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psnet.ahrq.gov/node/851069/psn-pdf
June 28, 2023 - Measurement and Monitoring of Safety Framework
(MMSF): learning from its implementation in Canada.
June 28, 2023
Carthey J. Measurement and Monitoring of Safety Framework (MMSF): learning from its implementation in
Canada. BMJ Qual Saf. 2023;32(8):441-443. doi:10.1136/bmjqs-2022-015680.
https://psnet.ahrq.gov/issu…
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psnet.ahrq.gov/node/46193/psn-pdf
May 31, 2017 - Communicating Clearly About Medicines: Proceedings of
a Workshop—in Brief.
May 31, 2017
National Academies of Sciences, Engineering, and Medicine. Washington, DC: National Academies Press;
2017.
https://psnet.ahrq.gov/issue/communicating-clearly-about-medicines-proceedings-workshop-brief
Medication safety is a gl…
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psnet.ahrq.gov/node/39065/psn-pdf
January 03, 2017 - Family alert: implementing direct family activation of a
pediatric rapid response team.
January 3, 2017
Ray EM, Smith R, Massie S, et al. Family alert: implementing direct family activation of a pediatric rapid
response team. Jt Comm J Qual Patient Saf. 2009;35(11):575-580.
https://psnet.ahrq.gov/issue/family-aler…
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psnet.ahrq.gov/node/50781/psn-pdf
January 08, 2020 - Harnessing the power of medical malpractice data to
improve patient care.
January 8, 2020
Siegal D, Swift J, Forget J, et al. Harnessing the power of medical malpractice data to improve patient care.
J Healthc Risk Manag. 2020;39(3):28-36. doi:10.1002/jhrm.21393.
https://psnet.ahrq.gov/issue/harnessing-power-medic…
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psnet.ahrq.gov/node/47978/psn-pdf
May 01, 2019 - Patient Safety.
May 1, 2019
GMS J Med Educ. 2019;36:Doc11-Doc22.
https://psnet.ahrq.gov/issue/patient-safety-16
Patient safety has been described as an unmet need in physician training. This special issue covers areas
of focus for a patient safety curriculum drawn from experience in the German medical education sy…
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psnet.ahrq.gov/node/34660/psn-pdf
December 24, 2008 - Building a learning organization.
December 24, 2008
Garvin DA. Building a learning organization. Harv Bus Rev. 1993;71(4):78-91.
https://psnet.ahrq.gov/issue/building-learning-organization
Garvin, a Harvard Business School professor, postulates that for organizations to truly improve over time
and succeed, they ne…
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psnet.ahrq.gov/node/45269/psn-pdf
November 18, 2016 - Surgeons' disclosures of clinical adverse events.
November 18, 2016
Elwy R, Itani KMF, Bokhour BG, et al. Surgeons' Disclosures of Clinical Adverse Events. JAMA Surg.
2016;151(11):1015-1021. doi:10.1001/jamasurg.2016.1787.
https://psnet.ahrq.gov/issue/surgeons-disclosures-clinical-adverse-events
Even though disclo…
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psnet.ahrq.gov/node/46767/psn-pdf
January 17, 2018 - What this computer needs is a physician: humanism and
artificial intelligence.
January 17, 2018
Verghese A, Shah NH, Harrington RA. What This Computer Needs Is a Physician: Humanism and Artificial
Intelligence. JAMA. 2018;319(1):19-20. doi:10.1001/jama.2017.19198.
https://psnet.ahrq.gov/issue/what-computer-needs-p…
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psnet.ahrq.gov/node/47114/psn-pdf
October 13, 2018 - Focused ethnography of diagnosis in academic medical
centers.
October 13, 2018
Chopra V, Harrod M, Winter S, et al. Focused Ethnography of Diagnosis in Academic Medical Centers. J
Hosp Med. 2018;13(10):668-672. doi:10.12788/jhm.2966.
https://psnet.ahrq.gov/issue/focused-ethnography-diagnosis-academic-medical-cente…
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psnet.ahrq.gov/node/43106/psn-pdf
September 27, 2016 - The sterile cockpit: an effective approach to reducing
medication errors?
September 27, 2016
Federwisch M, Ramos H, Adams S' C. The sterile cockpit: an effective approach to reducing medication
errors? Am J Nurs. 2014;114(2):47-55. doi:10.1097/01.NAJ.0000443777.80999.5c.
https://psnet.ahrq.gov/issue/sterile-cockpi…
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psnet.ahrq.gov/node/46731/psn-pdf
July 25, 2018 - When bullying affects patient safety.
July 25, 2018
When Bullying Affects Patient Safety. AORN J. 2018;108(1):78-80. doi:10.1002/aorn.12294.
https://psnet.ahrq.gov/issue/when-bullying-affects-patient-safety
Bullying has been recognized as an important factor to consider in health care work environments.
Describing…
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psnet.ahrq.gov/node/44617/psn-pdf
January 22, 2016 - Pediatric prehospital medication dosing errors: a mixed-
methods study.
January 22, 2016
Hoyle JD, Sleight D, Henry R, et al. Pediatric prehospital medication dosing errors: a mixed-methods study.
Prehosp Emerg Care. 2016;20(1):117-124. doi:10.3109/10903127.2015.1061625.
https://psnet.ahrq.gov/issue/pediatric-preh…
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psnet.ahrq.gov/node/44816/psn-pdf
June 29, 2016 - Paralyzed by errors, this Xbox designer is taking on
hospital safety.
June 29, 2016
Aleccia J.
https://psnet.ahrq.gov/issue/paralyzed-errors-xbox-designer-taking-hospital-safety
Patients who experience harm while receiving medical care can serve as powerful advocates for patient
safety. This news article reports …
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psnet.ahrq.gov/node/865491/psn-pdf
April 03, 2024 - Support and recovery strategies for second victims.
April 3, 2024
Croke L. Support and recovery strategies for second victims. AORN J. 2024;119(2):7-10.
doi:10.1002/aorn.14089.
https://psnet.ahrq.gov/issue/support-and-recovery-strategies-second-victims
Clinicians involved in medical errors can be psychologically a…
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psnet.ahrq.gov/node/48194/psn-pdf
August 28, 2019 - Framing of clinical information affects physicians'
diagnostic accuracy.
August 28, 2019
Popovich I, Szecket N, Nahill A. Framing of clinical information affects physicians' diagnostic accuracy.
Emerg Med J. 2019;36(10):589-594. doi:10.1136/emermed-2019-208409.
https://psnet.ahrq.gov/issue/framing-clinical-informa…
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psnet.ahrq.gov/node/866520/psn-pdf
August 14, 2024 - People are more error-prone after committing an error.
August 14, 2024
Adkins TJ, Zhang H, Lee TG. People are more error-prone after committing an error. Nat Commun.
2024;15(1):6422. doi:10.1038/s41467-024-50547-y.
https://psnet.ahrq.gov/issue/people-are-more-error-prone-after-committing-error
In order to improve …
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psnet.ahrq.gov/node/44649/psn-pdf
November 11, 2015 - Seven (potentially) deadly prescribing errors.
November 11, 2015
Graham LR, Scudder L, Stokowski L. Medscape. October 22, 2015.
https://psnet.ahrq.gov/issue/seven-potentially-deadly-prescribing-errors
Errors in the prescribing process can lead to adverse drug events. This slide set provides information about
commo…
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psnet.ahrq.gov/node/44090/psn-pdf
November 21, 2016 - Insensible losses: when the medical community forgets
the family.
November 21, 2016
Elias P. Insensible losses: when the medical community forgets the family. Health Aff (Millwood).
2015;34(4):707-710. doi:10.1377/hlthaff.2014.0536.
https://psnet.ahrq.gov/issue/insensible-losses-when-medical-community-forgets-fami…
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psnet.ahrq.gov/node/72667/psn-pdf
January 20, 2021 - Virtual urgent care quality and safety in the time of
Coronavirus.
January 20, 2021
Smith SW, Tiu J, Caspers CG, et al. Virtual Urgent Care Quality and Safety in the Time of Coronavirus. Jt
Comm J Qual Patient Saf. 2021;47(2):86-98. doi:10.1016/j.jcjq.2020.10.001.
https://psnet.ahrq.gov/issue/virtual-urgent-care-q…
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psnet.ahrq.gov/node/48135/psn-pdf
August 28, 2019 - What causes prescribing errors in children? Scoping
review.
August 28, 2019
Conn RL, Kearney O, Tully MP, et al. What causes prescribing errors in children? Scoping review. BMJ
Open. 2019;9(8):e028680. doi:10.1136/bmjopen-2018-028680.
https://psnet.ahrq.gov/issue/what-causes-prescribing-errors-children-scoping-rev…