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psnet.ahrq.gov/node/73466/psn-pdf
July 07, 2021 - COVID-19 and open notes: a new method to enhance
patient safety and trust.
July 7, 2021
Blease CR, Salmi L, Hägglund M, et al. COVID-19 and open notes: a new method to enhance patient
safety and trust. JMIR Ment Health. 2021;8(6):e29314. doi:10.2196/29314.
https://psnet.ahrq.gov/issue/covid-19-and-open-notes-new-m…
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psnet.ahrq.gov/node/866527/psn-pdf
August 14, 2024 - Developing, implementing, evaluating electronic apparent
cause analysis across a health care system.
August 14, 2024
Oster CA, Woods E, Mumma J, et al. Developing, implementing, evaluating electronic apparent cause
analysis across a health care system. Jt Comm J Qual Patient Saf. 2024;50(10):724-736.
doi:10.1016/j…
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psnet.ahrq.gov/node/48019/psn-pdf
June 26, 2019 - Please reconcile, not wait a while.
June 26, 2019
Trivedi A, Sharma S, Ajitsaria R, et al. Please reconcile, not wait a while. Arch Dis Child Educ Pract Ed.
2019;105(2):122-126. doi:10.1136/archdischild-2018-316356.
https://psnet.ahrq.gov/issue/please-reconcile-not-wait-while
Medication reconciliation to ensure ac…
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psnet.ahrq.gov/node/844548/psn-pdf
February 15, 2023 - Use of complete medication history to identify and correct
transitions-of-care medication errors at psychiatric
hospital admission.
February 15, 2023
Vargas V, Blakeslee WW, Banas CA, et al. Use of complete medication history to identify and correct
transitions-of-care medication errors at psychiatric hospital adm…
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psnet.ahrq.gov/node/41646/psn-pdf
September 05, 2012 - Interventions to increase clinical incident reporting in
health care.
September 5, 2012
Parmelli E, Flodgren G, Fraser SG, et al. Interventions to increase clinical incident reporting in health care.
Cochrane Database Syst Rev. 2012;8(8):CD005609. doi:10.1002/14651858.cd005609.pub2.
https://psnet.ahrq.gov/issue/in…
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psnet.ahrq.gov/node/45299/psn-pdf
July 20, 2016 - Reducing readmission at an academic medical center:
results of a pharmacy-facilitated discharge counseling
and medication reconciliation program.
July 20, 2016
Zemaitis CT, Morris G, Cabie M, et al. Reducing Readmission at an Academic Medical Center: Results of a
Pharmacy-Facilitated Discharge Counseling and Medic…
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psnet.ahrq.gov/node/72658/psn-pdf
January 20, 2021 - “I made a mistake!”: a narrative analysis of experienced
physicians' stories of preventable error.
January 20, 2021
Kandasamy S, Vanstone M, Colvin E, et al. “I made a mistake!”: a narrative analysis of experienced
physicians' stories of preventable error. J Eval Clin Pract. 2021;27(2):236-245. doi:10.1111/jep.1353…
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psnet.ahrq.gov/node/46903/psn-pdf
December 04, 2018 - Salzburg Global Seminar Session 565—Better Health
Care: How Do We Learn About Improvement?
December 4, 2018
Massoud MR, Kimble LE, Goldmann D, eds. Int J Qual Health Care. 2018;30(suppl 1):1-41.
https://psnet.ahrq.gov/issue/salzburg-global-seminar-session-565-better-health-care-how-do-we-learn-
about-improvement
…
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psnet.ahrq.gov/node/35300/psn-pdf
March 04, 2011 - How strong is the evidence for the use of perioperative
beta blockers in non-cardiac surgery? Systematic review
and meta-analysis of randomised controlled trials.
March 4, 2011
Devereaux PJ, Beattie WS, Choi PT-L, et al. How strong is the evidence for the use of perioperative ?
blockers in non-cardiac surgery? Sys…
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psnet.ahrq.gov/node/852285/psn-pdf
August 09, 2023 - Risk Evaluation and Mitigation Strategy (REMS) Programs
and Medication Safety: Parts I and II.
August 9, 2023
ISMP Medication Safety Alert! Acute care edition. July 13, 2023;(4):1-3;July 27, 2023;(5):1-5.
https://psnet.ahrq.gov/issue/risk-evaluation-and-mitigation-strategy-rems-programs-and-medication-safety-
part…
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psnet.ahrq.gov/node/45805/psn-pdf
April 12, 2017 - 2016 Updated American Society of Clinical
Oncology/Oncology Nursing Society Chemotherapy
Administration Safety Standards, including standards for
pediatric oncology.
April 12, 2017
Belderson KM, Billett AL. Chemotherapy safety standards: A pediatric perspective. J Oncol Pract.
2017;64(6):e26484. doi:10.1002/pbc.2…
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psnet.ahrq.gov/node/46142/psn-pdf
June 14, 2017 - Introducing a new junior doctor electronic weekend
handover on an orthopaedic ward.
June 14, 2017
Maroo S, Raj D. Introducing a New Junior Doctor Electronic Weekend Handover on an Orthopaedic Ward.
BMJ Qual Improv Rep. 2017;6(1). doi:10.1136/bmjquality.u212695.w5059.
https://psnet.ahrq.gov/issue/introducing-new-ju…
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psnet.ahrq.gov/node/46312/psn-pdf
August 15, 2018 - Improving adherence to long-term opioid therapy
guidelines to reduce opioid misuse in primary care: a
cluster-randomized trial.
August 15, 2018
Liebschutz JM, Xuan Z, Shanahan CW, et al. Improving Adherence to Long-term Opioid Therapy
Guidelines to Reduce Opioid Misuse in Primary Care. JAMA Intern Med. 2017;177(9)…
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psnet.ahrq.gov/node/39046/psn-pdf
October 28, 2009 - Medication reconciliation in ambulatory care: attempts at
improvement.
October 28, 2009
Nassaralla CL, Naessens JM, Hunt VL, et al. Medication reconciliation in ambulatory care: attempts at
improvement. Qual Saf Health Care. 2009;18(5):402-7. doi:10.1136/qshc.2007.024513.
https://psnet.ahrq.gov/issue/medication-re…
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psnet.ahrq.gov/node/37784/psn-pdf
May 27, 2011 - A risk analysis method to evaluate the impact of a
Computerized Provider Order Entry system on patient
safety.
May 27, 2011
Bonnabry P, Despont-Gros C, Grauser D, et al. A risk analysis method to evaluate the impact of a
computerized provider order entry system on patient safety. J Am Med Inform Assoc. 2008;15(4):…
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psnet.ahrq.gov/node/849325/psn-pdf
January 01, 2024 - Medication safety event reporting: factors that contribute
to safety events during times of organizational stress.
May 24, 2023
Cohen TN, Berdahl CT, Coleman BL, et al. Medication safety event reporting: factors that contribute to
safety events during times of organizational stress. J Nurs Care Qual. 2024;39(1):51-…
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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…
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psnet.ahrq.gov/node/48064/psn-pdf
June 12, 2019 - Lives Lost, Lives Saved: An Updated Comparative
Analysis of Avoidable Deaths at Hospitals Graded by The
Leapfrog Group.
June 12, 2019
Austin M, Derk J. Baltimore, MD: Armstrong Institute for Patient Safety and Quality, and Johns Hopkins
Medicine; May 2019.
https://psnet.ahrq.gov/issue/lives-lost-lives-saved-updat…
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www.ahrq.gov/topics/women.html
Topic: Women
The AHRQ Policy on the Inclusion of Priority Populations in Research (NOT-HS-03-010) requires that priority populations be included in all AHRQ-supported research projects involving human subjects, unless a clear and compelling rationale and justification is provided that inclusion is inappropriate. Rese…
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psnet.ahrq.gov/node/837762/psn-pdf
August 03, 2022 - A scoping review of real-time automated clinical
deterioration alerts and evidence of impacts on
hospitalised patient outcomes.
August 3, 2022
Blythe R, Parsons R, White NM, et al. A scoping review of real-time automated clinical deterioration alerts
and evidence of impacts on hospitalised patient outcomes. BMJ Qu…