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psnet.ahrq.gov/node/38402/psn-pdf
February 11, 2009 - Near misses: paradoxical realities in everyday clinical
practice.
February 11, 2009
Jeffs L, Affonso DD, Macmillan K. Near misses: paradoxical realities in everyday clinical practice. Int J Nurs
Pract. 2008;14(6):486-94. doi:10.1111/j.1440-172X.2008.00724.x.
https://psnet.ahrq.gov/issue/near-misses-paradoxical-rea…
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psnet.ahrq.gov/node/47977/psn-pdf
August 14, 2019 - Reducing Diagnostic Error: Measurement Considerations.
August 14, 2019
National Quality Forum
https://psnet.ahrq.gov/issue/reducing-diagnostic-error-measurement-considerations
This website tracks the progress of a project focused on the development and review of measures to
enhance viability, reporting, accountabi…
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psnet.ahrq.gov/node/36744/psn-pdf
August 02, 2011 - Nurses relate the contributing factors involved in
medication errors.
August 2, 2011
Tang F-I, Sheu S-J, Yu S, et al. Nurses relate the contributing factors involved in medication errors. J Clin
Nurs. 2007;16(3):447-57.
https://psnet.ahrq.gov/issue/nurses-relate-contributing-factors-involved-medication-errors
The…
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psnet.ahrq.gov/node/42130/psn-pdf
June 10, 2018 - Survey results: community liaison programs to decrease
hospital readmissions.
June 10, 2018
ISMP Medication Safey Alert! Acute Care Edition. March 7, 2013;18:1-3.
https://psnet.ahrq.gov/issue/survey-results-community-liaison-programs-decrease-hospital-readmissions
This newsletter article details the characteristic…
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psnet.ahrq.gov/node/38398/psn-pdf
February 11, 2009 - Laparoscopic bile duct injury: understanding the
psychology and heuristics of the error.
February 11, 2009
Dekker SWA, Hugh TB. Laparoscopic bile duct injury: understanding the psychology and heuristics of the
error. ANZ J Surg. 2008;78(12):1109-14. doi:10.1111/j.1445-2197.2008.04761.x.
https://psnet.ahrq.gov/issu…
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www.ahrq.gov/research/index.html
Research
EPC Evidence-Based Reports
Search complete titles of released evidence reports
MEPS Statistical Briefs
The most complete data source on cost a…
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digital.ahrq.gov/ahrq-funded-projects/infosage-information-sharing-across-generation-and-environments/citation/preferences
January 01, 2023 - Information sharing preferences of older patients and their families.
Citation
Crotty BH, Walker J, Dierks M, Lipsitz L, O'Brien J, Fischer S, Slack WV, Safran C. Information sharing preferences of older patients and their families. JAMA Intern Med. 2015 Sep;175(9):1492-7. doi: 10.1001/jamainternmed.2…
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digital.ahrq.gov/ahrq-funded-projects/infosage-information-sharing-across-generation-and-environments/citation/addressing
January 01, 2023 - Addressing the challenges of aging: how elders and their care partners seek information.
Citation
Walker J, Crotty BH, O'Brien J, et al. Addressing the challenges of aging: how elders and their care partners seek information. Gerontologist 2017 Oct 1;57(5):955-962. PMID: 27053506.
Link
https:…
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psnet.ahrq.gov/node/43534/psn-pdf
January 22, 2016 - Creating a fellowship curriculum in patient safety and
quality.
January 22, 2016
Abookire SA, Gandhi TK, Kachalia A, et al. Creating a Fellowship Curriculum in Patient Safety and Quality.
Am J Med Qual. 2016;31(1):27-30. doi:10.1177/1062860614549012.
https://psnet.ahrq.gov/issue/creating-fellowship-curriculum-pati…
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psnet.ahrq.gov/node/36966/psn-pdf
June 20, 2007 - Second Annual Nursing Leadership Congress: "Building
the Foundation for a Culture of Safety" conference
proceedings.
June 20, 2007
J Patient Saf. 2007;3(2):67-106.
https://psnet.ahrq.gov/issue/second-annual-nursing-leadership-congress-building-foundation-culture-safety-
conference
The authors summarize sessions …
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psnet.ahrq.gov/node/36973/psn-pdf
January 02, 2011 - The APSF: 20-year anniversary of the first patient safety
organization: past, present & future.
January 2, 2011
Cooper JB. APSF Newsletter. 2007;22(1):1,3.
https://psnet.ahrq.gov/issue/apsf-20-year-anniversary-first-patient-safety-organization-past-present-future
The author recounts the launch of the Anesthesia Pa…
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psnet.ahrq.gov/node/37704/psn-pdf
April 23, 2008 - Decreasing paediatric prescribing errors in a district
general hospital.
April 23, 2008
Davey AL, Britland A, Naylor RJ. Decreasing paediatric prescribing errors in a district general hospital.
Qual Saf Health Care. 2008;17(2):146-9. doi:10.1136/qshc.2006.021212.
https://psnet.ahrq.gov/issue/decreasing-paediatric-…
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www.ahrq.gov/news/noi-hsr-dept-boarding.html
January 01, 2025 - AHRQ Announces Interest in Health Services Research to Reduce Emergency Department Boarding and Hospital Crowding
A new Special Emphasis Notice from AHRQ signals the agency’s interest in receiving health services research grant applications for addressing Emergency Department (ED) boarding and hospital crowdi…
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digital.ahrq.gov/ahrq-funded-projects/electronic-health-record-linked-decision-support-communicating-genomic-data/citation/user
January 01, 2023 - User-centered design of multi-gene sequencing panel reports for clinicians.
Citation
Cutting E, Banchero M, Beitelshees AL, et al. User-centered design of multi-gene sequencing panel reports for clinicians. J Biomed Inform 2016 Oct;63:1-10. PMID: 27423699.
Link
https://www.ncbi.nlm.nih.gov/pub…
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digital.ahrq.gov/ahrq-funded-projects/evaluating-impact-acpoecds-system-outcomes/citation/prescriber
January 01, 2023 - Prescriber and staff perceptions of an electronic prescribing system in primary care: a qualitative assessment.
Citation
Devine EB, Williams EC, Martin DP, et al. Prescriber and staff perceptions of an electronic prescribing system in primary care: a qualitative assessment. BMC Med Inform Decis Mak 20…
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digital.ahrq.gov/ahrq-funded-projects/minimizing-stress-maximizing-success-physicians-use-health-information/citation/electronic
January 01, 2023 - The electronic elephant in the room: physicians and the electronic health record.
Citation
Kroth PJ, Morioka-Douglas N, Veres S, et al. The electronic elephant in the room: Physicians and the electronic health record. JAMIA Open. 2018 Jul; 1(1):49-56.
Link
https://academic.oup.com/jamia…
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digital.ahrq.gov/ahrq-funded-projects/pilot-testing-electronic-prescribing-standards/citation/provider-views-about
January 01, 2023 - Provider views about responsibility for medication adherence and content of physician-older patient discussions.
Citation
Tarn DM, Mattimore TJ, Bell DS, et al. Provider views about responsibility for medication adherence and content of physician-older patient discussions. J Am Geriatr Soc 2012 Jun;60…
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digital.ahrq.gov/ahrq-funded-projects/perception-and-use-patient-care-window-improve-care-and-family-engagement/citation/perception
January 01, 2023 - Nurses’ perceptions of a novel health information technology: a qualitative study in the pediatric intensive care unit.
Citation
Asan O, Flynn K, Azam L, et al. Nurses’ perceptions of a novel health information technology: a qualitative study in the pediatric intensive care unit. Int J Hum Comput Inte…
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digital.ahrq.gov/ahrq-funded-projects/clinical-decision-support-mild-traumatic-brain-injury/citation/understanding
January 01, 2023 - Understanding overuse of computed tomography for minor head injury in the emergency department: a triangulated qualitative study.
Citation
Melnick ER, Shafer K, Rodulfo N, et al. Understanding overuse of computed tomography for minor head injury in the emergency department: a triangulated qualitative …
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digital.ahrq.gov/ahrq-funded-projects/using-location-based-smartphone-alerts-within-system-care-coordination/citation/doctor
January 01, 2023 - "The doctor needs to know": acceptability of smartphone location tracking for care coordination.
Citation
Liss DT, Serrano E, Wakeman J, et al. "The doctor needs to know": acceptability of smartphone location tracking for care coordination. JMIR Mhealth Uhealth 2018 May 4;6(5):e112. PMID: 29728349.
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