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Showing results for "failures".

  1. The flaw of medicine: addressing racial and gender disparities in critical care. | PSNet

    psnet.ahrq.gov/issue/flaw-medicine-addressing-racial-and-gender-disparities-critical-care
    June 16, 2010 - Commentary The flaw of medicine: addressing racial and gender disparities in critical care. Citation Text: Hilton EJ, Goff KL, Sreedharan R, et al. The flaw of medicine: addressing racial and gender disparities in critical care. Anesthesiol Clin. 2020;38(2):357-368. doi:10.1016/j.anclin.…

  2. Diagnostic safety: needs assessment and informed curriculum at an academic children's hospital. | PSNet

    psnet.ahrq.gov/issue/diagnostic-safety-needs-assessment-and-informed-curriculum-academic-childrens-hospital
    June 28, 2023 - Study Diagnostic safety: needs assessment and informed curriculum at an academic children's hospital. Citation Text: Congdon M, Rasooly IR, Toto RL, et al. Diagnostic safety: needs assessment and informed curriculum at an academic children's hospital. Pediatr Qual Saf. 2024;9(6):e773. do…

  3. Nurse-staffing levels and the quality of care in hospitals. | PSNet

    psnet.ahrq.gov/issue/nurse-staffing-levels-and-quality-care-hospitals
    June 25, 2010 - Study Classic Nurse-staffing levels and the quality of care in hospitals. Citation Text: Needleman J, Buerhaus P, Mattke S, et al. Nurse-staffing levels and the quality of care in hospitals. N Engl J Med. 2002;346(22):1715-22. Copy Citation Format: …

  4. Disparities in racial, ethnic, and payer groups for pediatric safety events in US hospitals. | PSNet

    psnet.ahrq.gov/issue/disparities-racial-ethnic-and-payer-groups-pediatric-safety-events-us-hospitals
    February 21, 2024 - Study Disparities in racial, ethnic, and payer groups for pediatric safety events in US hospitals. Citation Text: Parikh K, Hall M, Tieder JS, et al. Disparities in racial, ethnic, and payer groups for pediatric safety events in US hospitals. Pediatrics. 2024;153(3):e2023063714. doi:10.1…

  5. Normal Accidents: Living with High-Risk Technologies. | PSNet

    psnet.ahrq.gov/issue/normal-accidents-living-high-risk-technologies
    March 06, 2005 - Book/Report Classic Normal Accidents: Living with High-Risk Technologies. Citation Text: Normal Accidents: Living with High-Risk Technologies. Perrow C. Princeton NJ: Princeton University Press; 1999. Copy Citation Save Save to you…

  6. Anesthetic mishaps: breaking the chain of accident evolution. | PSNet

    psnet.ahrq.gov/issue/anesthetic-mishaps-breaking-chain-accident-evolution
    April 08, 2011 - Commentary Classic Anesthetic mishaps: breaking the chain of accident evolution. Citation Text: Gaba DM, Maxwell M, DeAnda A. Anesthetic mishaps: breaking the chain of accident evolution. Anesthesiology. 1987;66(5):670-6. Copy Citation Format: Goo…

  7. Impact of pharmacist previsit input to providers on chronic opioid prescribing safety. | PSNet

    psnet.ahrq.gov/issue/impact-pharmacist-previsit-input-providers-chronic-opioid-prescribing-safety
    November 16, 2022 - Study Impact of pharmacist previsit input to providers on chronic opioid prescribing safety. Citation Text: Cox N, Tak CR, Cochella SE, et al. Impact of Pharmacist Previsit Input to Providers on Chronic Opioid Prescribing Safety. The Journal of the American Board of Family …

  8. Measuring and improving patient safety through health information technology: the Health IT Safety Framework. | PSNet

    psnet.ahrq.gov/issue/measuring-and-improving-patient-safety-through-health-information-technology-health-it-safety
    December 06, 2023 - Commentary Measuring and improving patient safety through health information technology: the Health IT Safety Framework. Citation Text: Singh H, Sittig DF. Measuring and improving patient safety through health information technology: The Health IT Safety Framework. BMJ Qual Saf. 2016;25(…

  9. Association of patient photographs and reduced retract-and-reorder events. | PSNet

    psnet.ahrq.gov/issue/association-patient-photographs-and-reduced-retract-and-reorder-events
    February 24, 2021 - Study Association of patient photographs and reduced retract-and-reorder events. Citation Text: Rzewnicki D, Kanvinde A, Gillespie S, et al. Association of patient photographs and reduced retract-and-reorder events. JAMIA Open. 2024;7(3):ooae042. doi:10.1093/jamiaopen/ooae042. Copy Cit…

  10. The effect of automated alerts on provider ordering behavior in an outpatient setting.   | PSNet

    psnet.ahrq.gov/issue/effect-automated-alerts-provider-ordering-behavior-outpatient-setting
    November 23, 2016 - Study The effect of automated alerts on provider ordering behavior in an outpatient setting.   Citation Text: Steele AW, Eisert S, Witter J, et al. The effect of automated alerts on provider ordering behavior in an outpatient setting. PLoS Med. 2005;2(9):e255. doi:10.1371/journal.pmed.…

  11. Diffusing aviation innovations in a hospital in the Netherlands. | PSNet

    psnet.ahrq.gov/issue/diffusing-aviation-innovations-hospital-netherlands
    August 12, 2020 - Study Diffusing aviation innovations in a hospital in the Netherlands. Citation Text: de Korne DF, van Wijngaarden JDH, Hiddema F, et al. Diffusing aviation innovations in a hospital in The Netherlands. Jt Comm J Qual Patient Saf. 2010;36(8):339-47. Copy Citation Format: Go…

  12. JAMA professionalism: disclosure of medical error. | PSNet

    psnet.ahrq.gov/issue/jama-professionalism-disclosure-medical-error
    December 19, 2018 - Commentary JAMA professionalism: disclosure of medical error. Citation Text: Levinson W, Yeung J, Ginsburg S. Disclosure of Medical Error. JAMA. 2016;316(7):764-5. doi:10.1001/jama.2016.9136. Copy Citation Format: DOI Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XM…

  13. Effects of an intervention to increase bed alarm use to prevent falls in hospitalized patients: a cluster randomized trial. | PSNet

    psnet.ahrq.gov/issue/effects-intervention-increase-bed-alarm-use-prevent-falls-hospitalized-patients-cluster
    January 03, 2017 - Study Effects of an intervention to increase bed alarm use to prevent falls in hospitalized patients: a cluster randomized trial. Citation Text: Shorr RI, Chandler M, Mion LC, et al. Effects of an intervention to increase bed alarm use to prevent falls in hospitalized patients: a clust…

  14. Achieving rapid door-to-balloon times: how top hospitals improve complex clinical systems. | PSNet

    psnet.ahrq.gov/issue/achieving-rapid-door-balloon-times-how-top-hospitals-improve-complex-clinical-systems
    November 07, 2012 - Study Achieving rapid door-to-balloon times: how top hospitals improve complex clinical systems. Citation Text: Bradley EH, Curry LA, Webster TR, et al. Achieving rapid door-to-balloon times: how top hospitals improve complex clinical systems. Circulation. 2006;113(8):1079-85. Copy C…

  15. Errors and omissions in hospital prescriptions: a survey of prescription writing in a hospital. | PSNet

    psnet.ahrq.gov/issue/errors-and-omissions-hospital-prescriptions-survey-prescription-writing-hospital
    April 13, 2022 - Study Errors and omissions in hospital prescriptions: a survey of prescription writing in a hospital. Citation Text: Calligaris L, Panzera A, Arnoldo L, et al. Errors and omissions in hospital prescriptions: a survey of prescription writing in a hospital. BMC Clin Pharmacol. 2009;9:9. d…

  16. Barriers and facilitators for taking action after classroom-based crew resource management training at three ICUs. | PSNet

    psnet.ahrq.gov/issue/barriers-and-facilitators-taking-action-after-classroom-based-crew-resource-management
    July 10, 2013 - Study Barriers and facilitators for taking action after classroom-based crew resource management training at three ICUs. Citation Text: Kemper PE, van Dyck C, Wagner C, et al. Barriers and facilitators for taking action after classroom-based crew resource management training at three ICU…

  17. Adverse Events Among In-Hospital Medicare Patients in 2021 and 2022. | PSNet

    psnet.ahrq.gov/issue/adverse-events-among-hospital-medicare-patients-2021-and-2022
    November 20, 2024 - Book/Report Adverse Events Among In-Hospital Medicare Patients in 2021 and 2022. Citation Text: Rodrick D, Timashenka A, Umscheid C. Adverse Events Among In-Hospital Medicare Patients In 2021 And 2022. Rockville, MD: Agency for Healthcare Research and Quality; 2024. AHRQ Publication no. …

  18. Implementing a patient safety and quality program across two merged pediatric institutions. | PSNet

    psnet.ahrq.gov/issue/implementing-patient-safety-and-quality-program-across-two-merged-pediatric-institutions
    June 03, 2013 - Study Implementing a patient safety and quality program across two merged pediatric institutions. Citation Text: Abramson EL, Hyman D, Osorio N, et al. Implementing a patient safety and quality program across two merged pediatric institutions. Jt Comm J Qual Patient Saf. 2009;35(1):43-…

  19. Opportunities to enhance laboratory professionals' role on the diagnostic team. | PSNet

    psnet.ahrq.gov/issue/opportunities-enhance-laboratory-professionals-role-diagnostic-team
    April 13, 2022 - Study Opportunities to enhance laboratory professionals' role on the diagnostic team. Citation Text: Taylor JR, Thompson PJ, Genzen JR, et al. Opportunities to enhance laboratory professionals' role on the diagnostic team. Lab Med. 2017;48(1):97-103. doi:10.1093/labmed/lmw048. Copy Cit…

  20. Multidisciplinary approach to inpatient medication reconciliation in an academic setting. | PSNet

    psnet.ahrq.gov/issue/multidisciplinary-approach-inpatient-medication-reconciliation-academic-setting
    January 05, 2017 - Study Multidisciplinary approach to inpatient medication reconciliation in an academic setting. Citation Text: Varkey P, Cunningham J, O'Meara J, et al. Multidisciplinary approach to inpatient medication reconciliation in an academic setting. Am J Health Syst Pharm. 2007;64(8):850-4. …
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