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4161. Preoperative surgical briefings do not delay operating room start times and are popular with surgical team members. | PSNet
      psnet.ahrq.gov/issue/preoperative-surgical-briefings-do-not-delay-operating-room-start-times-and-are-popular
      March 02, 2022 - Study Preoperative surgical briefings do not delay operating room start times and are popular with surgical team members. Citation Text: Ali M, Osborne A, Bethune R, et al. Preoperative surgical briefings do not delay operating room start times and are popular with surgical team member…

4162. Medical injuries among hospitalized children. | PSNet
      psnet.ahrq.gov/issue/medical-injuries-among-hospitalized-children
      February 15, 2017 - Study Medical injuries among hospitalized children. Citation Text: Meurer JR, Yang H, Guse CE, et al. Medical injuries among hospitalized children. Qual Saf Health Care. 2006;15(3):202-7. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML Endn…

4163. A systematic review of methods for medical record analysis to detect adverse events in hospitalized patients. | PSNet
      psnet.ahrq.gov/issue/systematic-review-methods-medical-record-analysis-detect-adverse-events-hospitalized-patients
      December 14, 2022 - Review A systematic review of methods for medical record analysis to detect adverse events in hospitalized patients. Citation Text: Klein DO, Rennenberg RJMW, Koopmans RP, et al. A systematic review of methods for medical record analysis to detect adverse events in hospitalized patients.…

4164. Promoting medication safety for older adults upon hospital discharge: guiding principles for a medication discharge plan. | PSNet
      psnet.ahrq.gov/issue/promoting-medication-safety-older-adults-upon-hospital-discharge-guiding-principles
      July 31, 2019 - Study Promoting medication safety for older adults upon hospital discharge: guiding principles for a medication discharge plan. Citation Text: Zhang FH, Lauzon J, Payette J, et al. Promoting medication safety for older adults upon hospital discharge: guiding principles for a medication d…

4165. Speaking up about safety concerns: multi-setting qualitative study of patients' views and experiences. | PSNet
      psnet.ahrq.gov/issue/speaking-about-safety-concerns-multi-setting-qualitative-study-patients-views-and-experiences
      May 18, 2016 - Study Speaking up about safety concerns: multi-setting qualitative study of patients' views and experiences. Citation Text: Entwistle VA, McCaughan D, Watt I, et al. Speaking up about safety concerns: multi-setting qualitative study of patients' views and experiences. Qual Saf Health C…

4166. Influence of doctor–patient conversations on behaviours of patients presenting to primary care with new or persistent symptoms: a video observation study. | PSNet
      psnet.ahrq.gov/issue/influence-doctor-patient-conversations-behaviours-patients-presenting-primary-care-new-or
      February 17, 2021 - Study Influence of doctor–patient conversations on behaviours of patients presenting to primary care with new or persistent symptoms: a video observation study. Citation Text: Amelung D, Whitaker KL, Lennard D, et al. Influence of doctor-patient conversations on behaviours of patients pr…

4167. Perceptions of hospital electronic health record (EHR) training, support, and patient safety by staff position and tenure. | PSNet
      psnet.ahrq.gov/issue/perceptions-hospital-electronic-health-record-ehr-training-support-and-patient-safety-staff
      October 03, 2018 - Study Perceptions of hospital electronic health record (EHR) training, support, and patient safety by staff position and tenure. Citation Text: Campione JR, Liu H. Perceptions of hospital electronic health record (EHR) training, support, and patient safety by staff position and tenure. B…

4168. The Medication Metronome Project - 2011 | Digital Healthcare Research
      digital.ahrq.gov/ahrq-funded-projects/medication-metronome-project/annual-summary/2011
      January 01, 2011 - The Medication Metronome Project - 2011 Project Name The Medication Metronome Project Principal Investigator Atlas, Steven J. Organization Massachusetts General Hospital Funding Mechanism PAR: HS08-270: Utilizing Health Information Technology to Improve Health Care …

4169. Lessons learned in implementing a chronic opioid therapy management system. | PSNet
      psnet.ahrq.gov/issue/lessons-learned-implementing-chronic-opioid-therapy-management-system
      July 13, 2022 - Study Lessons learned in implementing a chronic opioid therapy management system. Citation Text: Carlile N, Fuller TE, Benneyan JC, et al. Lessons learned in implementing a chronic opioid therapy management system. J Patient Saf. 2022;18(8):e1142-e1149. doi:10.1097/pts.0000000000001039. …

4170. Soft factors, smooth transport? The role of safety climate and team processes in reducing adverse events during intrahospital transport in intensive care. | PSNet
      psnet.ahrq.gov/issue/soft-factors-smooth-transport-role-safety-climate-and-team-processes-reducing-adverse-events
      September 27, 2016 - Commentary Soft factors, smooth transport? The role of safety climate and team processes in reducing adverse events during intrahospital transport in intensive care. Citation Text: Latzke M, Schiffinger M, Zellhofer D, et al. Soft Factors, Smooth Transport? The role of safety climate and…

4171. Effective interventions and implementation strategies to reduce adverse drug events in the Veterans Affairs (VA) system. | PSNet
      psnet.ahrq.gov/issue/effective-interventions-and-implementation-strategies-reduce-adverse-drug-events-veterans
      January 02, 2017 - Study Effective interventions and implementation strategies to reduce adverse drug events in the Veterans Affairs (VA) system. Citation Text: Mills PD, Neily J, Kinney LM, et al. Effective interventions and implementation strategies to reduce adverse drug events in the Veterans Affairs…

4172. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/50647/psn-pdf
      November 06, 2019 - ‘Fear of falling’: how hospitals do even more harm by keeping patients in bed. November 6, 2019 Bailey M. Kaiser Health News. October 17, 2019. https://psnet.ahrq.gov/issue/fear-falling-how-hospitals-do-even-more-harm-keeping-patients-bed Patient falls with harm are a common sentinel event. This news story discuss…

4173. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/837863/psn-pdf
      August 17, 2022 - The Nursing Home Expert Panel’s Falls Investigation Guide Toolkit: How-To Guide. August 17, 2022 Portland, OR: Oregon Patient Safety Commission; 2022.  https://psnet.ahrq.gov/issue/nursing-home-expert-panels-falls-investigation-guide-toolkit-how-guide Patient falls are common sentinel events. The latest revis…

4174. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/50862/psn-pdf
      February 05, 2020 - Assessment of nursing home reporting of major injury falls for quality measurement on Nursing Home Compare. February 5, 2020 Sanghavi P, Pan S, Caudry D. Assessment of nursing home reporting of major injury falls for quality measurement on nursing home compare. Health Serv Res. 2020;55(2):201-210. doi:10.1111/1475-…

4175. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/38715/psn-pdf
      February 17, 2011 - Medicare nonpayment, hospital falls, and unintended consequences. February 17, 2011 Inouye SK, Brown CJ, Tinetti ME. Medicare nonpayment, hospital falls, and unintended consequences. N Engl J Med. 2009;360(23):2390-3. doi:10.1056/NEJMp0900963. https://psnet.ahrq.gov/issue/medicare-nonpayment-hospital-falls-and-uni…

4176. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/37792/psn-pdf
      February 15, 2011 - Exploring organizational context and structure as predictors of medication errors and patient falls. February 15, 2011 Mark BA, Hughes LC, Belyea M, et al. Exploring Organizational Context and Structure as Predictors of Medication Errors and Patient Falls. J Patient Saf. 2008;4(2). doi:10.1097/pts.0b013e3181695671.…

4177. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/37518/psn-pdf
      March 13, 2008 - Innovation in patient safety: a new task design in reducing patient falls. March 13, 2008 Tzeng H-M, Yin C-Y. Innovation in patient safety: a new task design in reducing patient falls. J Nurs Care Qual. 2008;23(1):34-42. doi:10.1097/01.NCQ.0000303803.07457.e5. https://psnet.ahrq.gov/issue/innovation-patient-safety…

4178. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/40454/psn-pdf
      June 01, 2012 - Influence of unit-level staffing on medication errors and falls in military hospitals. June 1, 2012 Breckenridge-Sproat S, Johantgen M, Patrician PA. Influence of unit-level staffing on medication errors and falls in military hospitals. West J Nurs Res. 2012;34(4):455-74. doi:10.1177/0193945911407090. https://psne…

4179. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/47508/psn-pdf
      October 24, 2018 - Root cause analysis of reported patient falls in ORs in the Veterans Health Administration. October 24, 2018 Soncrant CM, Warner LJ, Neily J, et al. Root Cause Analysis of Reported Patient Falls in ORs in the Veterans Health Administration. AORN J. 2018;108(4):386-397. doi:10.1002/aorn.12372. https://psnet.ahrq.go…

4180. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/39255/psn-pdf
      February 02, 2011 - The patient who falls: "It's always a trade-off." February 2, 2011 Tinetti ME, Kumar C. The patient who falls: "It's always a trade-off". JAMA. 2010;303(3):258-66. doi:10.1001/jama.2009.2024. https://psnet.ahrq.gov/issue/patient-who-falls-its-always-trade Through a case study, this article reviews evidence on risk…