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effectivehealthcare.ahrq.gov/sites/default/files/zikmund.pdf
May 29, 2025 - Zikmund
Slide
1: The
Right Tool is What They
Need, Not What We
Have: A Taxonomy
of Appropriate
Levels of Precision in Patient Risk Communication
Brian J. Zikmund-‐Fisher, Ph.D.
Assistant Professor, Health Behavior & Health Education
University of Michigan School of…
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psnet.ahrq.gov/node/60844/psn-pdf
August 26, 2020 - Surgical errors happen, but are learners trained to
recover from them? A survey of North American surgical
residents and fellows.
August 26, 2020
Gabrysz-Forget F, Young M, Zahabi S, et al. Surgical errors happen, but are learners trained to recover
from them? A survey of North American surgical residents and fell…
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psnet.ahrq.gov/node/33662/psn-pdf
January 01, 2008 - particular hospital, but it captured all the salient features of some of the terrible things that happened
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psnet.ahrq.gov/node/843080/psn-pdf
January 25, 2023 - Bad things can happen: are medical students aware of
patient centered care and safety?
January 25, 2023
Gillissen A, Kochanek T, Zupanic M, et al. Bad things can happen: are medical students aware of patient
centered care and safety? Diagnosis (Berl). 2023;10(2):110-120. doi:10.1515/dx-2022-0072.
https://psnet.ahr…
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psnet.ahrq.gov/node/60877/psn-pdf
September 02, 2020 - When bad things happen: training medical students to
anticipate the aftermath of medical errors.
September 2, 2020
Musunur S, Waineo E, Walton E, et al. When bad things happen: training medical students to anticipate the
aftermath of medical errors. Acad Psychiatry. 2020;44(5):586-591. doi:10.1007/s40596-020-01278-…
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psnet.ahrq.gov/node/45664/psn-pdf
July 02, 2017 - Intraoperative adverse events in abdominal surgery: what
happens in the operating room does not stay in the
operating room.
July 2, 2017
Bohnen JD, Mavros MN, Ramly EP, et al. Intraoperative Adverse Events in Abdominal Surgery: What
Happens in the Operating Room Does Not Stay in the Operating Room. Ann Surg. 2017;…
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psnet.ahrq.gov/node/838180/psn-pdf
January 01, 2023 - To err is human, but what happens when surgeons err?
September 28, 2022
Lin JS, Olutoye OO, Samora JB. To err is human, but what happens when surgeons err? J Pediatr Surg.
2023;58(3):496-502. doi:10.1016/j.jpedsurg.2022.06.019.
https://psnet.ahrq.gov/issue/err-human-what-happens-when-surgeons-err
Clinicians involv…
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psnet.ahrq.gov/node/850356/psn-pdf
June 14, 2023 - Prescribing errors in children: why they happen and how
to prevent them.
June 14, 2023
Conn R, Fox A, Carrington A, et al. Prescribing errors in children: why they happen and how to prevent
them. Pharmaceutical Journal. 2023;310:7973. doi:10.1211/pj.2023.1.184013.
https://psnet.ahrq.gov/issue/prescribing-errors-ch…
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psnet.ahrq.gov/node/42567/psn-pdf
September 11, 2013 - What happens to the medication regimens of older adults
during and after an acute hospitalization?
September 11, 2013
Harris CM, Sridharan A, Landis R, et al. What happens to the medication regimens of older adults during
and after an acute hospitalization? J Patient Saf. 2013;9(3):150-3. doi:10.1097/PTS.0b013e3182…
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psnet.ahrq.gov/node/36149/psn-pdf
September 29, 2010 - When incidents happen.
September 29, 2010
Newfield JS. When Incidents Happen. Home Health Care Manag Pract. 2006;18(5).
doi:10.1177/1084822306287998.
https://psnet.ahrq.gov/issue/when-incidents-happen
The author discusses post-incident documentation for the home care setting and addresses legal issues.
https://ps…
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psnet.ahrq.gov/node/45874/psn-pdf
February 22, 2017 - Ethics in the pediatric emergency department: when
mistakes happen: an approach to the process, evaluation,
and response to medical errors.
February 22, 2017
Dreisinger N, Zapolsky N. Ethics in the Pediatric Emergency Department: When Mistakes Happen: An
Approach to the Process, Evaluation, and Response to Medical…
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psnet.ahrq.gov/node/39923/psn-pdf
September 03, 2014 - Sued for misdiagnosis? It could happen to you.
September 3, 2014
Lippman H, Davenport J. Sued for misdiagnosis? It could happen to you. J Fam Pract. 2010;59(9):498-508.
https://psnet.ahrq.gov/issue/sued-misdiagnosis-it-could-happen-you
This article explains how to avoid diagnostic error, minimize litigation, and pr…
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psnet.ahrq.gov/node/47757/psn-pdf
February 06, 2019 - Doctors make mistakes. A new documentary explores
what happens when they do—and how to fix it.
February 6, 2019
Park A. Time Magazine. January 24, 2019.
https://psnet.ahrq.gov/issue/doctors-make-mistakes-new-documentary-explores-what-happens-when-they-
do-and-how-fix-it
This news article reports on the documentar…
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psnet.ahrq.gov/node/38215/psn-pdf
November 14, 2011 - Could it happen here? Learning from other organizations'
safety errors.
November 14, 2011
Conway JB. Could it happen here? Learning from other organizations' safety errors. Healthcare Executive.
2008;23(6):64, 66-67.
https://psnet.ahrq.gov/issue/could-it-happen-here-learning-other-organizations-safety-errors
This…
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psnet.ahrq.gov/node/40194/psn-pdf
June 20, 2011 - What happens when things go wrong?
June 20, 2011
Brandom BW, Callahan P, Micalizzi DA. What happens when things go wrong? Paediatr Anaesth.
2011;21(7):730-6. doi:10.1111/j.1460-9592.2010.03513.x.
https://psnet.ahrq.gov/issue/what-happens-when-things-go-wrong
This commentary reveals a personal story of loss and dis…
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psnet.ahrq.gov/node/39489/psn-pdf
June 11, 2010 - What happens between visits? Adverse and potential
adverse events among a low-income, urban, ambulatory
population with diabetes.
June 11, 2010
Sarkar U, Handley MA, Gupta R, et al. What happens between visits? Adverse and potential adverse
events among a low-income, urban, ambulatory population with diabetes. Qua…
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psnet.ahrq.gov/node/35181/psn-pdf
June 23, 2009 - Communication during trauma resuscitation: do we know
what is happening?
June 23, 2009
Bergs EAG, Rutten FLPA, Tadros T, et al. Communication during trauma resuscitation: do we know what is
happening? Injury. 2005;36(8):905-11.
https://psnet.ahrq.gov/issue/communication-during-trauma-resuscitation-do-we-know-what-…
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psnet.ahrq.gov/node/44359/psn-pdf
January 06, 2016 - What happens when healthcare innovations collide?
January 6, 2016
Pendharkar SR, Woiceshyn J, da Silveira GJC, et al. What happens when healthcare innovations collide?
BMJ Qual Saf. 2016;25(1):9-13. doi:10.1136/bmjqs-2015-004441.
https://psnet.ahrq.gov/issue/what-happens-when-healthcare-innovations-collide
Innovat…
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psnet.ahrq.gov/node/44132/psn-pdf
May 13, 2015 - Adverse outcomes: why bad things happen to good
people.
May 13, 2015
Sonnenberg A. Adverse outcomes: why bad things happen to good people. Clin Gastroenterol Hepatol.
2015;13(5):820-3.e1. doi:10.1016/j.cgh.2014.07.064.
https://psnet.ahrq.gov/issue/adverse-outcomes-why-bad-things-happen-good-people
This commentary…
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psnet.ahrq.gov/node/46506/psn-pdf
October 11, 2017 - Getting Ahead of Harm Before It Happens: A Guide About
Proactive Analysis for Improving Surgical Care Safety.
October 11, 2017
Wiley K, Davies JM. Edmonton, AB: Canadian Patient Safety Institute; 2017.
https://psnet.ahrq.gov/issue/getting-ahead-harm-it-happens-guide-about-proactive-analysis-improving-
surgical-car…