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201. Trust and Safety. | PSNet
     psnet.ahrq.gov/issue/trust-missing-pieces-safety-puzzle
     November 09, 2022 - November 28, 2018 Addressing the quality and safety gap—parts I-III.

202. Fighting a common enemy: a catalyst to close intractable safety gaps. | PSNet
     psnet.ahrq.gov/issue/fighting-common-enemy-catalyst-close-intractable-safety-gaps
     June 30, 2021 - Citation Related Resources From the Same Author(s) Bridging the feedback gap

203. Disclosing harmful medical errors to patients: tackling three tough cases. | PSNet
     psnet.ahrq.gov/issue/disclosing-harmful-medical-errors-patients-tackling-three-tough-cases
     December 19, 2018 - This article uses case reports to highlight challenging disclosure dilemmas and examine the gap between

204. ISMP Medication Safety Self Assessment for Hospitals. | PSNet
     psnet.ahrq.gov/issue/ismp-medication-safety-self-assessment-hospitals
     April 17, 2024 - February 6, 2019 ISMP Gap Analysis Tool (GAT) for Safe IV Push Medication Practices.

205. The Transforming Care at the Bedside (TCAB) Toolkit. | PSNet
     psnet.ahrq.gov/issue/transforming-care-bedside-tcab-toolkit
     January 17, 2024 - April 3, 2013 Addressing the quality and safety gap—parts I-III.

206. ISMP List of Error-Prone Abbreviations, Symbols, and Dose Designations. | PSNet
     psnet.ahrq.gov/issue/ismp-list-error-prone-abbreviations-symbols-and-dose-designations
     January 14, 2024 - February 6, 2019 ISMP Gap Analysis Tool (GAT) for Safe IV Push Medication Practices.

207. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/46173/psn-pdf
     August 20, 2018 - An overarching theme of these studies is the gap between recommended communication practices and usual

208. Patient safety at ten: unmistakable progress, troubling gaps. | PSNet
     psnet.ahrq.gov/issue/patient-safety-ten-unmistakable-progress-troubling-gaps
     March 02, 2011 - Commentary Classic Patient safety at ten: unmistakable progress, troubling gaps. Citation Text: Wachter R. Patient safety at ten: unmistakable progress, troubling gaps. Health Aff (Millwood). 2010;29(1):165-173. doi:10.1377/hlthaff.2009.0785. Copy Citation …

209. Bridging gaps in handoffs: a continuity of care based approach. | PSNet
     psnet.ahrq.gov/issue/bridging-gaps-handoffs-continuity-care-based-approach
     January 07, 2015 - Study Bridging gaps in handoffs: a continuity of care based approach. Citation Text: Abraham J, Kannampallil TG, Patel VL. Bridging gaps in handoffs: a continuity of care based approach. J Biomed Inform. 2012;45(2):240-54. doi:10.1016/j.jbi.2011.10.011. Copy Citation Format: …

210. Confronting safety gaps across labor and delivery teams. | PSNet
     psnet.ahrq.gov/issue/confronting-safety-gaps-across-labor-and-delivery-teams
     December 04, 2013 - Study Confronting safety gaps across labor and delivery teams. Citation Text: Maxfield DG, Lyndon A, Kennedy HP, et al. Confronting safety gaps across labor and delivery teams. Am J Obstet Gynecol. 2013;209(5). doi:10.1016/j.ajog.2013.07.013. Copy Citation Format: DOI Googl…

211. Gaps in ambulatory patient safety for immunosuppressive specialty medications. | PSNet
     psnet.ahrq.gov/issue/gaps-ambulatory-patient-safety-immunosuppressive-specialty-medications
     November 19, 2018 - Study Gaps in ambulatory patient safety for immunosuppressive specialty medications. Citation Text: Patterson S, Schmajuk G, Evans M, et al. Gaps in Ambulatory Patient Safety for Immunosuppressive Specialty Medications. Jt Comm J Qual Patient Saf. 2019;45(5):348-357. doi:10.1016/j.jcjq.2…

212. Request for proposals for clinical quality measures to improve diagnosis. | PSNet
     psnet.ahrq.gov/issue/request-proposals-clinical-quality-measures-improve-diagnosis
     December 17, 2008 - A lack of consensus on measures for the effectiveness and accuracy of diagnosis represents a  gap  in

213. Prolonged DKA in Pregnancy: A Case of Communication Breakdown. | PSNet
     psnet.ahrq.gov/web-mm/prolonged-dka-pregnancy-case-communication-breakdown
     June 28, 2023 - urea nitrogen (BUN) to creatinine ratio of 15 (suggesting mild volume depletion), an elevated anion gap … ’s symptoms persisted, and she developed a progressively worsening metabolic acidosis with an anion gap … The patient’s care was assumed by the obstetrics team, and within 12 hours her anion gap was closed. … U: I’m uncomfortable with her anion gap increasing. S: This is a patient safety issue .

214. High-Alert Medication Learning Guides for Consumers. | PSNet
     psnet.ahrq.gov/issue/high-alert-medication-learning-guides-consumers
     April 30, 2019 - Copy Citation Related Resources From the Same Author(s) ISMP Gap Analysis

215. Do doctors understand test results? | PSNet
     psnet.ahrq.gov/issue/do-doctors-understand-test-results
     February 12, 2020 - October 3, 2017 Gap assessment of hospitals' adoption of the just culture principles.

216. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/45190/psn-pdf
     February 15, 2017 - weekend-mortality-emergency-admissions-large-multicentre-study https://psnet.ahrq.gov/issue/comprehensive-stroke-centers-overcome-weekend-versus-weekday-gap-stroke-treatment-and

217. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/44427/psn-pdf
     October 13, 2015 - practices that were common among the top performers were financial incentives, problem-oriented charting, gap

218. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/43690/psn-pdf
     March 26, 2015 - These findings are consistent with prior studies of error disclosure, but demonstrate a gap in frontline

219. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/43630/psn-pdf
     April 15, 2016 - This gap between patient reports and hospital documentation emphasizes the ongoing challenge of safe

220. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/45167/psn-pdf
     May 25, 2016 - The toolkit includes videos, slides, gap analysis assessments and teaching materials.