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psnet.ahrq.gov/node/47960/psn-pdf
May 15, 2019 - A systematic review of clinical decision support systems
for clinical oncology practice.
May 15, 2019
Pawloski PA, Brooks GA, Nielsen ME, et al. A Systematic Review of Clinical Decision Support Systems for
Clinical Oncology Practice. J Natl Compr Canc Netw. 2019;17(4):331-338. doi:10.6004/jnccn.2018.7104.
https://…
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psnet.ahrq.gov/node/38907/psn-pdf
January 03, 2017 - Applying Toyota Production System principles to a
psychiatric hospital: making transfers safer and more
timely.
January 3, 2017
Young JQ, Wachter R. Applying Toyota Production System principles to a psychiatric hospital: making
transfers safer and more timely. Jt Comm J Qual Patient Saf. 2009;35(9):439-448.
https…
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psnet.ahrq.gov/node/50556/psn-pdf
January 01, 2021 - The compliance with a patient safety bundle for
management of placenta accreta spectrum.
October 16, 2019
Quist-Nelson J, Crank A, Oliver EA, et al. The compliance with a patient-safety bundle for management of
placenta accreta spectrum†. J Matern Fetal Neonatal Med. 2021;34(17):2880-2886.
doi:10.1080/14767058.201…
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psnet.ahrq.gov/node/46512/psn-pdf
August 17, 2018 - The problem with using patient complaints for
improvement.
August 17, 2018
de Vos MS, Hamming JF, van de Mheen PJM-. The problem with using patient complaints for
improvement. BMJ Qual Saf. 2018;27(9):758-762. doi:10.1136/bmjqs-2017-007463.
https://psnet.ahrq.gov/issue/problem-using-patient-complaints-improvement
…
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psnet.ahrq.gov/node/41968/psn-pdf
February 19, 2013 - Characterising physician listening behaviour during
hospitalist handoffs using the HEAR checklist.
February 19, 2013
Greenstein EA, Arora V, Staisiunas PG, et al. Characterising physician listening behaviour during
hospitalist handoffs using the HEAR checklist. BMJ Qual Saf. 2013;22(3):203-9. doi:10.1136/bmjqs-2012…
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psnet.ahrq.gov/node/34909/psn-pdf
February 27, 2009 - Decreasing clinically significant adverse events using
feedback to emergency physicians of telephone follow-up
outcomes.
February 27, 2009
Chern C-H, How C-K, Wang L-M, et al. Decreasing clinically significant adverse events using feedback to
emergency physicians of telephone follow-up outcomes. Ann Emerg Med. 200…
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psnet.ahrq.gov/node/74763/psn-pdf
June 25, 2021 - FDA Safety Communication: flexible bronchoscopes and
updated recommendations for reprocessing.
June 25, 2021
Silver Springs, MD: US Food and Drug Administration: June 25, 2021.
https://psnet.ahrq.gov/issue/fda-safety-communication-flexible-bronchoscopes-and-updated-
recommendations-reprocessing
Incomplete reproce…
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psnet.ahrq.gov/node/36917/psn-pdf
September 01, 2011 - Analysis of deaths related to anesthesia in the period
1996-2004 from closed claims registered by the Danish
Patient Insurance Association.
September 1, 2011
Hove LD, Steinmetz J, Christoffersen JK, et al. Analysis of deaths related to anesthesia in the period 1996-
2004 from closed claims registered by the Danish…
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psnet.ahrq.gov/node/36690/psn-pdf
January 18, 2011 - The risk of adverse drug events and hospital-related
morbidity and mortality among older adults with
potentially inappropriate medication use.
January 18, 2011
Page RL, Ruscin M. The risk of adverse drug events and hospital-related morbidity and mortality among
older adults with potentially inappropriate medicatio…
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psnet.ahrq.gov/node/50671/psn-pdf
November 20, 2019 - Critical errors in infrequently performed trauma
procedures after training.
November 20, 2019
Mackenzie CF, Shackelford SA, Tisherman SA, et al. Critical errors in infrequently performed trauma
procedures after training. Surgery. 2019;166(5):835-843. doi:10.1016/j.surg.2019.05.031.
https://psnet.ahrq.gov/issue/cri…
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psnet.ahrq.gov/node/839814/psn-pdf
January 01, 2023 - Influencing a culture of quality and safety through
huddles.
November 9, 2022
McCain N, Ferguson T, Barry Hultquist T, et al. Influencing a culture of quality and safety through huddles.
J Nurs Care Qual. 2023;38(1):26-32. doi:10.1097/ncq.0000000000000642.
https://psnet.ahrq.gov/issue/influencing-culture-quality-a…
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psnet.ahrq.gov/node/838083/psn-pdf
September 14, 2022 - A pause in pediatrics: implementation of a pediatric
diagnostic time-out.
September 14, 2022
Yale SC, Cohen SS, Kliegman RM, et al. A pause in pediatrics: implementation of a pediatric diagnostic
time-out. Diagnosis (Berl). 2022;9(3):348-351. doi:10.1515/dx-2022-0010.
https://psnet.ahrq.gov/issue/pause-pediatrics-…
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psnet.ahrq.gov/node/74703/psn-pdf
January 26, 2022 - Research to improve diagnosis: time to study the real
world.
January 26, 2022
Ranji SR, Thomas EJ. Research to improve diagnosis: time to study the real world. BMJ Qual Saf.
2022;31(4):255-258. doi:10.1136/bmjqs-2021-014071.
https://psnet.ahrq.gov/issue/research-improve-diagnosis-time-study-real-world
Diagnostic …
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psnet.ahrq.gov/node/45970/psn-pdf
March 22, 2017 - A learning health care system using computer-aided
diagnosis.
March 22, 2017
Cahan A, Cimino JJ. A Learning Health Care System Using Computer-Aided Diagnosis. J Med Internet
Res. 2017;19(3):e54. doi:10.2196/jmir.6663.
https://psnet.ahrq.gov/issue/learning-health-care-system-using-computer-aided-diagnosis
Although…
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psnet.ahrq.gov/node/43758/psn-pdf
March 17, 2015 - A patient safety checklist for the cardiac catheterisation
laboratory.
March 17, 2015
Cahill TJ, Clarke SC, Simpson IA, et al. A patient safety checklist for the cardiac catheterisation laboratory.
Heart. 2015;101(2):91-3. doi:10.1136/heartjnl-2014-306927.
https://psnet.ahrq.gov/issue/patient-safety-checklist-card…
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psnet.ahrq.gov/node/838194/psn-pdf
September 28, 2022 - Measure Dx: implementing pathways to discover and
learn from diagnostic errors.
September 28, 2022
Bradford A, Shofer M, Singh H. Measure Dx: Implementing pathways to discover and learn from diagnostic
errors. Int J Qual Health Care. 2022;34(3):mzac068. doi:10.1093/intqhc/mzac068.
https://psnet.ahrq.gov/issue/meas…
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psnet.ahrq.gov/node/846157/psn-pdf
March 15, 2023 - Patient perception of fall risk and fall risk screening
scores.
March 15, 2023
Solares NP, Calero P, Connelly CD. Patient perception of fall risk and fall risk screening scores. J Nurs
Care Qual. 2023;38(2):100-106. doi:10.1097/ncq.0000000000000645.
https://psnet.ahrq.gov/issue/patient-perception-fall-risk-and-fal…
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psnet.ahrq.gov/node/48104/psn-pdf
August 28, 2019 - The computer will see you now.
August 28, 2019
Whitaker P. New Statesman. August 2, 2019;148:38-43.
https://psnet.ahrq.gov/issue/computer-will-see-you-now
Artificial intelligence (AI) and advanced computing technologies can enhance clinical decision-making.
Exploring the strengths and weaknesses of artificial inte…
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psnet.ahrq.gov/node/46831/psn-pdf
April 18, 2018 - Guideline Summary: Medication Safety.
April 18, 2018
Guideline Summary: Medication Safety. AORN J. 2018;107(4):489-494. doi:10.1002/aorn.12096.
https://psnet.ahrq.gov/issue/guideline-summary-medication-safety
Perioperative medication errors can result in patient harm as well as emotional distress among clinical
te…
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psnet.ahrq.gov/node/46458/psn-pdf
May 30, 2018 - Development of the Huddle Observation Tool for
structured case management discussions to improve
situation awareness on inpatient clinical wards.
May 30, 2018
Edbrooke-Childs J, Hayes J, Sharples E, et al. Development of the Huddle Observation Tool for structured
case management discussions to improve situation aw…