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psnet.ahrq.gov/node/47806/psn-pdf
January 01, 2021 - Pursuing patient safety at the intersection of design,
systems engineering, and health care delivery research:
an ongoing assessment.
February 27, 2019
Henriksen K, Rodrick D, Grace EN, et al. Pursuing Patient Safety at the Intersection of Design, Systems
Engineering, and Health Care Delivery Research: An Ongoing …
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psnet.ahrq.gov/node/37471/psn-pdf
February 17, 2011 - Delayed time to defibrillation after in-hospital cardiac
arrest.
February 17, 2011
Chan PS, Krumholz HM, Nichol G, et al. Delayed time to defibrillation after in-hospital cardiac arrest. N
Engl J Med. 2008;358(1):9-17. doi:10.1056/NEJMoa0706467.
https://psnet.ahrq.gov/issue/delayed-time-defibrillation-after-hospit…
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psnet.ahrq.gov/node/838242/psn-pdf
January 01, 2023 - Are pathologists self-aware of their diagnostic accuracy?
Metacognition and the diagnostic process in pathology.
October 5, 2022
Clayton DA, Eguchi MM, Kerr KF, et al. Are pathologists self-aware of their diagnostic accuracy?
Metacognition and the diagnostic process in pathology. Med Decis Making. 2023;43(2):164-17…
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psnet.ahrq.gov/node/35872/psn-pdf
September 07, 2011 - Improving ambulatory prescribing safety with a handheld
decision support system: a randomized controlled trial.
September 7, 2011
Berner ES, Houston TK, Ray MN, et al. Improving ambulatory prescribing safety with a handheld decision
support system: a randomized controlled trial. J Am Med Inform Assoc. 2006;13(2):17…
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psnet.ahrq.gov/node/37153/psn-pdf
October 06, 2011 - The effect of a rapid response team on major clinical
outcome measures in a community hospital.
October 6, 2011
Dacey MJ, Mirza ER, Wilcox V, et al. The effect of a rapid response team on major clinical outcome
measures in a community hospital. Crit Care Med. 2007;35(9):2076-82.
https://psnet.ahrq.gov/issue/effect…
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psnet.ahrq.gov/node/844769/psn-pdf
January 01, 2020 - Failure to administer recommended chemotherapy:
acceptable variation or cancer care quality blind spot?
September 18, 2019
Ellis RJ, Schlick CJR, Feinglass J, et al. Failure to administer recommended chemotherapy: acceptable
variation or cancer care quality blind spot? BMJ Qual Saf. 2020;29(2):103-112. doi:10.1136/…
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psnet.ahrq.gov/node/858162/psn-pdf
January 01, 2024 - Assessing the clinical, economic, and health resource
utilization impacts of prefilled syringes versus
conventional medication administration methods: results
from a systematic literature review.
December 13, 2023
Benhamou D, Weiss M, Borms M, et al. Assessing the clinical, economic, and health resource utilizatio…
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psnet.ahrq.gov/node/34671/psn-pdf
June 15, 2011 - Confidential clinician-reported surveillance of adverse
events among medical inpatients.
June 15, 2011
Weingart SN, Ship AN, Aronson MD. Confidential clinician-reported surveillance of adverse events among
medical inpatients. J Gen Intern Med. 2003;15(7). doi:10.1046/j.1525-1497.2000.06269.x.
https://psnet.ahrq.go…
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psnet.ahrq.gov/node/851200/psn-pdf
July 05, 2023 - Deficient Care of a Patient Who Died by Suicide and
Facility Leaders' Response at the Charlie Norwood VA
Medical Center in Augusta, Georgia.
July 5, 2023
Washington DC: Department of Veterans Affairs, Office of Inspector General; May 10, 2023.
Report no. 22-01116-110.
https://psnet.ahrq.gov/issue/defi…
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psnet.ahrq.gov/node/47059/psn-pdf
May 16, 2018 - Participating in a multisite study exploring operational
failures encountered by frontline nurses: lessons learned.
May 16, 2018
Melnyk H, Rosenfeld P, Glassman KS. Participating in a Multisite Study Exploring Operational Failures
Encountered by Frontline Nurses: Lessons Learned. J Nurs Adm. 2018;48(4):203-208.
do…
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psnet.ahrq.gov/node/37837/psn-pdf
June 11, 2008 - Testing process errors and their harms and
consequences reported from family medicine practices: a
study of the American Academy of Family Physicians
National Research Network.
June 11, 2008
Hickner J, Graham DG, Elder NC, et al. Testing process errors and their harms and consequences
reported from family medicin…
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psnet.ahrq.gov/node/844052/psn-pdf
July 01, 2012 - Does responsibility affect the public's valuation of health
care interventions? A relative valuation approach to
health care safety.
July 1, 2012
Singh J, Lord J, Longworth L, et al. Does responsibility affect the public's valuation of health care
interventions? A relative valuation approach to health care safety.…
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psnet.ahrq.gov/node/74201/psn-pdf
December 22, 2021 - Next of kin involvement in regulatory investigations of
adverse events that caused patient death: a process
evaluation.
December 22, 2021
Wiig S, Haraldseid-Driftland C, Tvete Zachrisen R, et al. J Patient Saf. 2021;17(8):e1707-
e1718.
https://psnet.ahrq.gov/issue/next-kin-involvement-regulatory-inves…
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psnet.ahrq.gov/node/838631/psn-pdf
October 19, 2022 - An asset-based quality improvement tool for health care
organizations: cultivating organization wide quality
improvement and health care professional engagement.
October 19, 2022
Loving VA, Nolan C, Bessel M. An asset-based quality improvement tool for health care organizations:
cultivating organization wide quali…
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psnet.ahrq.gov/node/843414/psn-pdf
February 01, 2023 - Leadership behavior associations with domains of safety
culture, engagement, and healthcare worker well-being.
February 1, 2023
Tawfik DS, Adair KC, Palassof S, et al. Leadership behavior associations with domains of safety culture,
engagement, and healthcare worker well-being. Jt Comm J Qual Patient Saf. 2023;49(3…
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psnet.ahrq.gov/node/840148/psn-pdf
November 16, 2022 - Safety culture and the positive association of being a
primary care training practice during COVID-19: the
results of the multi-country European PRICOV-19 Study.
November 16, 2022
Silva B, Ožva?i? Adži? Z, Vanden Bussche P, et al. Safety culture and the positive association of being a
primary care training practic…
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psnet.ahrq.gov/node/45902/psn-pdf
October 13, 2018 - Are informed policies in place to promote safe and usable
EHRs? A cross-industry comparison.
October 13, 2018
Savage EL, Fairbanks RJ, Ratwani RM. Are informed policies in place to promote safe and usable EHRs?
A cross-industry comparison. J Am Med Inform Assoc. 2017;24(4):769-775. doi:10.1093/jamia/ocw185.
https:…
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psnet.ahrq.gov/node/44577/psn-pdf
October 21, 2015 - Improving patient safety in clinical oncology: applying
lessons from Normal Accident Theory.
October 21, 2015
Chera BS, Mazur L, Buchanan I, et al. Improving Patient Safety in Clinical Oncology: Applying Lessons
From Normal Accident Theory. JAMA Oncol. 2015;1(7):958-64. doi:10.1001/jamaoncol.2015.0891.
https://psn…
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psnet.ahrq.gov/node/36407/psn-pdf
April 19, 2011 - Adverse events experienced while transferring the
critically ill patient from the emergency department to the
intensive care unit.
April 19, 2011
Gillman L, Leslie G, Williams T, et al. Adverse events experienced while transferring the critically ill patient
from the emergency department to the intensive care unit…
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psnet.ahrq.gov/node/866564/psn-pdf
August 21, 2024 - Care quality and safety in long-term aged care settings: a
systematic review and narrative analysis of missed care
measurements.
August 21, 2024
Wang X, Rihari?Thomas J, Bail K, et al. Care quality and safety in long?term aged care settings: a
systematic review and narrative analysis of missed care measurements. J…