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psnet.ahrq.gov/issue/teaming-prevent-crashes-some-hospitals-give-patients-power-get-extra-help-stat
August 23, 2007 - January 5, 2014
How could this happen?
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psnet.ahrq.gov/node/848124/psn-pdf
April 26, 2023 - Risk prediction is a score that tells you
what might happen to a person, not what will happen. … We would
like to see that happen, and our work is leading in that direction.
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psnet.ahrq.gov/node/33791/psn-pdf
September 01, 2015 - have
this great EHR, you should be harnessing it for safety, but these transcription errors still happen
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psnet.ahrq.gov/issue/lessons-health-care-leaders-rethinking-and-reinvesting-patient-safety
May 01, 2019 - Commentary
Lessons from health care leaders: rethinking and reinvesting in patient safety.
Citation Text:
doi:10.1056/CAT.23.0090.
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DOI BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId RIS
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psnet.ahrq.gov/issue/minnesota-lets-nurses-practice-while-disciplinary-investigations-drag-patients-keep-getting
April 22, 2020 - Newspaper/Magazine Article
Minnesota lets nurses practice while disciplinary investigations drag on. Patients keep getting hurt.
Citation Text:
Minnesota lets nurses practice while disciplinary investigations drag on. Patients keep getting hurt. Hopkins E, Kohler J. ProPublica. April 3, …
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psnet.ahrq.gov/node/33642/psn-pdf
November 01, 2006 - We need to know
that we're nearing that point where, if we don't react, some danger is going to happen … There are two things we can guarantee about these
types of unexpected events: One is that they will happen … , and two, when they happen they will be
unexpected.
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psnet.ahrq.gov/node/33855/psn-pdf
April 01, 2018 - Every patient
is different and things happen in the hospitalization, so to get the acute situation under
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psnet.ahrq.gov/issue/managing-hospitalized-patients-ambulatory-pumps-findings-ismp-survey-part-1
November 18, 2015 - June 19, 2019
Hospitals look to computers to predict patient emergencies before they happen
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psnet.ahrq.gov/issue/err-human-delay-deadly
July 11, 2017 - March 27, 2005
How could this happen?
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psnet.ahrq.gov/issue/please-dont-sleep-through-wake-call
May 07, 2018 - May 3, 2023
Fatal PCA adverse events continue to happen...better patient monitoring is
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psnet.ahrq.gov/issue/electronic-fetal-heart-rate-monitoring-applying-principles-patient-safety
October 10, 2018 - July 29, 2020
Surgical safety does not happen by accident: learning from perioperative
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psnet.ahrq.gov/issue/drawn-curtains-muted-alarms-and-diverted-attention-lead-tragedy-postanesthesia-care-unit
June 10, 2018 - June 10, 2018
Fatal PCA adverse events continue to happen...better patient monitoring
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psnet.ahrq.gov/issue/covid-19-assessing-risk-public-protection-posed-doctor-result-concerns-about-their-practice
July 15, 2015 - September 30, 2020
When bad things happen: training medical students to anticipate the
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psnet.ahrq.gov/issue/patient-safety-article-collection
December 19, 2012 - Multi-use Website
Patient Safety Article Collection.
Citation Text:
Patient Safety Article Collection. American Patient Rights Association. 2012-2022.
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psnet.ahrq.gov/issue/when-surgeon-too-old-operate
February 12, 2016 - Newspaper/Magazine Article
When is the surgeon too old to operate?
Citation Text:
When is the surgeon too old to operate? Span P. New York Times. February 1, 2019.
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psnet.ahrq.gov/issue/mistaking-error
July 06, 2011 - Book/Report
Mistaking error.
Citation Text:
Mistaking error. Cook RI, Woods DD. Chapter in: Youngberg BJ, Hatlie, MJ, ed. Patient Safety Handbook, Sudbury, MA: Jones and Bartlett; 2004.
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psnet.ahrq.gov/node/33845/psn-pdf
November 01, 2017 - WP: I've seen it happen naturally pretty well. … become more self-reliant, then maybe that is not as important, and maybe the interactions that do
happen … about both the additional workload that it would create
and the potential bad interactions that could happen
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psnet.ahrq.gov/node/33700/psn-pdf
October 01, 2010 - there and trying to motivate
change, as opposed to being more prescriptive about how to make change happen … It's not going to happen just by encouraging people to do better. … And we don't have the kind of rigorous investment
that we need to really make things happen.
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psnet.ahrq.gov/node/33765/psn-pdf
April 01, 2014 - First
of all, how did that happen, and second, how did you think it worked? … How did that happen? … objects left in after surgery, and my mother just stared at me and she said, "Wait a minute, that can
happen
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psnet.ahrq.gov/node/33720/psn-pdf
November 01, 2011 - Pilots go from A to B, but a lot of things
can happen in between: unexpected events, crises that they … You project very quickly what's going to happen
after you make that mistake—when golfers kneel down