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Understanding complaints made about surgical departments in a UK district general hospital. | PSNet

psnet.ahrq.gov/issue/understanding-complaints-made-about-surgical-departments-uk-district-general-hospital

September 23, 2020 - Study Understanding complaints made about surgical departments in a UK district general hospital. Citation Text: Claydon O, Keeler B, Khanna A. Understanding complaints made about surgical departments in a UK district general hospital. Int J Qual Health Care. 2021;33(3). doi:10.1093/intq…

Do HSMRs really measure patient safety? | PSNet

psnet.ahrq.gov/issue/do-hsmrs-really-measure-patient-safety

June 22, 2009 - Special or Theme Issue Do HSMRs really measure patient safety? Citation Text: Do HSMRs really measure patient safety? Leatt P; Wen E; Sandoval C; Zelmer J; Webster G; Jarman B; McKinley J; Gibson D; Ardal S; Zahn C; Baker M; MacNaughton J; Flemming C; Bell R; Figler S; Brien SE; Gh…

How does patient safety culture in the operating room and post-anesthesia care unit compare to the rest of the hospital? | PSNet

psnet.ahrq.gov/issue/how-does-patient-safety-culture-operating-room-and-post-anesthesia-care-unit-compare-rest

October 14, 2009 - Study How does patient safety culture in the operating room and post-anesthesia care unit compare to the rest of the hospital? Citation Text: Kaafarani HMA, Itani KMF, Rosen AK, et al. How does patient safety culture in the operating room and post-anesthesia care unit compare to the re…

Reducing errors through discharge medication reconciliation by pharmacy services. | PSNet

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October 20, 2021 - Study Reducing errors through discharge medication reconciliation by pharmacy services. Citation Text: Bishop MA, Cohen BA, Billings LK, et al. Reducing errors through discharge medication reconciliation by pharmacy services. Am J Health Syst Pharm. 2015;72(17 Suppl 2):S120-6. doi:10.21…

Reflections on implementing a hospital-wide provider-based electronic inpatient mortality review system: lessons learnt. | PSNet

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August 12, 2020 - Study Reflections on implementing a hospital-wide provider-based electronic inpatient mortality review system: lessons learnt. Citation Text: Mendu ML, Lu Y, Petersen A, et al. Reflections on implementing a hospital-wide provider-based electronic inpatient mortality review system: lesson…

Towards international consensus on patient harm: perspectives on pressure injury policy. | PSNet

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September 27, 2016 - Review Towards international consensus on patient harm: perspectives on pressure injury policy. Citation Text: Jackson D, Hutchinson M, Barnason S, et al. Towards international consensus on patient harm: perspectives on pressure injury policy. J Nurs Manag. 2016;24(7):902-914. doi:10.111…

Prevented harm and cost avoidance with pharmacist intervention while utilizing a discharge medication reconciliation tool. | PSNet

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October 19, 2022 - Study Prevented harm and cost avoidance with pharmacist intervention while utilizing a discharge medication reconciliation tool. Citation Text: Hoffman AM, Walls JL, Prusch A, et al. Prevented harm and cost avoidance with pharmacist intervention while utilizing a discharge medication rec…

The patient's right to safety—improving the quality of care through litigation against hospitals. | PSNet

psnet.ahrq.gov/issue/patients-right-safety-improving-quality-care-through-litigation-against-hospitals

February 17, 2011 - Commentary The patient's right to safety—improving the quality of care through litigation against hospitals. Citation Text: Annas GJ. The patient's right to safety--improving the quality of care through litigation against hospitals. N Engl J Med. 2006;354(19):2063-2066. Copy Citation…

Relating faults in diagnostic reasoning with diagnostic errors and patient harm. | PSNet

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April 30, 2014 - Study Relating faults in diagnostic reasoning with diagnostic errors and patient harm. Citation Text: Zwaan L, Thijs A, Wagner C, et al. Relating faults in diagnostic reasoning with diagnostic errors and patient harm. Acad Med. 2012;87(2):149-156. doi:10.1097/ACM.0b013e31823f71e6. Copy…

Implementing an electronic root cause analysis reporting system to decrease hospital-acquired pressure injuries. | PSNet

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December 22, 2021 - Study Implementing an electronic root cause analysis reporting system to decrease hospital-acquired pressure injuries. Citation Text: Armstrong AA. Implementing an electronic root cause analysis reporting system to decrease hospital-acquired pressure injuries. J Healthc Qual. 2023;45(3):…

Improving the quality of written prescriptions in a general hospital: the influence of 10 years of serial audits and targeted interventions. | PSNet

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August 24, 2022 - Study Improving the quality of written prescriptions in a general hospital: the influence of 10 years of serial audits and targeted interventions. Citation Text: Gommans J, McIntosh P, Bee S, et al. Improving the quality of written prescriptions in a general hospital: the influence of …

Long-term reduction in adverse drug events: an evidence-based improvement model. | PSNet

psnet.ahrq.gov/issue/long-term-reduction-adverse-drug-events-evidence-based-improvement-model

August 28, 2024 - Study Long-term reduction in adverse drug events: an evidence-based improvement model. Citation Text: Gazarian M, Graudins LV. Long-term reduction in adverse drug events: an evidence-based improvement model. Pediatrics. 2012;129(5):e1334-42. doi:10.1542/peds.2011-1902. Copy Citation …

Implementation and spread of a simple and effective way to improve the accuracy of medicines reconciliation on discharge: a hospital-based quality improvement project and success story. | PSNet

psnet.ahrq.gov/issue/implementation-and-spread-simple-and-effective-way-improve-accuracy-medicines-reconciliation

March 04, 2009 - Study Implementation and spread of a simple and effective way to improve the accuracy of medicines reconciliation on discharge: a hospital-based quality improvement project and success story. Citation Text: Botros S, Dunn J. Implementation and spread of a simple and effective way to impr…

Extent, nature and consequences of adverse events: results of a retrospective casenote review in a large NHS hospital. | PSNet

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March 03, 2011 - Study Extent, nature and consequences of adverse events: results of a retrospective casenote review in a large NHS hospital. Citation Text: Sari AB-A, Sheldon T, Cracknell A, et al. Extent, nature and consequences of adverse events: results of a retrospective casenote review in a large…

Evaluating the Patient Safety Indicators: how well do they perform on Veterans Health Administration data? | PSNet

psnet.ahrq.gov/issue/evaluating-patient-safety-indicators-how-well-do-they-perform-veterans-health-administration

April 01, 2010 - Study Evaluating the Patient Safety Indicators: how well do they perform on Veterans Health Administration data? Citation Text: Rosen AK, Rivard PE, Zhao S, et al. Evaluating the patient safety indicators: how well do they perform on Veterans Health Administration data? Med Care. 2005;…

Organizational culture: an important context for addressing and improving hospital to community patient discharge. | PSNet

psnet.ahrq.gov/issue/organizational-culture-important-context-addressing-and-improving-hospital-community-patient

December 30, 2014 - Study Organizational culture: an important context for addressing and improving hospital to community patient discharge. Citation Text: Hesselink G, Vernooij-Dassen M, Pijnenborg L, et al. Organizational culture: an important context for addressing and improving hospital to community pa…

Inappropriate hospital admission as a risk factor for the subsequent development of adverse events: a cross-sectional study. | PSNet

psnet.ahrq.gov/issue/inappropriate-hospital-admission-risk-factor-subsequent-development-adverse-events-cross

March 09, 2022 - Study Inappropriate hospital admission as a risk factor for the subsequent development of adverse events: a cross-sectional study. Citation Text: San José-Saras D, Vicente-Guijarro J, Sousa P, et al. Inappropriate hospital admission as a risk factor for the subsequent development of adve…

The nature and causes of unintended events reported at ten emergency departments. | PSNet

psnet.ahrq.gov/issue/nature-and-causes-unintended-events-reported-ten-emergency-departments

February 20, 2013 - Study The nature and causes of unintended events reported at ten emergency departments. Citation Text: Smits M, Groenewegen PP, Timmermans D, et al. The nature and causes of unintended events reported at ten emergency departments. BMC Emerg Med. 2009;9:16. doi:10.1186/1471-227X-9-16. …

Every error a treasure: improving medication use with a nonpunitive reporting system. | PSNet

psnet.ahrq.gov/issue/every-error-treasure-improving-medication-use-nonpunitive-reporting-system

August 17, 2016 - Study Every error a treasure: improving medication use with a nonpunitive reporting system. Citation Text: Lehmann DF, Page N, Kirschman K, et al. Every Error a Treasure: Improving Medication Use with a Nonpunitive Reporting System. Jt Comm J Qual Patient Saf. 2016;33(7):401-407. doi:10.…

Potentially avoidable hospitalizations among historically marginalized nursing home residents. | PSNet

psnet.ahrq.gov/issue/potentially-avoidable-hospitalizations-among-historically-marginalized-nursing-home-residents

September 09, 2011 - Study Potentially avoidable hospitalizations among historically marginalized nursing home residents. Citation Text: Estrada LV, Barcelona V, Dhingra L, et al. Potentially avoidable hospitalizations among historically marginalized nursing home residents. JAMA Netw Open. 2024;7(5):e249312.…

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