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psnet.ahrq.gov/issue/role-chief-executive-officers-quality-improvement-qualitative-study
September 17, 2014 - Study
The role of chief executive officers in a quality improvement: a qualitative study.
Citation Text:
Parand A, Dopson S, Vincent CA. The role of chief executive officers in a quality improvement : a qualitative study. BMJ Open. 2013;3(1). doi:10.1136/bmjopen-2012-001731.
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psnet.ahrq.gov/issue/clinical-supervisors-are-they-key-making-care-safer
June 26, 2019 - Commentary
Clinical supervisors: are they the key to making care safer?
Citation Text:
Walton M, Barraclough B. Clinical supervisors: are they the key to making care safer? BMJ Qual Saf. 2013;22(8):609-12. doi:10.1136/bmjqs-2012-001637.
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psnet.ahrq.gov/issue/impact-nurse-peer-review-culture-safety
November 29, 2023 - Commentary
Impact of nurse peer review on a culture of safety.
Citation Text:
Herrington CR, Hand MW. Impact of Nurse Peer Review on a Culture of Safety. J Nurs Care Qual. 2019;34(2):158-162. doi:10.1097/NCQ.0000000000000361.
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psnet.ahrq.gov/node/72811/psn-pdf
September 01, 2022 - Algorithm-Based Decision Support System Guides
Trauma Staff During Initial Treatment, Leading to Fewer
Medical Errors
Originally published on March 3, 2021
Last updated on March 16, 2021
https://psnet.ahrq.gov/innovation/algorithm-based-decision-support-system-guides-trauma-staff-during-
initial-treatment
Summar…
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psnet.ahrq.gov/node/33875/psn-pdf
March 01, 2019 - In Conversation With… Susan Haas, MD, MSc
March 1, 2019
In Conversation With… Susan Haas, MD, MSc. PSNet [internet]. 2019.
https://psnet.ahrq.gov/perspective/conversation-susan-haas-md-msc
Editor's note: Dr. Haas is an obstetrician–gynecologist and co-Principal Investigator for Ariadne Labs'
work focused on health…
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psnet.ahrq.gov/node/866869/psn-pdf
October 02, 2024 - Core Elements of Hospital Diagnostic Excellence (DxEx).
October 2, 2024
Core Elements of Hospital Diagnostic Excellence (DxEx). Centers for Disease Control and Prevention.
https://psnet.ahrq.gov/issue/core-elements-hospital-diagnostic-excellence-dxex
Diagnostic excellence is an expansion of the diagnostic error red…
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psnet.ahrq.gov/node/838147/psn-pdf
July 01, 2020 - Care Compare.
July 1, 2020
Centers for Medicare and Medicaid Services.
https://psnet.ahrq.gov/issue/care-compare
The Centers for Medicare & Medicaid Services (CMS) support transparency through the provision of
publicly available information on the quality of health care service in the United States. This portal en…
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psnet.ahrq.gov/node/60810/psn-pdf
August 12, 2020 - Hospitals Can Take Key Steps to Improve Safe Use of
Digital Systems.
August 12, 2020
Philadelphia, PA: Pew Charitable Trusts; July 21, 2020.
https://psnet.ahrq.gov/issue/hospitals-can-take-key-steps-improve-safe-use-digital-systems
Tracking problems with health information technology (Health IT) is an important st…
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psnet.ahrq.gov/node/38022/psn-pdf
August 27, 2008 - Hospitals try to calm doctors' outbursts: medical road
rage affecting patient safety, group says.
August 27, 2008
Kowalczyk L.
https://psnet.ahrq.gov/issue/hospitals-try-calm-doctors-outbursts-medical-road-rage-affecting-patient-
safety-group-says
This article describes how physician outbursts can affect patient …
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psnet.ahrq.gov/node/39091/psn-pdf
June 28, 2011 - Integration of prospective and retrospective methods for
risk analysis in hospitals.
June 28, 2011
Kessels-Habraken M, van der Schaaf TW, De Jonge J, et al. Integration of prospective and retrospective
methods for risk analysis in hospitals. Int J Qual Health Care. 2009;21(6):427-32.
doi:10.1093/intqhc/mzp043.
ht…
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psnet.ahrq.gov/node/44415/psn-pdf
October 28, 2015 - Medication discrepancies at pediatric hospital discharge.
October 28, 2015
Gattari TB, Krieger LN, Hu HM, et al. Medication Discrepancies at Pediatric Hospital Discharge. Hosp
Pediatr. 2015;5(8):439-45. doi:10.1542/hpeds.2014-0085.
https://psnet.ahrq.gov/issue/medication-discrepancies-pediatric-hospital-discharge
…
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psnet.ahrq.gov/node/40407/psn-pdf
October 04, 2011 - Insights into the climate of safety towards the prevention
of falls among hospital staff.
October 4, 2011
Black AA, Brauer SG, Bell RAR, et al. Insights into the climate of safety towards the prevention of falls
among hospital staff. J Clin Nurs. 2011;20(19-20):2924-30. doi:10.1111/j.1365-2702.2010.03535.x.
https:…
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psnet.ahrq.gov/node/39675/psn-pdf
January 19, 2011 - A 5-year analysis of rapid response system activation at
an in-hospital haemodialysis unit.
January 19, 2011
Galhotra S, Devita MA, Dew MA, et al. A 5-year analysis of rapid response system activation at an in-
hospital haemodialysis unit. Qual Saf Health Care. 2010;19(6):e38. doi:10.1136/qshc.2008.031666.
https:/…
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psnet.ahrq.gov/node/47466/psn-pdf
October 17, 2018 - ASHP guidelines on preventing medication errors in
hospitals.
October 17, 2018
Billstein-Leber M, Carrillo CJD, Cassano AT, et al. ASHP Guidelines on Preventing Medication Errors in
Hospitals. Am J Health-Syst Pharm. 2018;75(19):1493-1517. doi:10.2146/ajhp170811.
https://psnet.ahrq.gov/issue/ashp-guidelines-preven…
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psnet.ahrq.gov/node/72781/psn-pdf
February 24, 2021 - Reducing prescribing errors in hospitalized children on
the ketogenic diet.
February 24, 2021
Siegel BI, Johnson M, Dawson TE, et al. Reducing prescribing errors in hospitalized children on the
ketogenic diet. Pediatr Neurol. 2020;115:42-47. doi:10.1016/j.pediatrneurol.2020.11.009.
https://psnet.ahrq.gov/issue/red…
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psnet.ahrq.gov/node/861776/psn-pdf
January 31, 2024 - The Sunday story: when hospitals don't say sorry.
January 31, 2024
Rascoe A, Gorenstein D. National Public Radio. January 21, 2024.
https://psnet.ahrq.gov/issue/sunday-story-when-hospitals-dont-say-sorry
Openness about making mistakes is a challenge in health care due to fear of litigation and career damage.
This …
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psnet.ahrq.gov/node/60166/psn-pdf
March 25, 2020 - For 4 days, the hospital thought he had just pneumonia. It
was coronavirus.
March 25, 2020
Goldstein J, Salcedo A. For 4 days, the hospital thought he had just pneumonia. It was coronavirus. New
York Times. 2020;March 10.
https://psnet.ahrq.gov/issue/4-days-hospital-thought-he-had-just-pneumonia-it-was-coronavirus…
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psnet.ahrq.gov/node/40637/psn-pdf
October 03, 2012 - Surgical site infections in colon surgery: the patient, the
procedure, the hospital, and the surgeon.
October 3, 2012
Hübner M, Diana M, Zanetti G, et al. Surgical site infections in colon surgery: the patient, the procedure,
the hospital, and the surgeon. Arch Surg. 2011;146(11):1240-5. doi:10.1001/archsurg.2011.1…
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psnet.ahrq.gov/node/60356/psn-pdf
May 20, 2020 - How the pandemic is reshaping hospital architecture and
design.
May 20, 2020
Booker C. PBSNewshour Weekend. May 10, 2020.
https://psnet.ahrq.gov/issue/how-pandemic-reshaping-hospital-architecture-and-design
Built environment characteristics can contribute to the spread of infection. This news segment discusses
de…
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psnet.ahrq.gov/node/60565/psn-pdf
June 03, 2020 - The public has been forgiving. But hospitals got some
things wrong.
June 3, 2020
Ofri D. The public has been forgiving. But hospitals got some things wrong. New York Times. 2020; May
21.
https://psnet.ahrq.gov/issue/public-has-been-forgiving-hospitals-got-some-things-wrong
The complexity of the COVID-19 crisis cr…