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psnet.ahrq.gov/issue/comparative-economic-analyses-patient-safety-improvement-strategies-acute-care-systematic
November 07, 2012 - Review
Comparative economic analyses of patient safety improvement strategies in acute care: a systematic review.
Citation Text:
Etchells E, Koo M, Daneman N, et al. Comparative economic analyses of patient safety improvement strategies in acute care: a systematic review. BMJ Qual Saf.…
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psnet.ahrq.gov/issue/health-literacy-related-safety-events-qualitative-study-health-literacy-failures-patient
August 24, 2022 - Study
Health literacy-related safety events: a qualitative study of health literacy failures in patient safety events.
Citation Text:
Morrison AK, Gibson C, Higgins C, et al. Health literacy-related safety events: a qualitative study of health literacy failures in patient safety events. …
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psnet.ahrq.gov/issue/changes-medical-errors-after-implementation-handoff-program
April 24, 2018 - Study
Classic
Changes in medical errors after implementation of a handoff program.
Citation Text:
Starmer AJ, Spector ND, Srivastava R, et al. Changes in medical errors after implementation of a handoff program. New Engl J Med. 2014;371(19):1803-1812. doi:10.105…
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psnet.ahrq.gov/issue/culture-change-infection-control-applying-psychological-principles-improve-hand-hygiene
November 21, 2021 - Study
Culture change in infection control: applying psychological principles to improve hand hygiene.
Citation Text:
Cumbler E, Castillo L, Satorie L, et al. Culture change in infection control: applying psychological principles to improve hand hygiene. J Nurs Care Qual. 2013;28(4):304…
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psnet.ahrq.gov/issue/inadequate-hand-communication
April 02, 2015 - Sentinel Event Alerts
Inadequate hand-off communication.
Citation Text:
Inadequate hand-off communication. Sentinel event alert. 2017;58(58):1-6.
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psnet.ahrq.gov/issue/exploring-safety-culture-within-inpatient-mental-health-units-results-participant-observation
September 23, 2020 - Study
Exploring safety culture within inpatient mental health units: the results from participant observation across three mental health services.
Citation Text:
Molloy L, Wilson V, O'Connor MF, et al. Exploring safety culture within inpatient mental health units: the results from partic…
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psnet.ahrq.gov/issue/patients-and-doctors-views-and-experiences-patient-safety-trajectory-breast-cancer-care
December 08, 2021 - Study
Patients' and doctors' views and experiences of the patient safety trajectory of breast cancer care.
Citation Text:
Forrest C, O'Sullivan MJ, Ryan M, et al. Patients' and doctors’ views and experiences of the patient safety trajectory of breast cancer care. Breast. 2024;75:103699. …
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psnet.ahrq.gov/issue/adverse-drug-event-detection-pediatric-oncology-and-hematology-patients-using-medication
November 16, 2022 - Study
Adverse drug event detection in pediatric oncology and hematology patients: using medication triggers to identify patient harm in a specialized pediatric patient population.
Citation Text:
Call RJ, Burlison JD, Robertson JJ, et al. Adverse drug event detection in pediatric oncology…
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psnet.ahrq.gov/issue/psychological-experience-obstetric-patients-and-health-care-workers-after-implementation
March 30, 2022 - Study
The psychological experience of obstetric patients and health care workers after implementation of universal SARS-CoV-2 testing.
Citation Text:
Bender WR, Srinivas S, Coutifaris P, et al. The psychological experience of obstetric patients and health care workers after implementatio…
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psnet.ahrq.gov/issue/developing-process-measure-actual-harm-medication-errors-paediatric-inpatients-design
January 18, 2023 - Study
Developing a process to measure actual harm from medication errors in paediatric inpatients: from design to implementation.
Citation Text:
Mumford V, Raban MZ, Li L, et al. Developing a process to measure actual harm from medication errors in paediatric inpatients: from design to i…
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psnet.ahrq.gov/issue/impact-health-care-strikes-patient-mortality-systematic-review-and-meta-analysis
April 27, 2022 - Review
The impact of health care strikes on patient mortality: a systematic review and meta-analysis of observational studies.
Citation Text:
Essex R, Weldon SM, Thompson T, et al. The impact of health care strikes on patient mortality: a systematic review and meta‐analysis of observatio…
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psnet.ahrq.gov/print/pdf/node/842920
December 14, 2022 - year-old man with a history of untreated depression and suicide attempts (but no history of
psychiatric hospitalizations … year-old man with a history of untreated depression and suicide attempts (but no history of
psychiatric hospitalizations
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psnet.ahrq.gov/node/40848/psn-pdf
October 12, 2011 - IBEAS: A Pioneer Study on Patient Safety in Latin
America: Towards Safer Hospital Care.
October 12, 2011
Geneva, Switzerland: World Health Organization; 2011.
https://psnet.ahrq.gov/issue/ibeas-pioneer-study-patient-safety-latin-america-towards-safer-hospital-care
This publication reports on the findings of…
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psnet.ahrq.gov/node/36393/psn-pdf
May 20, 2024 - Your Safety in our Hands in Hospital.
May 20, 2024
Patient Safety Surveillance Unit. Department of Health, Perth: Western Australia.
https://psnet.ahrq.gov/issue/your-safety-our-hands-hospital
This annual report shares the results of Western Australia's sentinel event reporting program. Medication
errors were the …
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psnet.ahrq.gov/node/38202/psn-pdf
November 12, 2008 - The tipping point: the relationship between volume and
patient harm.
November 12, 2008
Pedroja AT. The tipping point: the relationship between volume and patient harm. Am J Med Qual.
2008;23(5):336-41. doi:10.1177/1062860608320628.
https://psnet.ahrq.gov/issue/tipping-point-relationship-between-volume-and-patient-…
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psnet.ahrq.gov/node/36216/psn-pdf
August 03, 2012 - Hospital Medication Errors Commonplace.
August 3, 2012
Berwick D; Lassman S; Bates D. National Public Radio. July 28, 2006.
https://psnet.ahrq.gov/issue/hospital-medication-errors-commonplace
This segment features Donald Berwick, David Bates, and other experts discussing the Institute of Medicine
(IOM) report Prev…
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psnet.ahrq.gov/node/41197/psn-pdf
March 07, 2012 - Fear of punitive response to hospital errors lingers.
March 7, 2012
O'Reilly KB. American Medical News. February 20, 2012.
https://psnet.ahrq.gov/issue/fear-punitive-response-hospital-errors-lingers
This news article highlights the problem of blame culture in health care, which hinders incident reporting
and safet…
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psnet.ahrq.gov/node/40523/psn-pdf
August 31, 2011 - A Hospital Accident: Lessons Learned – A Death, A
Conviction, and A Healing.
August 31, 2011
Texas Medical Institute of Technology. June 16, 2011.
https://psnet.ahrq.gov/issue/hospital-accident-lessons-learned-death-conviction-and-healing
This webinar covered how medical errors affect both the family and provider …
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psnet.ahrq.gov/node/36827/psn-pdf
April 25, 2007 - Adverse Drug Events in US Hospitals, 2004.
April 25, 2007
Elixhauser A, Owens P. HCUP Statistical Brief #29. Rockville, MD: Agency for Healthcare Research and
Quality; April 2007.
https://psnet.ahrq.gov/issue/adverse-drug-events-us-hospitals-2004
This report presents data on adverse drug events from the Healthcare…
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psnet.ahrq.gov/node/35074/psn-pdf
March 07, 2016 - Library-hospital pairing empowers patients, improves
safety.
March 7, 2016
https://psnet.ahrq.gov/issue/library-hospital-pairing-empowers-patients-improves-safety
This article describes the Partnering for Patient Empowerment Through Community Awareness program,
a model for utilizing libraries to educate consumers …