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Effectiveness of pharmacist intervention to reduce medication errors and health-care resources utilization after transitions of care: a meta-analysis of randomized controlled trials. | PSNet

psnet.ahrq.gov/issue/effectiveness-pharmacist-intervention-reduce-medication-errors-and-health-care-resources

August 04, 2021 - Review Effectiveness of pharmacist intervention to reduce medication errors and health-care resources utilization after transitions of care: a meta-analysis of randomized controlled trials. Citation Text: De Oliveira GS, Castro-Alves LJ, Kendall MC, et al. Effectiveness of Pharmacist Int…

Implementation of electronic triggers to identify diagnostic errors in emergency departments. | PSNet

psnet.ahrq.gov/issue/implementation-electronic-triggers-identify-diagnostic-errors-emergency-departments

September 25, 2024 - Study Implementation of electronic triggers to identify diagnostic errors in emergency departments. Citation Text: Vaghani V, Gupta A, Mir U, et al. Implementation of electronic triggers to identify diagnostic errors in emergency departments. JAMA Intern Med. 2025;185(2):143-151. doi:10.…

When order sets do not align with clinician workflow: assessing practice patterns in the electronic health record. | PSNet

psnet.ahrq.gov/issue/when-order-sets-do-not-align-clinician-workflow-assessing-practice-patterns-electronic-health

March 24, 2019 - Study When order sets do not align with clinician workflow: assessing practice patterns in the electronic health record. Citation Text: Li RC, Wang JK, Sharp C, et al. When order sets do not align with clinician workflow: assessing practice patterns in the electronic health record. BMJ Q…

A taxonomy for advancing systematic error analysis in multi-site electronic health record-based clinical concept extraction. | PSNet

psnet.ahrq.gov/issue/taxonomy-advancing-systematic-error-analysis-multi-site-electronic-health-record-based

March 24, 2019 - Study A taxonomy for advancing systematic error analysis in multi-site electronic health record-based clinical concept extraction. Citation Text: Fu S, Wang L, He H, et al. A taxonomy for advancing systematic error analysis in multi-site electronic health record-based clinical concept ex…

Impact of hospital-acquired pneumonia on the Medicare program. | PSNet

psnet.ahrq.gov/issue/impact-hospital-acquired-pneumonia-medicare-program

August 07, 2013 - Study Impact of hospital-acquired pneumonia on the Medicare program. Citation Text: Baker DL, Giuliano KK, Desmarais M, et al. Impact of hospital-acquired pneumonia on the Medicare program. Infect Control Hosp Epidemiol. 2024;45(3):316-321. doi:10.1017/ice.2023.221. Copy Citation F…

Deficient Care of a Patient Who Died by Suicide and Facility Leaders' Response at the Charlie Norwood VA Medical Center in Augusta, Georgia. | PSNet

psnet.ahrq.gov/issue/deficient-care-patient-who-died-suicide-and-facility-leaders-response-charlie-norwood-va

November 29, 2023 - Book/Report Deficient Care of a Patient Who Died by Suicide and Facility Leaders' Response at the Charlie Norwood VA Medical Center in Augusta, Georgia. Citation Text: Deficient Care of a Patient Who Died by Suicide and Facility Leaders' Response at the Charlie Norwood VA Medical Center …

Risk factors for clinically relevant deviations in patients' medication lists reported by patients in personal health records: a prospective cohort study in a hospital setting. | PSNet

psnet.ahrq.gov/issue/risk-factors-clinically-relevant-deviations-patients-medication-lists-reported-patients

March 23, 2022 - Study Risk factors for clinically relevant deviations in patients' medication lists reported by patients in personal health records: a prospective cohort study in a hospital setting. Citation Text: van der Nat DJ, Taks M, Huiskes VJB, et al. Risk factors for clinically relevant deviation…

Severe illness getting noticed sooner - SIGNS-for-Kids: developing an illness recognition tool to connect home and hospital. | PSNet

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September 23, 2020 - Study Severe illness getting noticed sooner - SIGNS-for-Kids: developing an illness recognition tool to connect home and hospital. Citation Text: Gilleland J, Bayfield D, Bayliss A, et al. Severe illness getting noticed sooner – SIGNS-for-Kids: developing an illness recognition tool to c…

Laboratory medicine handoff gaps experienced by primary care practices: a report from the Shared Networks of Collaborative Ambulatory Practices and Partners (SNOCAP). | PSNet

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September 01, 2012 - Study Laboratory medicine handoff gaps experienced by primary care practices: a report from the Shared Networks of Collaborative Ambulatory Practices and Partners (SNOCAP). Citation Text: West DR, James KA, Fernald DH, et al. Laboratory medicine handoff gaps experienced by primary care p…

Information management goals and process failures during home visits for middle-aged and older adults receiving skilled home healthcare services after hospital discharge: a multisite, qualitative study. | PSNet

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November 15, 2023 - Study Information management goals and process failures during home visits for middle-aged and older adults receiving skilled home healthcare services after hospital discharge: a multisite, qualitative study. Citation Text: Arbaje AI, Hughes A, Werner N, et al. Information management goa…

Classification of medication incidents associated with information technology. | PSNet

psnet.ahrq.gov/issue/classification-medication-incidents-associated-information-technology

November 23, 2012 - Study Classification of medication incidents associated with information technology. Citation Text: Cheung K-C, van der Veen W, Bouvy ML, et al. Classification of medication incidents associated with information technology. J Am Med Inform Assoc. 2014;21(e1):e63-70. doi:10.1136/amiajnl-2…

Association between limiting the number of open records in a tele-critical care setting and retract-reorder errors. | PSNet

psnet.ahrq.gov/issue/association-between-limiting-number-open-records-tele-critical-care-setting-and-retract

July 22, 2020 - Study Association between limiting the number of open records in a tele-critical care setting and retract-reorder errors. Citation Text: Udeh C, Canfield C, Briskin I, et al. Association between limiting the number of open records in a tele-critical care setting and retract–reorder error…

'I think this medicine actually killed my wife': patient and family perspectives on shared decision-making to optimize medications and safety. | PSNet

psnet.ahrq.gov/issue/i-think-medicine-actually-killed-my-wife-patient-and-family-perspectives-shared-decision

October 05, 2022 - Study 'I think this medicine actually killed my wife': patient and family perspectives on shared decision-making to optimize medications and safety. Citation Text: Mangin D, Risdon C, Lamarche L, et al. 'I think this medicine actually killed my wife': patient and family perspectives on s…

When doctors share visit notes with patients: a study of patient and doctor perceptions of documentation errors, safety opportunities and the patient–doctor relationship. | PSNet

psnet.ahrq.gov/issue/when-doctors-share-visit-notes-patients-study-patient-and-doctor-perceptions-documentation

October 27, 2021 - Study When doctors share visit notes with patients: a study of patient and doctor perceptions of documentation errors, safety opportunities and the patient–doctor relationship. Citation Text: Bell SK, Mejilla R, Anselmo M, et al. When doctors share visit notes with patients: a study of p…

Patient identification of diagnostic safety blindspots and participation in "good catches" through shared visit notes. | PSNet

psnet.ahrq.gov/issue/patient-identification-diagnostic-safety-blindspots-and-participation-good-catches-through

October 27, 2021 - Study Patient identification of diagnostic safety blindspots and participation in "good catches" through shared visit notes. Citation Text: Bell SK, Bourgeois FC, Dong J, et al. Patient identification of diagnostic safety blindspots and participation in "good catches" through shared visi…

Do patient engagement interventions work for all patients? A systematic review and realist synthesis of interventions to enhance patient safety. | PSNet

psnet.ahrq.gov/issue/do-patient-engagement-interventions-work-all-patients-systematic-review-and-realist-synthesis

May 25, 2022 - Review Do patient engagement interventions work for all patients? A systematic review and realist synthesis of interventions to enhance patient safety. Citation Text: Newman B, Joseph K, Chauhan A, et al. Do patient engagement interventions work for all patients? A systematic review and …

Patient safety culture as a space of social struggle: understanding infection prevention practice and patient safety culture within hospital isolation settings - a qualitative study. | PSNet

psnet.ahrq.gov/issue/patient-safety-culture-space-social-struggle-understanding-infection-prevention-practice-and

November 30, 2022 - Study Patient safety culture as a space of social struggle: understanding infection prevention practice and patient safety culture within hospital isolation settings - a qualitative study. Citation Text: Hunt J, Gammon J, Williams S, et al. Patient safety culture as a space of social str…

User-testing guidelines to improve the safety of intravenous medicines administration: a randomised in situ simulation study. | PSNet

psnet.ahrq.gov/issue/user-testing-guidelines-improve-safety-intravenous-medicines-administration-randomised-situ

November 16, 2022 - Study User-testing guidelines to improve the safety of intravenous medicines administration: a randomised in situ simulation study. Citation Text: Jones MD, McGrogan A, Raynor DK, et al. User-testing guidelines to improve the safety of intravenous medicines administration: a randomised i…

Use of recalled devices in new device authorizations under the US Food and Drug Administration's 510(k) pathway and risk of subsequent recalls. | PSNet

psnet.ahrq.gov/issue/use-recalled-devices-new-device-authorizations-under-us-food-and-drug-administrations-510k

April 13, 2022 - Study Use of recalled devices in new device authorizations under the US Food and Drug Administration's 510(k) pathway and risk of subsequent recalls. Citation Text: Kramer DB, Yeh RW. Use of recalled devices in new device authorizations under the US Food and Drug Administration's 510(k) …

Observing sources of system resilience using in situ alarm simulations. | PSNet

psnet.ahrq.gov/issue/observing-sources-system-resilience-using-situ-alarm-simulations

August 30, 2023 - Study Observing sources of system resilience using in situ alarm simulations. Citation Text: McLoone M, McNamara M, Jennings MA, et al. Observing sources of system resilience using in situ alarm simulations. J Hosp Med. 2023;18(11):994-998. doi:10.1002/jhm.13217. Copy Citation Form…

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