet.ahrq.gov/…
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psnet.ahrq.gov/node/60555/psn-pdf
January 01, 2021 - Putting the patient in patient safety investigations:
barriers and strategies for involvement.
June 3, 2020
Busch IM, Saxena A, Wu AW. Putting the patient in patient safety investigations: barriers and strategies for
involvement. J Patient Saf. 2021;17(5):358-362. doi:10.1097/pts.0000000000000699.
https://psnet.ah…
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psnet.ahrq.gov/node/45545/psn-pdf
October 05, 2016 - How to Improve Electronic Health Record Usability and
Patient Safety.
October 5, 2016
Philadelphia, PA: Pew Charitable Trusts; September 6, 2016.
https://psnet.ahrq.gov/issue/how-improve-electronic-health-record-usability-and-patient-safety
The usability of electronic health record (EHR) systems can affect clinici…
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psnet.ahrq.gov/node/45547/psn-pdf
October 05, 2016 - Sick children face potentially deadly danger: medication
errors.
October 5, 2016
Furfaro H. Wall Street Journal. September 25, 2016.
https://psnet.ahrq.gov/issue/sick-children-face-potentially-deadly-danger-medication-errors
Medication errors in pediatric care are common in the hospital and at home. This newspaper…
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psnet.ahrq.gov/node/42135/psn-pdf
April 22, 2013 - Interprofessional education in team communication:
working together to improve patient safety.
April 22, 2013
Brock DM, Abu-Rish E, Chiu C-R, et al. Interprofessional education in team communication: working
together to improve patient safety. BMJ Qual Saf. 2013;22(5):414-23. doi:10.1136/bmjqs-2012-000952.
https:/…
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psnet.ahrq.gov/node/72535/psn-pdf
December 02, 2020 - Learning from influenza vaccine errors to prepare for
COVID-19 vaccination campaigns.
December 2, 2020
ISMP Medication Safety Alert! Acute care edition. November 19, 2020;25(23):1-6.
https://psnet.ahrq.gov/issue/learning-influenza-vaccine-errors-prepare-covid-19-vaccination-campaigns
Safety professionals enco…
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psnet.ahrq.gov/node/838031/psn-pdf
September 13, 2022 - Addressing the Loss of Trust in Safety Culture.
September 7, 2022
Philadelphia, PA: Building Trust and the ABIM Foundation; September 13, 2022.
https://psnet.ahrq.gov/issue/addressing-loss-trust-safety-culture
Trust in patient safety processes encourages reporting of concerns, learning from error, and develop…
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psnet.ahrq.gov/node/73691/psn-pdf
September 08, 2021 - Pump up the volume: tips for increasing error reporting
and decreasing patient harm.
September 8, 2021
ISMP Medication Safety Alert! Acute care edition. August 26, 2021;26(17);1-5.
https://psnet.ahrq.gov/issue/pump-volume-tips-increasing-error-reporting-and-decreasing-patient-harm
Error reporting is an essen…
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psnet.ahrq.gov/node/47933/psn-pdf
August 07, 2019 - Just culture: it's more than policy.
August 7, 2019
Paradiso L, Sweeney N. Just culture: It's more than policy. Nurs Manage. 2019;50(6):38-45.
doi:10.1097/01.NUMA.0000558482.07815.ae.
https://psnet.ahrq.gov/issue/just-culture-its-more-policy
This survey study examined the relationship between just culture—a cultur…
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psnet.ahrq.gov/node/47645/psn-pdf
April 17, 2019 - When a nurse is prosecuted for a fatal medical mistake,
does it make medicine safer?
April 17, 2019
Gordon M. Health Shots. National Public Radio. April 10, 2019.
https://psnet.ahrq.gov/issue/when-nurse-prosecuted-fatal-medical-mistake-does-it-make-medicine-safer
Punitive responses to medical errors persist despit…
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psnet.ahrq.gov/node/47774/psn-pdf
April 08, 2019 - Association of emotional intelligence with malpractice
claims: a review.
April 8, 2019
Shouhed D, Beni C, Manguso N, et al. Association of Emotional Intelligence With Malpractice Claims: A
Review. JAMA Surg. 2019;154(3):250-256. doi:10.1001/jamasurg.2018.5065.
https://psnet.ahrq.gov/issue/association-emotional-int…
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psnet.ahrq.gov/node/39903/psn-pdf
January 19, 2011 - Assessing teamwork attitudes in healthcare: development
of the TeamSTEPPS teamwork attitudes questionnaire.
January 19, 2011
Baker DP, Amodeo AM, Krokos KJ, et al. Assessing teamwork attitudes in healthcare: development of the
TeamSTEPPS teamwork attitudes questionnaire. Qual Saf Health Care. 2010;19(6):e49.
doi:1…
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psnet.ahrq.gov/node/46161/psn-pdf
May 31, 2017 - Developing team cognition: a role for simulation.
May 31, 2017
Fernandez R, Shah S, Rosenman ED, et al. Developing Team Cognition. Simul Healthc. 2017;12(2):96-
103. doi:10.1097/sih.0000000000000200.
https://psnet.ahrq.gov/issue/developing-team-cognition-role-simulation
Simulation training has been advocated as a …
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psnet.ahrq.gov/node/72845/psn-pdf
March 17, 2021 - Toward the development of the perfect medical team:
critical components for adaptation.
March 17, 2021
Gregory ME, Hughes AM, Benishek LE, et al. Toward the development of the perfect medical team: critical
components for adaptation. J Patient Saf. 2021;17(2):e47-e70. doi:10.1097/pts.0000000000000598.
https://psne…