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psnet.ahrq.gov/web-mm/low-totem-pole
October 01, 2003 - SPOTLIGHT CASE
Low on the Totem Pole
Citation Text:
Wachter R. Low on the Totem Pole. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2005.
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psnet.ahrq.gov/perspective/conversation-withjack-barker-phd
January 01, 2006 - you need to find out what their skill set is and also make them feel part of the team—that's part of establishing
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psnet.ahrq.gov/issue/wrong-site-sinus-surgery-otolaryngology
July 30, 2014 - Study
Wrong-site sinus surgery in otolaryngology.
Citation Text:
Shah RK, Nussenbaum B, Kienstra M, et al. Wrong-site sinus surgery in otolaryngology. Otolaryngol Head Neck Surg. 2010;143(1):37-41. doi:10.1016/j.otohns.2010.04.003.
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psnet.ahrq.gov/issue/disclosing-harmful-medical-errors-patients-time-professional-action
June 01, 2004 - Commentary
Disclosing harmful medical errors to patients: a time for professional action.
Citation Text:
Gallagher TH, Levinson W. Disclosing Harmful Medical Errors to Patients. Arch Intern Med. 2005;165(16). doi:10.1001/archinte.165.16.1819.
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psnet.ahrq.gov/issue/special-section-iea-health-care-2021
August 02, 2010 - Special or Theme Issue
Special Section: IEA Health Care 2021.
Citation Text:
Special Section: IEA Health Care 2021. Hum Factors. 2024;66(3):633-769.
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psnet.ahrq.gov/issue/rapid-response-teams-whats-latest
December 12, 2012 - Commentary
Rapid response teams: what's the latest?
Citation Text:
Jackson SA. Rapid response teams: What's the latest? Nursing (Brux). 2017;47(12):34-41. doi:10.1097/01.NURSE.0000526885.10306.21.
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psnet.ahrq.gov/issue/national-safety-board-made-transportation-safer-and-could-do-same-health-care-advocates-say
August 09, 2023 - Newspaper/Magazine Article
A national safety board made transportation safer and could do the same for health care, advocates say.
Citation Text:
A national safety board made transportation safer and could do the same for health care, advocates say. Jaklevic MC. CNN. May 30, 2023.
Co…
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psnet.ahrq.gov/issue/accelerating-adoption-safety-culture
July 12, 2023 - Newspaper/Magazine Article
Accelerating the adoption of a safety culture.
Citation Text:
Birk S. Accelerating the Adoption of a Safety Culture. Healthcare Executive. 2015;30(2):18-20, 22-24, 26.
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psnet.ahrq.gov/issue/hospitals-slow-adopt-patient-apology-policies
April 22, 2016 - Newspaper/Magazine Article
Hospitals slow to adopt patient apology policies.
Citation Text:
Rice S. Hospitals slow to adopt patient apology policies. Modern healthcare. 2015;45(33):16, 29-30.
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psnet.ahrq.gov/issue/recognizing-and-managing-errors-cognitive-underspecification
November 14, 2018 - Commentary
Recognizing and managing errors of cognitive underspecification.
Citation Text:
Duthie EA. Recognizing and managing errors of cognitive underspecification. J Patient Saf. 2014;10(1):1-5. doi:10.1097/PTS.0b013e3182a5f6e1.
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psnet.ahrq.gov/issue/do-no-harm-stories-life-death-and-brain-surgery
January 07, 2019 - Book/Report
Do No Harm: Stories of Life, Death, and Brain Surgery.
Citation Text:
Do No Harm: Stories of Life, Death, and Brain Surgery. Marsh H. New York, NY: Thomas Dunne Books; 2015. ISBN: 9781250065810.
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psnet.ahrq.gov/issue/fdasia-health-it-report-proposed-strategy-and-recommendations-risk-based-framework
June 29, 2016 - Government Resource
FDASIA Health IT Report: Proposed Strategy and Recommendations for a Risk-Based Framework.
Citation Text:
FDASIA Health IT Report: Proposed Strategy and Recommendations for a Risk-Based Framework. Washington, DC: Office of the National Coordinator for Health Informati…
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psnet.ahrq.gov/issue/wrong-site-surgery-otolaryngology-head-and-neck-surgery
March 03, 2021 - Review
Wrong site surgery in otolaryngology–head and neck surgery.
Citation Text:
Liou T-N, Nussenbaum B. Wrong site surgery in otolaryngology-head and neck surgery. Laryngoscope. 2014;124(1):104-109. doi:10.1002/lary.24140.
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psnet.ahrq.gov/issue/implementing-no-interruption-zones-perioperative-environment
June 09, 2021 - Commentary
Implementing No Interruption Zones in the perioperative environment.
Citation Text:
Wright I. Implementing No Interruption Zones in the Perioperative Environment. AORN J. 2016;104(6):536-540. doi:10.1016/j.aorn.2016.09.018.
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psnet.ahrq.gov/issue/wrong-site-surgery-wrong-patient-invasive-procedures-outpatient-settings
June 09, 2021 - Book/Report
Wrong Site Surgery - Wrong Patient: Invasive Procedures in Outpatient Settings.
Citation Text:
Wrong Site Surgery - Wrong Patient: Invasive Procedures in Outpatient Settings. Farnborough, UK: Healthcare Safety Investigation Branch; June 2021.
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psnet.ahrq.gov/issue/perceptions-radiation-safety-culture-medical-imaging-role
September 27, 2023 - Study
Perceptions of radiation safety culture in medical imaging by role.
Citation Text:
Perceptions of radiation safety culture in medical imaging by role. Moore QT, Haynes KW. Radiol Technol. 2023;94(5):337-347.
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psnet.ahrq.gov/issue/public-reporting-surgical-outcomes-surgeons-hospitals-or-both
April 05, 2013 - Commentary
Public reporting of surgical outcomes: surgeons, hospitals, or both?
Citation Text:
Jha AK. Public Reporting of Surgical Outcomes: Surgeons, Hospitals, or Both? JAMA. 2017;318(15):1429-1430. doi:10.1001/jama.2017.13815.
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psnet.ahrq.gov/issue/patient-safety-clinical-laboratory-longitudinal-analysis-specimen-identification-errors
March 19, 2019 - Study
Patient safety in the clinical laboratory: a longitudinal analysis of specimen identification errors.
Citation Text:
Wagar EA, Tamashiro L, Yasin B, et al. Patient safety in the clinical laboratory: a longitudinal analysis of specimen identification errors. Arch Pathol Lab Med. 2…
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psnet.ahrq.gov/issue/pump-volume-how-prioritize-events-and-analyze-error-data
March 14, 2023 - Newspaper/Magazine Article
Pump up the volume: how to prioritize events and analyze error data.
Citation Text:
Pump up the volume: how to prioritize events and analyze error data. ISMP Medication Safety Alert! Acute care edition. February 9, 2023;28(3):1-4.
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psnet.ahrq.gov/issue/national-database-nursing-quality-indicatorstm-ndnqir
May 25, 2022 - Commentary
The National Database of Nursing Quality Indicators(TM) (NDNQI®).
Citation Text:
The National Database of Nursing Quality Indicators(TM) (NDNQI®). Montalvo I. Online J Iss Nurs. 2007;12(3):Manuscript 2.
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