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Health and social care-associated harm amongst vulnerable children in primary care: mixed methods analysis of national safety reports. | PSNet

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October 12, 2016 - Study Health and social care-associated harm amongst vulnerable children in primary care: mixed methods analysis of national safety reports. Citation Text: Omar A, Rees P, Cooper A, et al. Health and social care-associated harm amongst vulnerable children in primary care: mixed methods a…

Physician antipsychotic overprescribing letters and cognitive, behavioral, and physical health outcomes among people with dementia: a secondary analysis of a randomized clinical trial. | PSNet

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March 05, 2025 - Study Physician antipsychotic overprescribing letters and cognitive, behavioral, and physical health outcomes among people with dementia: a secondary analysis of a randomized clinical trial. Citation Text: Harnisch M, Barnett ML, Coussens S, et al. Physician antipsychotic overprescribing…

The patient reporting and action for a safe environment (PRASE) intervention: a feasibility study. | PSNet

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July 21, 2017 - Study The patient reporting and action for a safe environment (PRASE) intervention: a feasibility study. Citation Text: O'Hara JK, Lawton R, Armitage G, et al. The patient reporting and action for a safe environment (PRASE) intervention: a feasibility study. BMC Health Serv Res. 2016;16(…

Do safety culture scores in nursing homes depend on job role and ownership? Results from a national survey. | PSNet

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April 05, 2017 - Study Do safety culture scores in nursing homes depend on job role and ownership? Results from a national survey. Citation Text: Banaszak-Holl J, Reichert H, Greene T, et al. Do Safety Culture Scores in Nursing Homes Depend on Job Role and Ownership? Results from a National Survey. J Am …

Association of inpatient hospital experience with patient safety indicators: a cross-sectional, Canadian study. | PSNet

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February 17, 2017 - Study Association of inpatient hospital experience with patient safety indicators: a cross-sectional, Canadian study. Citation Text: Kemp KA, Santana MJ, Southern DA, et al. Association of inpatient hospital experience with patient safety indicators: a cross-sectional, Canadian study. BM…

Optimizing Therapy to Prevent Avoidable Hospital Admissions in Multimorbid Older Adults (OPERAM): cluster randomised controlled trial. | PSNet

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December 21, 2022 - Study Optimizing Therapy to Prevent Avoidable Hospital Admissions in Multimorbid Older Adults (OPERAM): cluster randomised controlled trial. Citation Text: Blum MR, Sallevelt B, Spinewine A, et al. Optimizing Therapy to Prevent Avoidable Hospital Admissions in Multimorbid Older Adults (O…

Leadership, safety climate, and continuous quality improvement: impact on process quality and patient safety. | PSNet

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May 24, 2006 - Study Leadership, safety climate, and continuous quality improvement: impact on process quality and patient safety. Citation Text: McFadden KL, Stock GN, Gowen CR. Leadership, safety climate, and continuous quality improvement: impact on process quality and patient safety. Health Care Ma…

Misdiagnosis of thoracic aortic emergencies occurs frequently among transfers to aortic referral centers: an analysis of over 3700 patients. | PSNet

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October 28, 2020 - Study Misdiagnosis of thoracic aortic emergencies occurs frequently among transfers to aortic referral centers: an analysis of over 3700 patients. Citation Text: Arnaoutakis GJ, Ogami T, Aranda‐Michel E, et al. Misdiagnosis of thoracic aortic emergencies occurs frequently among transfers…

An asset-based quality improvement tool for health care organizations: cultivating organization wide quality improvement and health care professional engagement. | PSNet

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September 16, 2020 - Commentary An asset-based quality improvement tool for health care organizations: cultivating organization wide quality improvement and health care professional engagement. Citation Text: Loving VA, Nolan C, Bessel M. An asset-based quality improvement tool for health care organizations:…

Racial disparities in diagnostic delay among women with breast cancer. | PSNet

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November 10, 2021 - Study Racial disparities in diagnostic delay among women with breast cancer. Citation Text: Miller-Kleinhenz JM, Collin LJ, Seidel R, et al. Racial disparities in diagnostic delay among women with breast cancer. J Am Coll Radiol. 2021;18(10):1384-1393. doi:10.1016/j.jacr.2021.06.019. C…

Allergic adverse drug events after alert overrides in hospitalized patients. | PSNet

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May 25, 2022 - Study Allergic adverse drug events after alert overrides in hospitalized patients. Citation Text: Luri M, Gastaminza G, Idoate A, et al. Allergic adverse drug events after alert overrides in hospitalized patients. J Patient Saf. 2022;18(6):630-636. doi:10.1097/pts.0000000000001034. Cop…

Talking about falls: a qualitative exploration of spoken communication of patients' fall risks in hospitals and implications for multifactorial approaches to fall prevention. | PSNet

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July 20, 2022 - Study Talking about falls: a qualitative exploration of spoken communication of patients' fall risks in hospitals and implications for multifactorial approaches to fall prevention. Citation Text: McVey L, Alvarado N, Healey F, et al. Talking about falls: a qualitative exploration of spok…

Organizational readiness to change as a leverage point for improving safety: a national nursing home survey. | PSNet

psnet.ahrq.gov/issue/organizational-readiness-change-leverage-point-improving-safety-national-nursing-home-survey

August 26, 2020 - Study Organizational readiness to change as a leverage point for improving safety: a national nursing home survey. Citation Text: Quach ED, Kazis LE, Zhao S, et al. Organizational readiness to change as a leverage point for improving safety: a national nursing home survey. BMC Health Ser…

Adverse drug events in hospitalized patients: excess length of stay, extra costs, and attributable mortality. | PSNet

psnet.ahrq.gov/issue/adverse-drug-events-hospitalized-patients-excess-length-stay-extra-costs-and-attributable

February 10, 2011 - Study Classic Adverse drug events in hospitalized patients: excess length of stay, extra costs, and attributable mortality. Citation Text: Classen DC, Pestotnik SL, Evans RS, et al. Adverse drug events in hospitalized patients. Excess length of stay, extra cos…

A randomized trial of the effectiveness of on-demand versus computer-triggered drug decision support in primary care. | PSNet

psnet.ahrq.gov/issue/randomized-trial-effectiveness-demand-versus-computer-triggered-drug-decision-support-primary

March 11, 2011 - Study A randomized trial of the effectiveness of on-demand versus computer-triggered drug decision support in primary care. Citation Text: Tamblyn R, Huang A, Taylor L, et al. A randomized trial of the effectiveness of on-demand versus computer-triggered drug decision support in primar…

Digital Healthcare Research. | PSNet

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December 24, 2008 - August 19, 2020 Novel, High-Impact Studies Evaluating Health System and Healthcare Professional

AHRQ Grants by State. | PSNet

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December 24, 2008 - September 22, 2021 Novel, High-Impact Studies Evaluating Health System and Healthcare

Special Issue on Health Information Technology. | PSNet

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August 22, 2007 - June 29, 2022 Scoping review of studies evaluating frailty and its association with medication

Hospital mistakes kept secret. | PSNet

psnet.ahrq.gov/issue/hospital-mistakes-kept-secret

September 30, 2009 - June 21, 2017 Medication safety at the interface: evaluating risks associated with discharge

Radiology Missed an Intracranial Bleed in a Lethargic Infant. | PSNet

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August 21, 2016 - The initial head CT and skeletal survey provide critical information in screening and evaluating for … after a missed diagnosis of NAT – of these, 6 children later died and 10 survived with handicap. 9 Evaluating … A study evaluating discrepancies in head CT readings between referring community radiologists and fellowship-trained … Skeletal surveys and head CTs, critical for screening and evaluating for NAT, should generally be interpreted

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