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  1. psnet.ahrq.gov/issue/analysis-variation-between-diagnosis-admission-vs-discharge-and-clinical-outcomes-among
    June 22, 2022 - Study Analysis of variation between diagnosis at admission vs discharge and clinical outcomes among adults with possible bacteremia. Citation Text: Dregmans E, Kaal AG, Meziyerh S, et al. Analysis of variation between diagnosis at admission vs discharge and clinical outcomes among adults…
  2. psnet.ahrq.gov/issue/employee-silence-health-care-charting-new-avenues-leadership-and-management
    May 04, 2022 - Commentary Employee silence in health care: charting new avenues for leadership and management. Citation Text: Montgomery A, Lainidi O, Johnson J, et al. Employee silence in health care: Charting new avenues for leadership and management. Health Care Manage Rev. 2023;48(1):52-60. doi:10.…
  3. psnet.ahrq.gov/issue/application-strong-matrix-management-and-pdca-cycle-management-severe-covid-19-patients
    March 24, 2019 - Commentary The application of strong matrix management and PDCA cycle in the management of severe COVID-19 patients. Citation Text: Li Y, Wang H, Jiao J. The application of strong matrix management and PDCA cycle in the management of severe COVID-19 patients. Crit Care. 2020;24(1):157. d…
  4. psnet.ahrq.gov/issue/how-hospitals-select-their-patient-safety-priorities-exploratory-study-four-veterans-health
    March 15, 2016 - Study How hospitals select their patient safety priorities: an exploratory study of four Veterans Health Administration hospitals. Citation Text: George J, Parker VA, Sullivan JL, et al. How hospitals select their patient safety priorities. Health Care Manag Rev. 2020;45(4):E56-E67. doi:…
  5. psnet.ahrq.gov/issue/sociotechnical-framework-safety-related-electronic-health-record-research-reporting-safer
    February 16, 2022 - Commentary Emerging Classic A sociotechnical framework for safety-related electronic health record research reporting: the SAFER reporting framework. Citation Text: Singh H, Sittig DF. A sociotechnical framework for safety-related electronic health record resear…
  6. psnet.ahrq.gov/issue/safety-huddles-proactively-identify-and-address-electronic-health-record-safety
    January 23, 2019 - Study Safety huddles to proactively identify and address electronic health record safety. Citation Text: Menon S, Singh H, Giardina TD, et al. Safety huddles to proactively identify and address electronic health record safety. J Am Med Inform Assoc. 2017;24(2):261-267. doi:10.1093/jamia/…
  7. psnet.ahrq.gov/issue/organizational-conditions-engagement-quality-and-safety-improvement-longitudinal-qualitative
    November 25, 2020 - Study Organizational conditions for engagement in quality and safety improvement: a longitudinal qualitative study of community pharmacies. Citation Text: Phipps D, Jones CEL, Parker D, et al. Organizational conditions for engagement in quality and safety improvement: a longitudinal qual…
  8. psnet.ahrq.gov/issue/adverse-events-involving-telehealth-veterans-health-administration
    October 26, 2022 - Review Adverse events involving telehealth in the Veterans Health Administration. Citation Text: Mills PD, Tomolo A, Yackel EE. Adverse events involving telehealth in the Veterans Health Administration. Jt Comm J Qual Patient Saf. 2024;Epub Dec 20. doi:10.1016/j.jcjq.2024.12.002. Copy …
  9. psnet.ahrq.gov/issue/electronic-health-record-reviews-measure-diagnostic-uncertainty-primary-care
    August 20, 2018 - Study Electronic health record reviews to measure diagnostic uncertainty in primary care. Citation Text: Bhise V, Rajan SS, Sittig DF, et al. Electronic health record reviews to measure diagnostic uncertainty in primary care. J Eval Clin Pract. 2018;24(3):545-551. doi:10.1111/jep.12912. …
  10. psnet.ahrq.gov/issue/reliability-verbal-handoff-assessment-and-handoff-quality-and-after-implementation-resident
    November 16, 2022 - Study Reliability of verbal handoff assessment and handoff quality before and after implementation of a resident handoff bundle. Citation Text: Feraco AM, Starmer AJ, Sectish TC, et al. Reliability of Verbal Handoff Assessment and Handoff Quality Before and After Implementation of a Resi…
  11. psnet.ahrq.gov/issue/collective-intelligence-meets-medical-decision-making-collective-outperforms-best-radiologist
    August 17, 2016 - Study Classic Collective intelligence meets medical decision-making: the collective outperforms the best radiologist. Citation Text: Wolf M, Krause J, Carney PA, et al. Collective intelligence meets medical decision-making: the collective outperforms the best ra…
  12. psnet.ahrq.gov/issue/bedside-computer-vision-moving-artificial-intelligence-driver-assistance-patient-safety
    December 01, 2021 - Commentary Emerging Classic Bedside computer vision—moving artificial intelligence from driver assistance to patient safety. Citation Text: Yeung S, Downing L, Fei-Fei L, et al. Bedside Computer Vision - Moving Artificial Intelligence from Driver Assistance to P…
  13. psnet.ahrq.gov/issue/changes-safety-and-teamwork-climate-after-adding-structured-observations-patient-safety
    August 20, 2018 - Study Changes in safety and teamwork climate after adding structured observations to patient safety WalkRounds. Citation Text: Klimmeck S, Sexton B, Schwendimann R. Changes in safety and teamwork climate after adding structured observations to patient safety WalkRounds. Jt Comm J Qual Pa…
  14. psnet.ahrq.gov/issue/deficiencies-emergency-department-care-patient-who-died-suicide-john-cochran-division-va-st
    July 26, 2023 - Book/Report Deficiencies in Emergency Department Care for a Patient Who Died by Suicide at the John Cochran Division of the VA St. Louis Health Care System in Missouri. Citation Text: Deficiencies in Emergency Department Care for a Patient Who Died by Suicide at the John Cochran Division…
  15. psnet.ahrq.gov/issue/remote-patient-monitoring-during-covid-19-unexpected-patient-safety-benefit
    July 20, 2022 - Commentary Remote patient monitoring during COVID-19: an unexpected patient safety benefit. Citation Text: Pronovost PJ, Cole MD, Hughes RM. Remote patient monitoring during COVID-19: an unexpected patient safety benefit. JAMA. 2022;327(12):1125-1126. doi:10.1001/jama.2022.2040. Copy C…
  16. psnet.ahrq.gov/issue/20-years-after-err-human-bibliometric-analysis-iom-reports-impact-research-patient-safety
    July 15, 2020 - Review 20 years after To Err Is Human: a bibliometric analysis of ‘the IOM report’s’ impact on research on patient safety. Citation Text: St.Pierre M, Grawe P, Bergström J, et al. 20 years after To Err Is Human: a bibliometric analysis of ‘the IOM report’s’ impact on research on patient …
  17. psnet.ahrq.gov/issue/exploratory-study-knowledge-brokering-hospital-settings-facilitating-knowledge-sharing-and
    July 02, 2008 - Study An exploratory study of knowledge brokering in hospital settings: facilitating knowledge sharing and learning for patient safety? Citation Text: Waring J, Currie G, Crompton A, et al. An exploratory study of knowledge brokering in hospital settings: facilitating knowledge sharing …
  18. psnet.ahrq.gov/issue/postsurgical-prescriptions-opioid-naive-patients-and-association-overdose-and-misuse
    October 19, 2022 - Study Classic Postsurgical prescriptions for opioid naive patients and association with overdose and misuse: retrospective cohort study. Citation Text: Brat GA, Agniel D, Beam A, et al. Postsurgical prescriptions for opioid naive patients and association with ov…
  19. psnet.ahrq.gov/issue/validation-electronic-trigger-measure-missed-diagnosis-stroke-emergency-departments
    May 18, 2022 - Study Validation of an electronic trigger to measure missed diagnosis of stroke in emergency departments. Citation Text: Vaghani V, Wei L, Mushtaq U, et al. Validation of an electronic trigger to measure missed diagnosis of stroke in emergency departments. J Am Med Inform Assoc. 2021;28(…
  20. psnet.ahrq.gov/issue/how-physicians-think-case-based-diagnostic-simulation-exercise
    August 14, 2019 - Study How physicians think: a case-based diagnostic simulation exercise. Citation Text: Gupta A, Quinn M, Saint S, et al. The variability in how physicians think: a casebased diagnostic simulation exercise. Diagnosis (Berl). 2021;8(2):167-175. doi:10.1515/dx-2020-0010. Copy Citation …

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