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psnet.ahrq.gov/node/39302/psn-pdf
February 17, 2010 - Preoperative briefing in the operating room: shared
cognition, teamwork, and patient safety.
February 17, 2010
Einav Y, Gopher D, Kara I, et al. Preoperative briefing in the operating room: shared cognition, teamwork,
and patient safety. Chest. 2010;137(2):443-9. doi:10.1378/chest.08-1732.
https://psnet.ahrq.gov/i…
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psnet.ahrq.gov/node/38229/psn-pdf
November 18, 2016 - SQUIRE 2.0 (Standards for QUality Improvement
Reporting Excellence): revised publication guidelines
from a detailed consensus process.
November 18, 2016
Ogrinc G, Davies L, Goodman D, et al. SQUIRE 2.0 (Standards for QUality Improvement Reporting
Excellence): revised publication guidelines from a detailed consensu…
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psnet.ahrq.gov/node/46612/psn-pdf
February 22, 2018 - Influencing organisational culture to improve hospital
performance in care of patients with acute myocardial
infarction: a mixed-methods intervention study.
February 22, 2018
Curry LA, Brault MA, Linnander EL, et al. Influencing organisational culture to improve hospital
performance in care of patients with acute …
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psnet.ahrq.gov/node/845357/psn-pdf
March 29, 2023 - Reducing hospital harm: establishing a command centre
to foster situational awareness.
March 29, 2023
Collins B. Reducing hospital harm: establishing a command centre to foster situational awareness. Healthc
Q. 2022;25(2):75-81. doi:10.12927/hcq.2022.26885.
https://psnet.ahrq.gov/innovation/reducing-hospital-harm-…
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psnet.ahrq.gov/node/35854/psn-pdf
February 09, 2011 - Safe but sound: patient safety meets evidence-based
medicine.
February 9, 2011
Shojania KG, Duncan BW, McDonald KM, et al. Safe but Sound. JAMA. 2003;288(4):508-513.
doi:10.1001/jama.288.4.508.
https://psnet.ahrq.gov/issue/safe-sound-patient-safety-meets-evidence-based-medicine
This commentary summarizes the work…
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psnet.ahrq.gov/node/45905/psn-pdf
December 22, 2017 - Safe practice recommendations for the use of copy-
forward with nursing flow sheets in hospital settings.
December 22, 2017
Patterson ES, Sillars DM, Staggers N, et al. Safe Practice Recommendations for the Use of Copy-Forward
with Nursing Flow Sheets in Hospital Settings. Jt Comm J Qual Patient Saf. 2017;43(8):375…
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psnet.ahrq.gov/node/45730/psn-pdf
December 14, 2016 - Identification of priorities for improvement of medication
safety in primary care: a PRIORITIZE study.
December 14, 2016
Car LT, Papachristou N, Gallagher J, et al. Identification of priorities for improvement of medication safety
in primary care: a PRIORITIZE study. BMC Fam Pract. 2016;17(1):160.
https://psnet.ah…
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psnet.ahrq.gov/node/45684/psn-pdf
January 01, 2020 - A multilevel analysis of U.S. hospital patient safety
culture relationships with perceptions of voluntary event
reporting.
June 29, 2017
Burlison JD, Quillivan RR, Kath LM, et al. A Multilevel Analysis of U.S. Hospital Patient Safety Culture
Relationships With Perceptions of Voluntary Event Reporting. J Patient Sa…
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psnet.ahrq.gov/node/73241/psn-pdf
May 12, 2021 - Delayed or failure to follow-up abnormal breast cancer
screening mammograms in primary care: a systematic
review.
May 12, 2021
Reece JC, Neal EFG, Nguyen P, et al. Delayed or failure to follow-up abnormal breast cancer screening
mammograms in primary care: a systematic review. BMC Cancer. 2021;21(1):373. doi:10.11…
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psnet.ahrq.gov/node/38354/psn-pdf
September 24, 2010 - Barriers to emergency departments' adherence to four
medication safety–related Joint Commission National
Patient Safety Goals.
September 24, 2010
Juarez A, Gacki-Smith J, Bauer MR, et al. Barriers to emergency departments' adherence to four
medication safety-related Joint Commission National Patient Safety Goals. …
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psnet.ahrq.gov/node/39970/psn-pdf
January 22, 2017 - Hospital board checklist to improve culture and reduce
central line–associated bloodstream infections.
January 22, 2017
Goeschel CA, Holzmueller CG, Pronovost P. Hospital Board Checklist to improve culture and reduce
central line-associated bloodstream infections. Jt Comm J Qual Patient Saf. 2010;36(11):525-8.
htt…
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psnet.ahrq.gov/node/37910/psn-pdf
February 28, 2011 - Public reporting of antibiotic timing in patients with
pneumonia: lessons from a flawed performance measure.
February 28, 2011
Wachter R, Flanders S, Fee C, et al. Public reporting of antibiotic timing in patients with pneumonia:
lessons from a flawed performance measure. Ann Intern Med. 2008;149(1):29-32.
https:/…
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psnet.ahrq.gov/node/37327/psn-pdf
March 03, 2011 - Patterns of technical error among surgical malpractice
claims: an analysis of strategies to prevent injury to
surgical patients.
March 3, 2011
Regenbogen SE, Greenberg CC, Studdert DM, et al. Patterns of technical error among surgical malpractice
claims: an analysis of strategies to prevent injury to surgical pati…
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psnet.ahrq.gov/node/37254/psn-pdf
January 02, 2017 - Creating a fair and just culture: one institution's path
toward organizational change.
January 2, 2017
Connor M, Duncombe D, Barclay E, et al. Creating a fair and just culture: one institution's pat toward
organizational change. Jt Comm J Qual Patient Saf. 2007;33(10):617-24.
https://psnet.ahrq.gov/issue/creating-…
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psnet.ahrq.gov/node/43547/psn-pdf
July 03, 2016 - Health care-associated infections among critically ill
children in the US, 2007-2012.
July 3, 2016
Patrick SW, Kawai AT, Kleinman K, et al. Health care-associated infections among critically ill children in
the US, 2007-2012. Pediatrics. 2014;134(4):705-712. doi:10.1542/peds.2014-0613.
https://psnet.ahrq.gov/issue…
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psnet.ahrq.gov/node/39822/psn-pdf
February 17, 2011 - The disclosure dilemma—large-scale adverse events.
February 17, 2011
Dudzinski DM, Hébert PC, Foglia MB, et al. The disclosure dilemma--large-scale adverse events. New Engl
J Med. 2010;363(10):978-986. doi:10.1056/NEJMhle1003134.
https://psnet.ahrq.gov/issue/disclosure-dilemma-large-scale-adverse-events
Error disc…
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psnet.ahrq.gov/node/43091/psn-pdf
May 30, 2014 - Development of a professionalism committee approach to
address unprofessional medical staff behavior at an
academic medical center.
May 30, 2014
Speck RM, Foster JJ, Mulhern VA, et al. Development of a professionalism committee approach to address
unprofessional medical staff behavior at an academic medical center…
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psnet.ahrq.gov/node/38455/psn-pdf
January 02, 2017 - Clinical triggers: an alternative to a rapid response team.
January 2, 2017
Moldenhauer K, Sabel A, Chu ES, et al. Clinical triggers: an alternative to a rapid response team. Jt Comm
J Qual Patient Saf. 2009;35(3):164-74.
https://psnet.ahrq.gov/issue/clinical-triggers-alternative-rapid-response-team
A national cam…
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psnet.ahrq.gov/node/39839/psn-pdf
November 07, 2011 - The disparity of frontline clinical staff and managers'
perceptions of a quality and patient safety initiative.
November 7, 2011
Parand A, Burnett S, Benn J, et al. The disparity of frontline clinical staff and managers' perceptions of a
quality and patient safety initiative. J Eval Clin Pract. 2011;17(6):1184-90. …
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psnet.ahrq.gov/node/44096/psn-pdf
November 03, 2015 - Incidence of "never events" among weekend admissions
versus weekday admissions to US hospitals: national
analysis.
November 3, 2015
Attenello FJ, Wen T, Cen SY, et al. Incidence of "never events" among weekend admissions versus
weekday admissions to US hospitals: national analysis. BMJ. 2015;350:h1460. doi:10.1136…