-
psnet.ahrq.gov/node/40829/psn-pdf
January 05, 2014 - guide-reducing-unintended-consequences-electronic-health-records
This book discusses evidence, tools, and case examples
-
psnet.ahrq.gov/node/42275/psn-pdf
October 08, 2013 - commentary highlights the value of analyzing near misses in preventing errors and includes several
examples
-
psnet.ahrq.gov/node/38787/psn-pdf
May 07, 2018 - misidentification-alphanumeric-symbols-both-handwritten-and-computer-
generated-information
This article discusses examples
-
psnet.ahrq.gov/node/35082/psn-pdf
June 15, 2011 - The examples illustrate how the systems approach serves as an
effective tool for understanding errors
-
psnet.ahrq.gov/node/34606/psn-pdf
July 06, 2011 - Many of the examples are from anesthesiology, but the
conclusions can be applied broadly throughout
-
psnet.ahrq.gov/node/39272/psn-pdf
February 03, 2010 - https://psnet.ahrq.gov/issue/patient-safety-and-diagnostic-error-tips-your-next-shift
Through case examples
-
psnet.ahrq.gov/node/39941/psn-pdf
October 20, 2010 - normalization-deviance-do-we-unknowingly-accept-doing-wrong-thing
This commentary describes normalization of deviance and uses examples
-
digital.ahrq.gov/sites/default/files/docs/page/2006EmaniGarberFisher_052411comp.pdf
June 16, 2021 - Unrealistic for providers given their schedules
and time commitments
MAINTENANCE OF
RECORD
PCP office
EXAMPLES … Features and Functionality of Safe Health
Features and Functionality of Safe Health (cont'd)
Examples
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digital.ahrq.gov/sites/default/files/docs/page/Information%20Technology,%20Finance%20and%20Quantitative%20Decision%20Making%20Group%20Report.pdf
September 21, 2009 - that’s reasonably capable
Adaptable, but there’s a big cost
Max reliability
Max eff
Include specific examples … Needs to be scientifically sophisticated – level of an engineer
Important examples of shared dec-making
-
psnet.ahrq.gov/node/36188/psn-pdf
March 28, 2011 - /issue/role-medical-students-preventing-patient-harm-and-enhancing-patient-safety
The study offers examples
-
psnet.ahrq.gov/node/40066/psn-pdf
January 01, 2011 - Examples of major errors identified were commissions of allergies
to medications and omissions of intubations
-
psnet.ahrq.gov/node/39079/psn-pdf
June 06, 2018 - oral-syringes-crucial-and-economical-risk-reduction-strategy-has-not-been-
fully-utilized
This article describes examples
-
psnet.ahrq.gov/node/44137/psn-pdf
May 13, 2015 - Each set of videos provides examples of
learning tactics to address the needs of individual learners
-
psnet.ahrq.gov/node/34699/psn-pdf
January 04, 2017 - psnet.ahrq.gov/issue/organizational-costs-preventable-medical-errors
Using two composite case studies as examples
-
psnet.ahrq.gov/node/47435/psn-pdf
November 07, 2018 - This commentary reviews
examples of bias that commonly occur in medical practice and describes debiasing
-
psnet.ahrq.gov/node/34743/psn-pdf
March 28, 2005 - development
continuum, industry-oriented achievements in quality, geographical quality management examples
-
psnet.ahrq.gov/node/35564/psn-pdf
June 17, 2014 - medication-safety-issue-brief-small-and-rural-hospitals-unique-challenges-
unique-solutions
This safety brief provides examples
-
psnet.ahrq.gov/node/47588/psn-pdf
November 21, 2018 - This news article offers two examples of health care organizations that positioned medication
safety
-
psnet.ahrq.gov/node/39663/psn-pdf
June 09, 2011 - illustrates the role of human factors in medication errors in the intensive care unit and
provides examples
-
psnet.ahrq.gov/node/43597/psn-pdf
November 04, 2014 - concerns about over-reliance on laboratory tests to form diagnoses, this commentary
discusses two case examples