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psnet.ahrq.gov/issue/multimodal-system-designed-reduce-errors-recording-and-administration-drugs-anaesthesia
September 26, 2012 - Multimodal system designed to reduce errors in recording and administration of drugs in anaesthesia: … In this randomized controlled trial, a novel system for drug administration was evaluated in comparison … Multimodal system designed to reduce errors in recording and administration of drugs in anaesthesia: … January 12, 2022
A retrospective audit of postoperative days alive and out of hospital … a multistate hospital network--13 academic medical centers, April-June 2020.
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psnet.ahrq.gov/issue/barriers-emergency-departments-adherence-four-medication-safety-related-joint-commission
October 19, 2022 - The Institute of Medicine elevated concerns about the future of Emergency Care in a well publicized 2006 … Medication errors in emergency departments (EDs) are a particular focus of prevention strategies as … January 12, 2022
Duty hours in emergency medicine: balancing patient safety, resident … September 24, 2016
Association between waiting times and short term mortality and hospital … adverse events in older patients admitted to hospital: a retrospective cohort study.
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psnet.ahrq.gov/issue/medically-necessary-time-sensitive-procedures-scoring-system-ethically-and-efficiently-manage
October 11, 2017 - October 11, 2017
Optimizing Pediatric Patient Safety in the Emergency Care Setting. … April 12, 2023
Improving handoffs in the emergency department. … April 22, 2016
Seroprevalence of SARS-CoV-2 among frontline health care personnel in … a multistate hospital network--13 academic medical centers, April-June 2020. … June 3, 2020
Blueprint for restructuring a department of surgery in concert with the
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psnet.ahrq.gov/issue/prevalence-and-factors-associated-patient-requested-corrections-medical-record-through-use
October 02, 2024 - Cures Act, researchers found approximately 6.5% of patients requested changes to errors identified in … February 5, 2020
Fall prevention implementation strategies in use at 60 United States … hospitals: a descriptive study. … March 24, 2019
Changes in medication safety indicators in England throughout the covid … November 25, 2020
Frequency and types of patient-reported errors in electronic health
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psnet.ahrq.gov/issue/transparent-and-open-discussion-errors-does-not-increase-malpractice-risk-trauma-patients
October 19, 2022 - Study
Transparent and open discussion of errors does not increase malpractice risk in … Transparent and open discussion of errors does not increase malpractice risk in trauma patients. … Transparent and open discussion of errors does not increase malpractice risk in trauma patients. … hospital practice: factors associated with turnover, outcomes, and patient safety. … March 27, 2019
Effects of a communication-and-resolution program on hospitals' malpractice
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psnet.ahrq.gov/issue/surgical-case-listing-accuracy-failure-analysis-high-volume-academic-medical-center
September 25, 2011 - The error rate was constant across specialties and most frequently associated with mistakes in laterality … Incidence and characteristics of potential and actual retained foreign object events in … June 13, 2011
Association of hospital participation in a surgical outcomes monitoring … April 27, 2015
Families as partners in hospital error and adverse event surveillance. … August 26, 2011
Information transfer and communication in surgery: a systematic review
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psnet.ahrq.gov/issue/impact-weekend-effect-postoperative-mortality-patients-undergoing-emergency-general-surgery
December 04, 2016 - Review
Impact of weekend effect on postoperative mortality in patients undergoing … Impact of weekend effect on postoperative mortality in patients undergoing emergency General surgery … nationwide study of the "July Effect" concerning postpartum hemorrhage and its risk factors at teaching hospitals … September 1, 2018
Patients as partners in learning from unexpected events. … February 5, 2020
The need for surgical safety checklists in neurosurgery now and in the
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psnet.ahrq.gov/issue/insulin-pump-risks-and-benefits-clinical-appraisal-pump-safety-standards-adverse-event
June 03, 2020 - June 10, 2020
Restructuring of a general surgery residency program in an epicenter of … November 21, 2021
Patient safety, satisfaction, and quality of hospital care: cross sectional … surveys of nurses and patients in 12 countries in Europe and the United States. … September 20, 2011
Durable improvements in efficiency, safety, and satisfaction in the … February 14, 2007
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Hospitals
Health
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psnet.ahrq.gov/issue/effect-contextual-factors-prevalence-diagnostic-errors-among-patients-managed-physicians-same
February 02, 2022 - In this novel study, the diagnostic errors of a cohort of clinicians who practice in multiple locations … The results indicate, that among clinicians in the same specialty, it may be contextual factors (i.e. … 16, 2022
Prevalence and characterisation of diagnostic error among 7-day all-cause hospital … April 15, 2020
Missed diagnosis of cancer in primary care: insights from malpractice … August 7, 2019
In-hospital mortality associated with the misdiagnosis or unidentified
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psnet.ahrq.gov/issue/results-survey-among-gp-practices-how-they-manage-patient-safety-aspects-related-point-care
November 21, 2018 - survey among GP practices on how they manage patient safety aspects related to point-of-care testing in … survey among GP practices on how they manage patient safety aspects related to point-of-care testing in … survey among GP practices on how they manage patient safety aspects related to point-of-care testing in … a multistate hospital network--13 academic medical centers, April-June 2020. … 2023
Impact of altering referral threshold from out-of-hours primary care to hospital
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psnet.ahrq.gov/issue/delayed-workup-rectal-bleeding-adult-primary-care-examining-process-care-failures
April 24, 2018 - Delayed Workup of Rectal Bleeding in Adult Primary Care: Examining Process-of-Care Failures. … Delayed cancer diagnosis is a critical patient safety concern in primary care. … and trigger tools could address diagnostic delays in primary care. … hospital error and adverse event surveillance. … multistate hospital network--13 academic medical centers, April-June 2020.
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psnet.ahrq.gov/issue/prognosis-undiagnosed-chest-pain-linked-electronic-health-record-cohort-study
March 19, 2018 - A common undiagnosed symptom in outpatient medicine is chest pain . … The highest risk of myocardial infarction was in patients with diagnosed coronary artery disease, but … Download Citation
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Impact of initial hospital … followed by face-to-face feedback to prescribers on adverse drug events recognition and prevention in … in hospitals.
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psnet.ahrq.gov/issue/developing-high-value-care-programme-bottom-programme-faculty-resident-improvement-projects
December 16, 2020 - ordered in the intensive care unit, and fewer bone-density scans ordered in average-risk women under … primary care in England: retrospective case note review. … hospital practice: factors associated with turnover, outcomes, and patient safety. … Stigmatizing language and the transmission of bias in the medical record. … April 12, 2017
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Hospitals
Health
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psnet.ahrq.gov/issue/using-sociotechnical-theory-understand-medication-safety-work-primary-care-and-prescribers
November 09, 2022 - Study
Using sociotechnical theory to understand medication safety work in primary … Using sociotechnical theory to understand medication safety work in primary care and prescribers’ use … Using sociotechnical theory to understand medication safety work in primary care and prescribers’ use … November 9, 2022
Electronic prescribing systems in hospitals to improve medication safety … in England: retrospective case note review.
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psnet.ahrq.gov/issue/novel-icu-hand-over-tool-glass-door-patient-room
October 12, 2009 - intensive care unit developed a daily goals template attached to a widely used door that aided in … August 4, 2021
The cost of serious fall-related injuries at three midwestern hospitals … September 25, 2011
Effect of hospital follow-up appointment on clinical event outcomes … September 26, 2016
Optimizing Pediatric Patient Safety in the Emergency Care Setting. … , 2022
Effect of standardized handoff curriculum on improved clinician preparedness in
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psnet.ahrq.gov/issue/2017-acgme-common-work-hour-standards-promoting-physician-learning-and-professional
October 19, 2022 - The 2017 ACGME common work hour standards: promoting physician learning and professional development in … The 2017 ACGME Common Work Hour Standards: Promoting Physician Learning and Professional Development in … hospital practice: factors associated with turnover, outcomes, and patient safety. … July 26, 2017
Ethical considerations in the development of the Flexibility in Duty Hour … September 16, 2009
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Hospitals
Health
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psnet.ahrq.gov/issue/evaluating-efforts-optimize-teamstepps-implementation-surgical-and-pediatric-intensive-care
April 12, 2014 - results in durable provider behavior change. … In this AHRQ-funded study, the TeamSTEPPS training program was introduced in two intensive care units … The program resulted in improvement in directly observed team behaviors and measures of safety culture … hospital practice: factors associated with turnover, outcomes, and patient safety. … Attitudes and barriers to a medical emergency team system at a tertiary paediatric hospital
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psnet.ahrq.gov/issue/patient-safety-general-practice-during-covid-19-descriptive-analysis-38-countries-pricov-19
November 16, 2022 - in 38 countries (PRICOV-19). … Patient safety in general practice during COVID-19: a descriptive analysis in 38 countries (PRICOV-19 … Patient safety in general practice during COVID-19: a descriptive analysis in 38 countries (PRICOV-19 … care units and hospital emergency services. … March 9, 2022
Inappropriate hospital admission as a risk factor for the subsequent development
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psnet.ahrq.gov/issue/work-patterns-and-fatigue-related-risk-among-junior-doctors
July 29, 2020 - Mandated work hour restrictions for physicians-in-training began in 2003. … Three practice theoretical perspectives on medication administration technologies in nursing. … June 15, 2016
Community-acquired and hospital-acquired medication harm among older inpatients … February 28, 2024
Public opinion of resident physician work hours in 2022. … June 26, 2019
Associations between in-hospital mortality, health care utilization, and
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psnet.ahrq.gov/issue/comparison-medication-administration-errors-original-medication-packaging-and-multi
July 24, 2024 - medication administration errors from original medication packaging and multi-compartment compliance aids in … September 6, 2023
6-PACK programme to decrease fall injuries in acute hospitals: cluster … June 8, 2010
Realist synthesis of intentional rounding in hospital wards: exploring the … evidence of what works, for whom, in what circumstances and why. … against the NHS in England 1995-2007.