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psnet.ahrq.gov/node/72853/psn-pdf
March 17, 2021 - Evaluating the relationship between health information
technology and safer-prescribing in the long-term care
setting: a systematic review.
March 17, 2021
Kruse CS, Mileski M, Syal R, et al. Evaluating the relationship between health information technology and
safer-prescribing in the long-term care setting: a sys…
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psnet.ahrq.gov/node/73986/psn-pdf
October 20, 2021 - Fidelity and the impact of patient safety huddles on
teamwork and safety culture: an evaluation of the Huddle
Up for Safer Healthcare (HUSH) project.
October 20, 2021
Lamming L, Montague J, Crosswaite K, et al. Fidelity and the impact of patient safety huddles on teamwork
and safety culture: an evaluation of the H…
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psnet.ahrq.gov/node/48138/psn-pdf
July 17, 2019 - Beyond the clinical team: evaluating the human factors-
oriented training of non-clinical professionals working in
healthcare contexts.
July 17, 2019
Lavelle M, Reedy GB, Attoe C, et al. Beyond the clinical team: evaluating the human factors-oriented
training of non-clinical professionals working in healthcare con…
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psnet.ahrq.gov/node/838325/psn-pdf
October 12, 2022 - Comprehensive Healthcare Inspection Summary Report:
Evaluation of Care Coordination in Veterans Health
Administration Facilities, Fiscal Year 2021.
October 12, 2022
Washington, DC: VA Office of the Inspector General; September 15, 2022. Report no. 22-00815-232.
https://psnet.ahrq.gov/issue/comprehensive-healthcare…
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psnet.ahrq.gov/node/846149/psn-pdf
March 15, 2023 - Medication errors in community pharmacies: evaluation
of a standardized safety program.
March 15, 2023
Ledlie S, Gomes T, Dolovich L, et al. Medication errors in community pharmacies: evaluation of a
standardized safety program. Explor Res Clin Soc Pharm. 2023;9:100218.
doi:10.1016/j.rcsop.2022.100218.
https://ps…
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psnet.ahrq.gov/node/73505/psn-pdf
July 21, 2021 - Improving medication reconciliation with comprehensive
evaluation at a Veterans Affairs skilled-nursing facility.
July 21, 2021
Baughman AW, Triantafylidis LK, O'Neil N, et al. Improving medication reconciliation with comprehensive
evaluation at a Veterans Affairs skilled-nursing facility. Jt Comm J Qual Patient Sa…
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psnet.ahrq.gov/node/60874/psn-pdf
September 02, 2020 - A national mixed-methods evaluation of preparedness for
general surgery residency and the association with
resident burnout.
September 2, 2020
Engelhardt KE, Bilimoria KY, Johnson JK, et al. A national mixed-methods evaluation of preparedness for
general surgery residency and the association with resident burnout.…
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psnet.ahrq.gov/node/60762/psn-pdf
August 05, 2020 - Implementation and sustainability of a medication
reconciliation toolkit: a mixed methods evaluation.
August 5, 2020
Stolldorf DP, Mixon AS, Auerbach AD, et al. Implementation and sustainability of a medication
reconciliation toolkit: a mixed methods evaluation. Am J Health Syst Pharm. 2020;77(14):1135-1143.
doi:1…
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psnet.ahrq.gov/node/846754/psn-pdf
March 29, 2023 - Improving safety by evaluating the impact of the supply
chain and drug shortages on health-systems.
March 29, 2023
Patel V, Cieslak K, Hertig JB. Improving safety by evaluating the impact of the supply chain and drug
shortages on health-systems. Hosp Pharm. 2023;58(2):120-124. doi:10.1177/00185787221126338.
https:…
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psnet.ahrq.gov/node/846758/psn-pdf
March 29, 2023 - Evaluating patient identification practices during
intrahospital transfers: a human factors approach.
March 29, 2023
Suclupe S, Kitchin J, Sivalingam R, et al. Evaluating patient identification practices during intrahospital
transfers: a human factors approach. J Patient Saf. 2023;19(2):117-127.
doi:10.1097/pts.00…
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psnet.ahrq.gov/node/839815/psn-pdf
November 09, 2022 - A longitudinal evaluation of computed tomography
radiation incidents within a multisite NHS trust.
November 9, 2022
Adamson HK, Foster B, Clarke R, et al. A longitudinal evaluation of computed tomography radiation
incidents within a multisite NHS trust. J Patient Saf. 2022;18(7):e1096-e1101.
doi:10.1097/pts.000000…
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psnet.ahrq.gov/node/852285/psn-pdf
August 09, 2023 - Risk Evaluation and Mitigation Strategy (REMS) Programs
and Medication Safety: Parts I and II.
August 9, 2023
ISMP Medication Safety Alert! Acute care edition. July 13, 2023;(4):1-3;July 27, 2023;(5):1-5.
https://psnet.ahrq.gov/issue/risk-evaluation-and-mitigation-strategy-rems-programs-and-medication-safety-
part…
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psnet.ahrq.gov/node/34058/psn-pdf
September 29, 2017 - Research designs for studies evaluating the effectiveness
of change and improvement strategies.
September 29, 2017
Eccles M, Grimshaw J, Campbell M, et al. Research designs for studies evaluating the effectiveness of
change and improvement strategies. Qual Saf Health Care. 2003;12(1):47-52.
https://psnet.ahrq.gov/…
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psnet.ahrq.gov/node/44253/psn-pdf
August 24, 2015 - Acceptability and feasibility of the Leapfrog computerized
physician order entry evaluation tool for hospitals outside
the United States.
August 24, 2015
Cho IS, Lee J-H, Choi S-K, et al. Acceptability and feasibility of the Leapfrog computerized physician order
entry evaluation tool for hospitals outside the Unit…
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psnet.ahrq.gov/node/44105/psn-pdf
April 29, 2015 - What to expect when you're evaluating healthcare
improvement: a concordat approach to managing
collaboration and uncomfortable realities.
April 29, 2015
Brewster L, Aveling E-L, Martin G, et al. What to expect when you're evaluating healthcare improvement: a
concordat approach to managing collaboration and uncomfo…
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psnet.ahrq.gov/node/33804/psn-pdf
March 03, 2016 - actually serve as a motivator and an accelerant to measure standardization, which would make
future evaluations
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psnet.ahrq.gov/web-mm/spotlight-mistaken-attribution-diagnostic-misstep
July 01, 2011 - Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic
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psnet.ahrq.gov/node/49848/psn-pdf
January 01, 2019 - Inadequate Preanesthetic Evaluation, Airway Trouble
November 1, 2018
Blitz J. Inadequate Preanesthetic Evaluation, Airway Trouble. PSNet [internet]. 2018.
https://psnet.ahrq.gov/web-mm/inadequate-preanesthetic-evaluation-airway-trouble
The Case
Case #1:
A 34-year-old woman was scheduled for a hysteroscopy under g…
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psnet.ahrq.gov/node/36721/psn-pdf
May 05, 2010 - Systematic review and evaluation of physiological track
and trigger warning systems for identifying at-risk
patients on the ward.
May 5, 2010
Gao H, McDonnell A, Harrison DA, et al. Systematic review and evaluation of physiological track and
trigger warning systems for identifying at-risk patients on the ward. Int…
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psnet.ahrq.gov/node/38373/psn-pdf
January 28, 2009 - A simulation design for research evaluating safety
innovations in anaesthesia.
January 28, 2009
Merry AF, Weller JM, Robinson BJ, et al. A simulation design for research evaluating safety innovations in
anaesthesia*. Anaesthesia. 2008;63(12):1349-57. doi:10.1111/j.1365-2044.2008.05638.x.
https://psnet.ahrq.gov/iss…