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  1. psnet.ahrq.gov/web-mm/possible-probable-sure-wrong-premature-closure-and-anchoring-complicated-case
    October 02, 2013 - May 8, 2024 Rate of sepsis hospitalizations after misdiagnosis in adult emergency department
  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/60040/psn-pdf
    March 11, 2020 - Shifting the Mindset: A Closer Look at Hospital Complaints. March 11, 2020 Newcastle upon Tyne, UK: Healthwatch; January 2020. https://psnet.ahrq.gov/issue/shifting-mindset-closer-look-hospital-complaints Organizations need to do more than report and collect complaint data to realize improvements based on what is…
  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42893/psn-pdf
    March 13, 2014 - Effect of patient safety strategies on the incidence of adverse events. March 13, 2014 Sierra AF, del Aguila del MR, Espigares JLN, et al. Effect of patient safety strategies on the incidence of adverse events. J Eval Clin Pract. 2014;20(2):184-90. doi:10.1111/jep.12105. https://psnet.ahrq.gov/issue/effect-patient…
  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/864385/psn-pdf
    April 05, 2024 - Common Formats for Patient Safety Data Collection. March 13, 2024 Agency for Healthcare Research and Quality. Fed Register. Mar 6, 2024;89(45);15992. https://psnet.ahrq.gov/issue/common-formats-patient-safety-data-collection A standard system for voluntary reporting to patient safety organizations improves measurem…
  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/73489/psn-pdf
    July 15, 2021 - A diagnostic time-out to improve differential diagnosis in pediatric abdominal pain. July 15, 2021 Kasick RT, Melvin JE, Perera ST, et al. A diagnostic time-out to improve differential diagnosis in pediatric abdominal pain. Diagnosis (Berl). 2021;8(2):209-217. doi:10.1515/dx-2019-0054. https://psnet.ahrq.gov/issue…
  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/37486/psn-pdf
    January 23, 2009 - Medication report reduces number of medication errors when elderly patients are discharged from hospital. January 23, 2009 Midlöv P, Holmdahl L, Eriksson T, et al. Medication report reduces number of medication errors when elderly patients are discharged from hospital. Pharm World Sci. 2007;30(1):92-98. doi:10.1007…
  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/34086/psn-pdf
    May 27, 2011 - Overcoming barriers to adopting and implementing computerized physician order entry systems in U.S. hospitals. May 27, 2011 Poon EG, Blumenthal D, Jaggi T, et al. Overcoming barriers to adopting and implementing computerized physician order entry systems in U.S. hospitals. Health Aff (Millwood). 2004;23(4):184-90.…
  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/36895/psn-pdf
    March 10, 2011 - A systematic review of the performance characteristics of clinical event monitor signals used to detect adverse drug events in the hospital setting. March 10, 2011 Handler S, Altman RL, Perera S, et al. A systematic review of the performance characteristics of clinical event monitor signals used to detect adverse …
  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43551/psn-pdf
    January 22, 2016 - Barriers and enablers affecting patient engagement in managing medications within specialty hospital settings. January 22, 2016 Manias E, Rixon S, Williams A, et al. Barriers and enablers affecting patient engagement in managing medications within specialty hospital settings. Health Expect. 2015;18(6):2787-2798. d…
  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/837077/psn-pdf
    May 11, 2022 - At US hospitals, a drug mix-up is just a few keystrokes away. May 11, 2022 Kelman B. Kaiser Health News. April 29, 2022. https://psnet.ahrq.gov/issue/us-hospitals-drug-mix-just-few-keystrokes-away Technological solutions harbor unique risks that can result in patient harm. This article shares a response to report…
  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/39875/psn-pdf
    January 22, 2017 - Mobile in situ obstetric emergency simulation and teamwork training to improve maternal–fetal safety in hospitals. January 22, 2017 Guise J-M, Lowe NK, Deering S, et al. Mobile in situ obstetric emergency simulation and teamwork training to improve maternal-fetal safety in hospitals. Jt Comm J Qual Patient Saf. 20…
  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47233/psn-pdf
    November 02, 2018 - The STEP-up programme: engaging all staff in patient safety. November 2, 2018 Hamblin-Brown DJ; Ingram J. https://psnet.ahrq.gov/issue/step-programme-engaging-all-staff-patient-safety A transparent and respectful hospital culture is the foundation for improving working conditions to reduce preventable harm. This …
  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44863/psn-pdf
    July 01, 2016 - Rating the raters: the inconsistent quality of health care performance measurement. July 1, 2016 Shahian DM, Normand S-LT, Friedberg MW, et al. Rating the Raters: The Inconsistent Quality of Health Care Performance Measurement. Ann Surg. 2016;264(1):36-8. doi:10.1097/SLA.0000000000001631. https://psnet.ahrq.gov/is…
  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44564/psn-pdf
    October 14, 2015 - Reducing falls with a safety spotter program. October 14, 2015 Primmer P, Borenstein KK, Downing MT, et al. Reducing falls with a safety spotter program. Nursing (Brux). 2015;45(8):16-9. doi:10.1097/01.NURSE.0000469244.89222.27. https://psnet.ahrq.gov/issue/reducing-falls-safety-spotter-program Patients at high ri…
  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44190/psn-pdf
    June 03, 2015 - Minimizing medical mistakes: mother's mission to reduce hospital errors. June 3, 2015 Takahara D. KDVR. May 19, 2015. https://psnet.ahrq.gov/issue/minimizing-medical-mistakes-mothers-mission-reduce-hospital-errors Parents of children who experience harm in the course of medical care serve as advocates to drive saf…
  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/34033/psn-pdf
    April 11, 2011 - Adverse events and preventable adverse events in children. April 11, 2011 Woods D, Thomas EJ, Holl JL, et al. Adverse events and preventable adverse events in children. Pediatrics. 2005;115(1):155-60. https://psnet.ahrq.gov/issue/adverse-events-and-preventable-adverse-events-children Adverse events in hospitalize…
  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45326/psn-pdf
    January 03, 2017 - Consumer rankings and health care: toward validation and transparency. January 3, 2017 Hota B, Webb TA, Stein BD, et al. Consumer Rankings and Health Care: Toward Validation and Transparency. Jt Comm J Qual Patient Saf. 2016;42(10):439-446. https://psnet.ahrq.gov/issue/consumer-rankings-and-health-care-toward-vali…
  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45070/psn-pdf
    October 03, 2017 - When There's Harm in the Hospital: Can Transparency Replace "Deny and Defend"? October 3, 2017 National Health Policy Forum. Washington, DC: George Washington University. March 11, 2016. https://psnet.ahrq.gov/issue/when-theres-harm-hospital-can-transparency-replace-deny-and-defend This report provides the insight…
  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44145/psn-pdf
    September 27, 2017 - Nurse staffing levels and patient-reported missed nursing care. September 27, 2017 Dabney BW, Kalisch BJ. Nurse Staffing Levels and Patient-Reported Missed Nursing Care. J Nurs Care Qual. 2015;30(4):306-12. doi:10.1097/NCQ.0000000000000123. https://psnet.ahrq.gov/issue/nurse-staffing-levels-and-patient-reported-mi…
  20. psnet.ahrq.gov/perspective/rapid-response-teams-lessons-early-experience
    November 01, 2005 - Rapid Response Teams: Lessons from the Early Experience William S. Krimsky, MD | November 1, 2005  Also Read a Conversation View more articles from the same authors. Citation Text: Krimsky WS. Rapid Response Teams: Lessons from the Early Experience. PSNet [inter…

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