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8141. Hospice diagnosis: polypharmacy—a teachable moment. | PSNet
      psnet.ahrq.gov/issue/hospice-diagnosis-polypharmacy-teachable-moment
      April 24, 2018 - Commentary Hospice diagnosis: polypharmacy—a teachable moment. Citation Text: Larson CK, Kao H. Hospice Diagnosis: Polypharmacy: A Teachable Moment. JAMA Intern Med. 2015;175(11):1750-1751. doi:10.1001/jamainternmed.2015.5253. Copy Citation Format: DOI Google Scholar PubMed…

8142. Predictors of successful implementation of preoperative briefings and postoperative debriefings after medical team training. | PSNet
      psnet.ahrq.gov/issue/predictors-successful-implementation-preoperative-briefings-and-postoperative-debriefings
      December 21, 2014 - Study Predictors of successful implementation of preoperative briefings and postoperative debriefings after medical team training. Citation Text: Paull DE, Mazzia L, Izu BS, et al. Predictors of successful implementation of preoperative briefings and postoperative debriefings after medi…

8143. Safety in teletriage by nurses and physicians in the United States and Israel: narrative review and qualitative study. | PSNet
      psnet.ahrq.gov/issue/safety-teletriage-nurses-and-physicians-united-states-and-israel-narrative-review-and
      April 29, 2020 - Study Safety in teletriage by nurses and physicians in the United States and Israel: narrative review and qualitative study. Citation Text: Haimi M, Wheeler SQ. Safety in teletriage by nurses and physicians in the United States and Israel: narrative review and qualitative study. JMIR Hum…

8144. National Partnership for Maternal Safety: Consensus Bundle on Venous Thromboembolism. | PSNet
      psnet.ahrq.gov/issue/national-partnership-maternal-safety-consensus-bundle-venous-thromboembolism
      November 16, 2022 - Commentary National Partnership for Maternal Safety: Consensus Bundle on Venous Thromboembolism. Citation Text: D'Alton ME, Friedman AM, Smiley RM, et al. National Partnership for Maternal Safety: Consensus Bundle on Venous Thromboembolism. J Obstet Gynecol Neonatal Nurs. 2016;45(5):706-…

8145. What happened to my patient? An educational intervention to facilitate postdischarge patient follow-up. | PSNet
      psnet.ahrq.gov/issue/what-happened-my-patient-educational-intervention-facilitate-postdischarge-patient-follow
      June 22, 2022 - Commentary What happened to my patient? An educational intervention to facilitate postdischarge patient follow-up. Citation Text: Narayana S, Rajkomar A, Harrison JD, et al. What Happened to My Patient? An Educational Intervention to Facilitate Postdischarge Patient Follow-Up. J Grad Med…

8146. Speaking up and taking action: psychological safety and joint problem-solving orientation in safety improvement. | PSNet
      psnet.ahrq.gov/issue/speaking-and-taking-action-psychological-safety-and-joint-problem-solving-orientation-safety
      October 21, 2020 - Study Speaking up and taking action: psychological safety and joint problem-solving orientation in safety improvement. Citation Text: Bahadurzada H, Kerrissey M, Edmondson AC. Speaking up and taking action: psychological safety and joint problem-solving orientation in safety improvement.…

8147. Facing ambiguous threats. | PSNet
      psnet.ahrq.gov/issue/facing-ambiguous-threats
      December 24, 2008 - Commentary Facing ambiguous threats. Citation Text: Roberto MA, Bohmer RMJ, Edmondson A. Facing ambiguous threats. Harv Bus Rev. 2006;84(11):106-13, 157. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId RIS …

8148. Introducing second-year medical students to diagnostic reasoning concepts and skills via a virtual curriculum. | PSNet
      psnet.ahrq.gov/issue/introducing-second-year-medical-students-diagnostic-reasoning-concepts-and-skills-virtual
      April 24, 2018 - Study Introducing second-year medical students to diagnostic reasoning concepts and skills via a virtual curriculum. Citation Text: Chang C, Varghese N, Machiorlatti M. Introducing second-year medical students to diagnostic reasoning concepts and skills via a virtual curriculum. Diagnosi…

8149. Medication errors and trainees: advice for learners and organizations. | PSNet
      psnet.ahrq.gov/issue/medication-errors-and-trainees-advice-learners-and-organizations
      April 10, 2019 - Commentary Medication errors and trainees: advice for learners and organizations. Citation Text: Wheeler JS, Duncan R, Hohmeier K. Medication Errors and Trainees: Advice for Learners and Organizations. Ann Pharmacother. 2017;51(12):1138-1141. doi:10.1177/1060028017725092. Copy Citation…

8150. Identifying contributing factors associated with dental adverse events through a pragmatic electronic health record-based root cause analysis. | PSNet
      psnet.ahrq.gov/issue/identifying-contributing-factors-associated-dental-adverse-events-through-pragmatic
      May 23, 2018 - Study Identifying contributing factors associated with dental adverse events through a pragmatic electronic health record-based root cause analysis. Citation Text: Kalenderian E, Bangar S, Yansane A, et al. Identifying contributing factors associated with dental adverse events through a …

8151. Perceptual and interpretive error in diagnostic radiology—causes and potential solutions. | PSNet
      psnet.ahrq.gov/issue/perceptual-and-interpretive-error-diagnostic-radiology-causes-and-potential-solutions
      November 13, 2024 - Commentary Perceptual and interpretive error in diagnostic radiology—causes and potential solutions. Citation Text: Degnan AJ, Ghobadi EH, Hardy P, et al. Perceptual and Interpretive Error in Diagnostic Radiology-Causes and Potential Solutions. Acad Radiol. 2019;26(6):833-845. doi:10.101…

8152. Improving diagnosis by feedback and deliberate practice: one-on-one coaching for diagnostic maturation. | PSNet
      psnet.ahrq.gov/issue/improving-diagnosis-feedback-and-deliberate-practice-one-one-coaching-diagnostic-maturation
      July 06, 2022 - Study Improving diagnosis by feedback and deliberate practice: one-on-one coaching for diagnostic maturation. Citation Text: Sinha P, Pischel L, Sofair AN. Improving diagnosis by feedback and deliberate practice: one-on-one coaching for diagnostic maturation. Diagnosis (Berl). 2021;8(2):…

8153. Danger in discharge summaries: abbreviations create confusion for both author and recipient. | PSNet
      psnet.ahrq.gov/issue/danger-discharge-summaries-abbreviations-create-confusion-both-author-and-recipient
      March 15, 2017 - Study Danger in discharge summaries: abbreviations create confusion for both author and recipient. Citation Text: Coghlan A, Turner S, Coverdale S. Danger in discharge summaries: abbreviations create confusion for both author and recipient. Intern Med J. 2023;53(4):550-558. doi:10.1111/i…

8154. Assessing patient safety culture in hospital settings. | PSNet
      psnet.ahrq.gov/issue/assessing-patient-safety-culture-hospital-settings
      August 18, 2021 - Review Assessing patient safety culture in hospital settings. Citation Text: Azyabi A. Assessing patient safety culture in hospital settings. Int J Environ Res Public Health. 2021;18(5):2466. doi:10.3390/ijerph18052466. Copy Citation Format: DOI Google Scholar BibTeX EndNot…

8155. Building a learning organization. | PSNet
      psnet.ahrq.gov/issue/building-learning-organization
      June 16, 2011 - Study Classic Building a learning organization. Citation Text: Garvin DA. Building a learning organization. Harv Bus Rev. 1993;71(4):78-91. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId RI…

8156. The Role of Community Pharmacists in Patient Safety | PSNet
      psnet.ahrq.gov/perspective/role-community-pharmacists-patient-safety
      October 24, 2021 - They keep looking at the issues and they keep evaluating what's going right and what's going wrong, in

8157. Microsoft PowerPoint - Spotlight Case_The Risks of a Malpositioned Gastrostomy Tube_FINAL.pptx (pdf file)
      psnet.ahrq.gov/sites/default/files/2023-11/spotlight_case_the_risk_of_malpositioned.pdf
      January 01, 2023 - Microsoft PowerPoint - Spotlight Case_The Risks of a Malpositioned Gastrostomy Tube_FINAL.pptx Spotlight The Risks of a Malpositioned Gastrostomy Tube and Poor Communication Source and Credits • This presentation is based on the November 2023 AHRQ WebM&M Spotlight Case o See the full article at https://psnet.ahr…

8158. In Conversation with…Gerald B. Hickson, MD | PSNet
      psnet.ahrq.gov/perspective/conversation-withgerald-b-hickson-md
      December 01, 2009 - In Conversation with…Gerald B. Hickson, MD December 1, 2009  Also Read an Essay Citation Text: In Conversation with…Gerald B. Hickson, MD . PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2…

8159. How to Identify and Manage Problem Behaviors | PSNet
      psnet.ahrq.gov/perspective/how-identify-and-manage-problem-behaviors
      December 01, 2009 - How to Identify and Manage Problem Behaviors Alan H. Rosenstein, MD, MBA; Michelle O'Daniel, MSG, MHA | December 1, 2009  Also Read a Conversation View more articles from the same authors. Citation Text: Rosenstein AH, O'Daniel M. How to Identify and Manage Prob…

8160. The Risks of a Malpositioned Gastrostomy Tube and Poor Communication | PSNet
      psnet.ahrq.gov/web-mm/risks-malpositioned-gastrostomy-tube-and-poor-communication
      August 01, 2012 - SPOTLIGHT CASE The Risks of a Malpositioned Gastrostomy Tube and Poor Communication Citation Text: Hight RA. The Risks of a Malpositioned Gastrostomy Tube and Poor Communication. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Servic…