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psnet.ahrq.gov/node/47700/psn-pdf
January 16, 2019 - Current challenges in health information
technology–related patient safety.
January 16, 2019
Sittig DF, Wright A, Coiera E, et al. Current challenges in health information technology–related patient
safety. Health Inform J. 2020;26(1):181-189. doi:10.1177/1460458218814893.
https://psnet.ahrq.gov/issue/current-chal…
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psnet.ahrq.gov/node/43008/psn-pdf
November 21, 2014 - Understanding safety culture in long-term care: a case
study.
November 21, 2014
Halligan MH, Zecevic A, Kothari AR, et al. Understanding safety culture in long-term care: a case study. J
Patient Saf. 2014;10(4):192-201. doi:10.1097/PTS.0b013e31829d4ae7.
https://psnet.ahrq.gov/issue/understanding-safety-culture-lon…
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psnet.ahrq.gov/node/45801/psn-pdf
August 03, 2017 - Overcoming diagnostic errors in medical practice.
August 3, 2017
Bordini BJ, Stephany A, Kliegman RM. Overcoming Diagnostic Errors in Medical Practice. J Pediatr.
2017;185. doi:10.1016/j.jpeds.2017.02.065.
https://psnet.ahrq.gov/issue/overcoming-diagnostic-errors-medical-practice
This commentary describes a progra…
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psnet.ahrq.gov/node/45885/psn-pdf
May 03, 2017 - E-collection: Safety and Error Prevention in Health.
May 3, 2017
https://psnet.ahrq.gov/issue/e-collection-safety-and-error-prevention-health
The increasing implementation of health information technology has introduced both benefits and
challenges to patient safety. Articles in this series explore the impacts of t…
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psnet.ahrq.gov/node/60945/psn-pdf
September 23, 2020 - Safety in pediatric hospice and palliative care: a
qualitative study.
September 23, 2020
Pestian T, Thienprayoon R, Grossoehme D, et al. Safety in pediatric hospice and palliative care: a
qualitative study. Pediatr Qual Saf. 2020;5(4):e328. doi:10.1097/pq9.0000000000000328.
https://psnet.ahrq.gov/issue/safety-pedi…
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psnet.ahrq.gov/node/39295/psn-pdf
January 03, 2017 - The Veterans Affairs shift change physician-to-physician
handoff project.
January 3, 2017
Anderson J, Shroff D, Curtis A, et al. The Veterans Affairs shift change physician-to-physician handoff
project. Jt Comm J Qual Patient Saf. 2010;36(2):62-71.
https://psnet.ahrq.gov/issue/veterans-affairs-shift-change-physici…
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psnet.ahrq.gov/node/38055/psn-pdf
January 12, 2009 - Improving patient safety: patient-focused, high-reliability
team training.
January 12, 2009
McKeon LM, Cunningham PD, Oswaks JSD. Improving patient safety: patient-focused, high-reliability team
training. J Nurs Care Qual. 2009;24(1):76-82. doi:10.1097/NCQ.0b013e31818f5595.
https://psnet.ahrq.gov/issue/improving-p…
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psnet.ahrq.gov/node/45549/psn-pdf
October 12, 2016 - Preventing diagnostic errors in primary care.
October 12, 2016
Ely JW, Graber ML. Preventing Diagnostic Errors in Primary Care. Am Fam Physician. 2016;94(6):426-32.
https://psnet.ahrq.gov/issue/preventing-diagnostic-errors-primary-care
The Improving Diagnosis in Health Care report advocated for enhancing patient en…
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psnet.ahrq.gov/node/72601/psn-pdf
January 01, 2021 - Increasing physician reporting of diagnostic learning
opportunities.
December 23, 2020
Marshall TL, Ipsaro AJ, Le M, et al. Increasing physician reporting of diagnostic learning opportunities.
Pediatrics. 2021;147(1):e20192400. doi:10.1542/peds.2019-2400.
https://psnet.ahrq.gov/issue/increasing-physician-reporting…
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psnet.ahrq.gov/node/858173/psn-pdf
December 13, 2023 - Measurement of ambulatory medication errors in
children: a scoping review.
December 13, 2023
Rickey L, Auger K, Britto MT, et al. Measurement of ambulatory medication errors in children: a scoping
review. Pediatrics. 2023;152(6):e2023061281. doi:10.1542/peds.2023-061281.
https://psnet.ahrq.gov/issue/measurement-am…
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psnet.ahrq.gov/node/39268/psn-pdf
April 01, 2010 - Multi-professional patterns and methods of
communication during patient handoffs.
April 1, 2010
Benham-Hutchins MM, Effken JA. Multi-professional patterns and methods of communication during
patient handoffs. Int J Med Inform. 2010;79(4):252-67. doi:10.1016/j.ijmedinf.2009.12.005.
https://psnet.ahrq.gov/issue/mult…
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psnet.ahrq.gov/node/46367/psn-pdf
August 30, 2017 - Why are so many women being misdiagnosed?
August 30, 2017
Mickle K. Glamour. August 11, 2017.
https://psnet.ahrq.gov/issue/why-are-so-many-women-being-misdiagnosed
Implicit bias and differences in communication style can affect patient care. This magazine article reports
on factors that contribute to misdiagnosis …
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psnet.ahrq.gov/node/45071/psn-pdf
April 27, 2016 - Using simulation to identify sources of medical
diagnostic error in child physical abuse.
April 27, 2016
Anderst J, Nielsen-Parker M, Moffatt M, et al. Using simulation to identify sources of medical diagnostic
error in child physical abuse. Child Abuse Negl. 2016;52:62-69. doi:10.1016/j.chiabu.2015.12.015.
https:…
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psnet.ahrq.gov/issue/characteristics-and-predictors-missed-opportunities-lung-cancer-diagnosis-electronic-health
January 19, 2012 - October 31, 2014
Why Current Breast Pathology Practices Must Be Evaluated.
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psnet.ahrq.gov/issue/diagnostic-errors-musculoskeletal-oncology-and-possible-mitigation-strategies
May 01, 2013 - December 27, 2014
Why Current Breast Pathology Practices Must Be Evaluated.
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psnet.ahrq.gov/issue/big-dog-effect-variability-assessing-causes-error-diagnoses-patients-lung-cancer
March 28, 2012 - April 9, 2013
Why Current Breast Pathology Practices Must Be Evaluated.
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psnet.ahrq.gov/issue/patient-safety-leadership-academy-university-pennsylvania-first-cohorts-learning-experience
October 04, 2011 - June 18, 2013
Why Current Breast Pathology Practices Must Be Evaluated.
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psnet.ahrq.gov/issue/missed-lesions-abdominal-oncologic-ct-lessons-learned-quality-assurance
April 21, 2011 - October 4, 2011
Why Current Breast Pathology Practices Must Be Evaluated.
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psnet.ahrq.gov/issue/delayed-or-missed-diagnosis-cervical-spine-injuries
May 05, 2010 - October 31, 2014
Why Current Breast Pathology Practices Must Be Evaluated.
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psnet.ahrq.gov/issue/evaluation-12-strategies-obtaining-second-opinions-improve-interpretation-breast
November 03, 2015 - April 9, 2013
Why Current Breast Pathology Practices Must Be Evaluated.