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psnet.ahrq.gov/node/43043/psn-pdf
September 19, 2016 - "Second victim" casualties and how physician leaders
can help.
September 19, 2016
MacLeod L. "Second victim" casualties and how physician leaders can help. Physician Exect. 2014;40(1):8-
12.
https://psnet.ahrq.gov/issue/second-victim-casualties-and-how-physician-leaders-can-help
Second victims are clinicians who …
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digital.ahrq.gov/organizations/commonwealth-fund
January 01, 2023 - The Commonwealth Fund
The Commonwealth Fund's 2012 International Survey of Primary Care Doctors
Description
This is a questionnaire designed to be completed by physicians in an ambulatory setting. The tool includes questions to assess the current state of electronic health re…
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psnet.ahrq.gov/node/41440/psn-pdf
August 17, 2016 - The Toolkit for Using the AHRQ Quality Indicators: How
To Improve Hospital Quality and Safety.
August 17, 2016
Rockville, MD: Agency for Healthcare Research and Quality; July 2016.
https://psnet.ahrq.gov/issue/toolkit-using-ahrq-quality-indicators-how-improve-hospital-quality-and-safety
This toolkit provides resou…
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psnet.ahrq.gov/node/37515/psn-pdf
February 06, 2008 - Probabilistic risk assessment of accidental ABO-
incompatible thoracic organ transplantation before and
after 2003.
February 6, 2008
Cook RI, Wreathall J, Smith A, et al. Probabilistic risk assessment of accidental ABO-incompatible thoracic
organ transplantation before and after 2003. Transplantation. 2007;84(12):…
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psnet.ahrq.gov/node/43820/psn-pdf
February 18, 2015 - Care of the clinician after an adverse event.
February 18, 2015
Pratt SD, Jachna BR. Care of the clinician after an adverse event. Int J Obstet Anesth. 2014;24(1):54-63.
doi:10.1016/j.ijoa.2014.10.001.
https://psnet.ahrq.gov/issue/care-clinician-after-adverse-event
Spotlighting the emotional impact adverse events …
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psnet.ahrq.gov/node/47220/psn-pdf
September 12, 2018 - Strategically Advancing Patient and Family Advisory
Councils in New York State Hospitals.
September 12, 2018
Bethesda, MD: Institute for Patient- and Family-Centered Care; June 2018.
https://psnet.ahrq.gov/issue/strategically-advancing-patient-and-family-advisory-councils-new-york-state-
hospitals
Hospital patien…
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psnet.ahrq.gov/node/47885/psn-pdf
May 01, 2019 - Deny, Dismiss, Dehumanise: What Happened When I
Went to Hospital.
May 1, 2019
Cullen A. Uitgeverij van Brug: The Hague, The Netherlands; 2019. ISBN: 9789065232236.
https://psnet.ahrq.gov/issue/deny-dismiss-dehumanise-what-happened-when-i-went-hospital
Patient stories offer important insights regarding the impact m…
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psnet.ahrq.gov/node/34747/psn-pdf
August 04, 2009 - The Improvement Guide: A Practical Approach to
Enhancing Organizational Performance. 2nd ed.
August 4, 2009
Langley GJ, Moen R, Nolan KM, et al. Hoboken, NJ: Jossey-Bass; 2009. ISBN: 9780470430880.
https://psnet.ahrq.gov/issue/improvement-guide-practical-approach-enhancing-organizational-performance-
2nd-ed
Effec…
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psnet.ahrq.gov/node/46213/psn-pdf
June 28, 2017 - The second victim: a review.
June 28, 2017
Coughlan B, Powell D, Higgins MF. The Second Victim: a Review. Eur J Obstet Gynecol Reprod Biol.
2017;213:11-16. doi:10.1016/j.ejogrb.2017.04.002.
https://psnet.ahrq.gov/issue/second-victim-review
Maternity care is a high-risk environment. This review discusses second vic…
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psnet.ahrq.gov/node/46534/psn-pdf
January 31, 2018 - Safety considerations in learning new procedures: a
survey of surgeons.
January 31, 2018
Jaffe TA, Hasday SJ, Knol M, et al. Safety considerations in learning new procedures: a survey of
surgeons. J Surg Res. 2017;218:361-366. doi:10.1016/j.jss.2017.06.058.
https://psnet.ahrq.gov/issue/safety-considerations-learni…
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psnet.ahrq.gov/node/60065/psn-pdf
March 18, 2020 - Safety in Numbers: Hospital Performance on Leapfrog’s
Surgical Volume Standard Based on Results of the 2019
Leapfrog Hospital Survey.
March 18, 2020
Washington DC: Leapfrog Group; 2020.
https://psnet.ahrq.gov/issue/safety-numbers-hospital-performance-leapfrogs-surgical-volume-standard-
based-results-2019
Surgica…
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psnet.ahrq.gov/node/43121/psn-pdf
April 16, 2014 - Implementing the Safety Thermometer tool in one NHS
trust.
April 16, 2014
Buckley C, Cooney K, Sills E, et al. Implementing the Safety Thermometer tool in one NHS trust. Br J Nurs.
2014;23(5):268-72.
https://psnet.ahrq.gov/issue/implementing-safety-thermometer-tool-one-nhs-trust
This commentary details a National…
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psnet.ahrq.gov/node/47708/psn-pdf
February 13, 2019 - The role of purple pens in learning to prescribe.
February 13, 2019
Kinston R, McCarville N, Hassell A. The role of purple pens in learning to prescribe. Clin Teach.
2019;16(6):598-603. doi:10.1111/tct.12991.
https://psnet.ahrq.gov/issue/role-purple-pens-learning-prescribe
Interventions utilizing color as visual c…
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psnet.ahrq.gov/node/854265/psn-pdf
October 04, 2023 - Can AI help doctors come up with better diagnoses?
October 4, 2023
Landro L. Wall Street Journal. September 24, 2023.
https://psnet.ahrq.gov/issue/can-ai-help-doctors-come-better-diagnoses
Artificial intelligence (AI) is being considered as a strong contender in the effort to reduce harmful
diagnostic error, but c…
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psnet.ahrq.gov/node/45906/psn-pdf
June 22, 2017 - A piece of my mind. After the medical error.
June 22, 2017
Worthen M. After the Medical Error. JAMA. 2017;317(17):1763-1764. doi:10.1001/jama.2017.0004.
https://psnet.ahrq.gov/issue/piece-my-mind-after-medical-error
Patients who have been exposed to medical error could be reluctant to trust the health care system.
…
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psnet.ahrq.gov/node/46438/psn-pdf
September 20, 2017 - Communicating Clearly About Medicines: Proceedings of
a Workshop.
September 20, 2017
National Academies of Sciences, Engineering, and Medicine. Washington, DC: The National Academies
Press: 2017. ISBN: 9780309461856.
https://psnet.ahrq.gov/issue/communicating-clearly-about-medicines-proceedings-workshop
Patient h…
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psnet.ahrq.gov/node/38498/psn-pdf
September 27, 2016 - Nursing time devoted to medication administration in
long-term care: clinical, safety, and resource implications.
September 27, 2016
Thomson MS, Gruneir A, Lee M, et al. Nursing time devoted to medication administration in long-term care:
clinical, safety, and resource implications. J Am Geriatr Soc. 2009;57(2):266…
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psnet.ahrq.gov/node/45160/psn-pdf
May 18, 2016 - Clues to better health care from old malpractice lawsuits.
May 18, 2016
Landro L.
https://psnet.ahrq.gov/issue/clues-better-health-care-old-malpractice-lawsuits
Closed claims have been considered a source for adverse event data for years, and recently such data has
been utilized to inform safety improvement work. …
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psnet.ahrq.gov/node/39483/psn-pdf
May 25, 2010 - Teaching internal medicine residents quality improvement
and patient safety: a lean thinking approach.
May 25, 2010
Kim CS, Lukela MP, Parekh V, et al. Teaching internal medicine residents quality improvement and patient
safety: a lean thinking approach. Am J Med Qual. 2010;25(3):211-7. doi:10.1177/1062860609357466…
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psnet.ahrq.gov/node/40359/psn-pdf
May 30, 2011 - Professional values and reported behaviours of doctors
in the USA and UK: quantitative survey.
May 30, 2011
Roland M, Rao SR, Sibbald B, et al. Professional values and reported behaviours of doctors in the USA
and UK: quantitative survey. BMJ Qual Saf. 2011;20(6):515-21. doi:10.1136/bmjqs.2010.048173.
https://psne…