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Too many, too few, or too unsafe? Impact of inappropriate prescribing on mortality, and hospitalization in a cohort of community-dwelling oldest old. | PSNet

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December 02, 2020 - Study Too many, too few, or too unsafe? Impact of inappropriate prescribing on mortality, and hospitalization in a cohort of community-dwelling oldest old. Citation Text: Wauters M, Elseviers M, Vaes B, et al. Too many, too few, or too unsafe? Impact of inappropriate prescribing on morta…

Using Safety-II and resilient healthcare principles to learn from Never Events. | PSNet

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February 20, 2019 - Study Using Safety-II and resilient healthcare principles to learn from Never Events. Citation Text: Anderson JE, Watt AJ. Using Safety-II and resilient healthcare principles to learn from Never Events. Int J Qual Health Care. 2020;32(3):196-203. doi:10.1093/intqhc/mzaa009. Copy Citati…

Quantification of the Hawthorne effect in hand hygiene compliance monitoring using an electronic monitoring system: a retrospective cohort study. | PSNet

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July 29, 2020 - Study Classic Quantification of the Hawthorne effect in hand hygiene compliance monitoring using an electronic monitoring system: a retrospective cohort study. Citation Text: Srigley JA, Furness CD, Baker R, et al. Quantification of the Hawthorne effect in hand …

Changes in hospital adverse events and patient outcomes associated with private equity acquisition. | PSNet

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July 12, 2023 - Study Changes in hospital adverse events and patient outcomes associated with private equity acquisition. Citation Text: Kannan S, Bruch JD, Song Z. Changes in hospital adverse events and patient outcomes associated with private equity acquisition. JAMA. 2023;330(24):2365-2375. doi:10.10…

Using incident reports to assess communication failures and patient outcomes. | PSNet

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February 06, 2019 - Study Using incident reports to assess communication failures and patient outcomes. Citation Text: Umberfield E, Ghaferi AA, Krein SL, et al. Using Incident Reports to Assess Communication Failures and Patient Outcomes. Jt Comm J Qual Patient Saf. 2019;45(6):406-413. doi:10.1016/j.jcjq.2…

How can never event data be used to reflect or improve hospital safety performance? | PSNet

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March 30, 2022 - Study How can never event data be used to reflect or improve hospital safety performance? Citation Text: Olivarius‐McAllister J, Pandit M, Sykes A, et al. How can never event data be used to reflect or improve hospital safety performance? Anaesthesia. 2021;76(12):1616-1624. doi:10.1111/a…

Insurance claims for wrong-side, wrong-organ, wrong-procedure, or wrong-person surgical errors: a retrospective study for 10 years. | PSNet

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October 20, 2021 - Study Insurance claims for wrong-side, wrong-organ, wrong-procedure, or wrong-person surgical errors: a retrospective study for 10 years. Citation Text: Vacheron C-H, Acker A, Autran M, et al. Insurance claims for wrong-side, wrong-organ, wrong-procedure, or wrong-person surgical errors:…

Incidence and root cause analysis of wrong-site pain management procedures: a multicenter study. | PSNet

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April 29, 2020 - Study Incidence and root cause analysis of wrong-site pain management procedures: a multicenter study. Citation Text: Cohen SP, Hayek SM, Datta S, et al. Incidence and root cause analysis of wrong-site pain management procedures: a multicenter study. Anesthesiology. 2010;112(3):711-8. d…

Laboratory test ordering and results management systems: a qualitative study of safety risks identified by administrators in general practice. | PSNet

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March 16, 2016 - Study Laboratory test ordering and results management systems: a qualitative study of safety risks identified by administrators in general practice. Citation Text: Bowie P, Halley L, McKay J. Laboratory test ordering and results management systems: a qualitative study of safety risks id…

Wrong-site surgery, retained surgical items, and surgical fires: a systematic review of surgical never events. | PSNet

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March 13, 2013 - Review Wrong-site surgery, retained surgical items, and surgical fires: a systematic review of surgical never events. Citation Text: Hempel S, Maggard-Gibbons M, Nguyen DK, et al. Wrong-Site Surgery, Retained Surgical Items, and Surgical Fires : A Systematic Review of Surgical Never Even…

Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. | PSNet

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April 05, 2013 - Study Classic Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. Citation Text: Shanafelt TD, Hasan O, Dyrbye LN, et al. Changes in Burnout and Satisfaction With Work-Life Balance…

Systematic workup of transfusion reactions reveals passive co-reporting of handling errors. | PSNet

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December 21, 2016 - Study Systematic workup of transfusion reactions reveals passive co-reporting of handling errors. Citation Text: Nitsche E, Dreßler J, Henschler R. Systematic workup of transfusion reactions reveals passive co-reporting of handling errors. J Blood Med. 2023;14:435-443. doi:10.2147/jbm.s4…

Development of the Leapfrog Group's bar code medication administration standard to address hospital inpatient medication safety. | PSNet

psnet.ahrq.gov/issue/development-leapfrog-groups-bar-code-medication-administration-standard-address-hospital

November 10, 2015 - Commentary Development of the Leapfrog Group's bar code medication administration standard to address hospital inpatient medication safety. Citation Text: Austin JM, Bane A, Gooder V, et al. Development of the Leapfrog Group's bar code medication administration standard to address hospit…

Minimization of occurrence of retained surgical items using machine learning and deep learning techniques: a review. | PSNet

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July 06, 2012 - Review Minimization of occurrence of retained surgical items using machine learning and deep learning techniques: a review. Citation Text: Abo-Zahhad M, El-Malek AHA, Sayed MS, et al. Minimization of occurrence of retained surgical items using machine learning and deep learning technique…

How to avoid catastrophic events on the ward. | PSNet

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February 03, 2011 - Review How to avoid catastrophic events on the ward. Citation Text: Bein B, Seewald S, Gräsner J-T. How to avoid catastrophic events on the ward. Best Pract Res Clin Anaesthesiol. 2016;30(2):237-45. doi:10.1016/j.bpa.2016.04.003. Copy Citation Format: DOI Google Scholar Pub…

Associations between hospital characteristics, measure reporting, and the Centers for Medicare & Medicaid Services overall hospital quality star ratings. | PSNet

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February 14, 2017 - Study Associations between hospital characteristics, measure reporting, and the Centers for Medicare & Medicaid Services overall hospital quality star ratings. Citation Text: DeLancey JO, Softcheck J, Chung JW, et al. Associations Between Hospital Characteristics, Measure Reporting, and …

Wrong-site nerve blocks: 10 yr experience in a large multihospital health-care system. | PSNet

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January 14, 2011 - Study Wrong-site nerve blocks: 10 yr experience in a large multihospital health-care system. Citation Text: Hudson ME, Chelly JE, Lichter JR. Wrong-site nerve blocks: 10 yr experience in a large multihospital health-care system. Br J Anaesth. 2015;114(5):818-24. doi:10.1093/bja/aeu490. …

Introduction of a mobile adverse event reporting system is associated with participation in adverse event reporting. | PSNet

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July 03, 2016 - Study Introduction of a mobile adverse event reporting system is associated with participation in adverse event reporting. Citation Text: Rubin DS, Pesyna C, Jakubczyk S, et al. Introduction of a Mobile Adverse Event Reporting System Is Associated With Participation in Adverse Event Repo…

Accuracy of send-out test ordering: a College of American Pathologists Q-Probes study of ordering accuracy in 97 clinical laboratories. | PSNet

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November 12, 2008 - Study Accuracy of send-out test ordering: a College of American Pathologists Q-Probes study of ordering accuracy in 97 clinical laboratories. Citation Text: Valenstein PN, Walsh MK, Stankovic AK. Accuracy of send-out test ordering: a College of American Pathologists Q-Probes study of o…

A qualitative study of why general practitioners may participate in significant event analysis and educational peer assessment. | PSNet

psnet.ahrq.gov/issue/qualitative-study-why-general-practitioners-may-participate-significant-event-analysis-and

October 29, 2008 - Study A qualitative study of why general practitioners may participate in significant event analysis and educational peer assessment. Citation Text: Bowie P, McKay J, Dalgetty E, et al. A qualitative study of why general practitioners may participate in significant event analysis and e…

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