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psnet.ahrq.gov/node/48157/psn-pdf
August 21, 2019 - Recommendations for using the Revised Safer Dx
instrument to help measure and improve diagnostic
safety.
August 21, 2019
Singh H, Khanna A, Spitzmueller C, et al. Recommendations for using the Revised Safer Dx Instrument to
help measure and improve diagnostic safety. Diagnosis (Berl). 2019;6(4):315-323. doi:10.151…
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psnet.ahrq.gov/node/43342/psn-pdf
July 16, 2014 - Prevalence and severity of patient harm in a sample of
UK-hospitalised children detected by the Paediatric
Trigger Tool.
July 16, 2014
Chapman SM, Fitzsimons J, Davey N, et al. Prevalence and severity of patient harm in a sample of UK-
hospitalised children detected by the Paediatric Trigger Tool. BMJ Open. 2014;4…
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psnet.ahrq.gov/node/836852/psn-pdf
April 06, 2022 - Frequency and nature of communication and handoff
failures in medical malpractice claims.
April 6, 2022
Humphrey KE, Sundberg M, Milliren CE, et al. Frequency and nature of communication and handoff
failures in medical malpractice claims. J Patient Saf. 2022;18(2):130-137.
doi:10.1097/pts.0000000000000937.
https:…
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psnet.ahrq.gov/node/837139/psn-pdf
May 18, 2022 - Multispecialty physician online survey reveals that
burnout related to adverse event involvement may be
mitigated by peer support.
May 18, 2022
Gupta K, Rivadeneira NA, Lisker S, et al. Multispecialty physician online survey reveals that burnout related
to adverse event involvement may be mitigated by peer support…
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psnet.ahrq.gov/node/841770/psn-pdf
December 21, 2022 - A recent two-fold increase in medical adverse event
deaths among US inpatients.
December 21, 2022
Oura P, Sajantila A. A recent two-fold increase in medical adverse event deaths among US inpatients. J
Public Health Res. 2022;11(4):227990362211399. doi:10.1177/22799036221139935.
https://psnet.ahrq.gov/issue/recent-…
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psnet.ahrq.gov/node/853974/psn-pdf
January 01, 2024 - Barriers and facilitators associated with the
implementation of surgical safety checklists: a qualitative
systematic review.
September 27, 2023
Paterson C, Mckie A, Turner M, et al. Barriers and facilitators associated with the implementation of
surgical safety checklists: a qualitative systematic review. J Adv Nu…
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psnet.ahrq.gov/node/72570/psn-pdf
January 01, 2021 - Provider-patient communication and hospital ratings:
perceived gaps and forward thinking about the effects of
COVID-19.
December 16, 2020
Belasen AT, Hertelendy AJ, Belasen AR, et al. Provider–patient communication and hospital ratings:
perceived gaps and forward thinking about the effects of COVID-19. Int J Qual …
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psnet.ahrq.gov/node/837666/psn-pdf
July 13, 2022 - Developing and aligning a safety event taxonomy for
inpatient psychiatry.
July 13, 2022
Barnes T, Fontaine T, Bautista C, et al. Developing and aligning a safety event taxonomy for inpatient
psychiatry. J Patient Saf. 2022;18(4):e704-e713. doi:10.1097/pts.0000000000000935.
https://psnet.ahrq.gov/issue/developing-a…
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psnet.ahrq.gov/node/35104/psn-pdf
April 06, 2011 - Crisis management during anaesthesia: the development
of an anaesthetic crisis management manual.
April 6, 2011
Runciman WB, Kluger MT, Morris RW, et al. Crisis management during anaesthesia: the development of
an anaesthetic crisis management manual. Qual Saf Health Care. 2005;14(3):e1.
https://psnet.ahrq.gov/iss…
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psnet.ahrq.gov/node/60559/psn-pdf
June 03, 2020 - Omissions of care in nursing home settings: a narrative
review.
June 3, 2020
Ogletree AM, Mangrum R, Harris Y, et al. Omissions of care in nursing home settings: a narrative review. J
Am Med Dir Assoc. 2020;21(5):604-614.e6. doi:10.1016/j.jamda.2020.02.016.
https://psnet.ahrq.gov/issue/omissions-care-nursing-home-…
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psnet.ahrq.gov/node/865480/psn-pdf
April 03, 2024 - A narrative review of the well-being and burnout of U.S.
community pharmacists.
April 3, 2024
Wash A, Moczygemba LR, Brown CM, et al. A narrative review of the well-being and burnout of U.S.
community pharmacists. J Am Pharm Assoc (2003). 2023;64(2):337-349. doi:10.1016/j.japh.2023.11.017.
https://psnet.ahrq.gov/i…
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psnet.ahrq.gov/node/34784/psn-pdf
June 24, 2015 - The potential for improved teamwork to reduce medical
errors in the emergency department.
June 24, 2015
Risser DT, Rice MM, Salisbury ML, et al. The potential for improved teamwork to reduce medical errors in
the emergency department. Ann Emerg Med. 2005;34(3):373-383. doi:10.1016/s0196-0644(99)70134-4.
https://ps…
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psnet.ahrq.gov/node/39858/psn-pdf
September 22, 2010 - Problems after discharge and understanding of
communication with their primary care physicians (PCPs)
among hospitalized seniors: a mixed methods study.
September 22, 2010
Arora V, Prochaska ML, Farnan JM, et al. Problems after discharge and understanding of communication
with their primary care physicians among h…
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psnet.ahrq.gov/node/47652/psn-pdf
February 20, 2019 - Strategy on Reducing Regulatory and Administrative
Burden Relating to the Use of Health IT and EHRs.
February 20, 2019
Washington, DC: Office of the National Coordinator for Health Information Technology; November 28,
2018.
https://psnet.ahrq.gov/issue/strategy-reducing-regulatory-and-administrative-burden-relatin…
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psnet.ahrq.gov/node/46702/psn-pdf
April 16, 2018 - Characteristics of medical liability claims against
dermatologists from 1991 through 2015.
April 16, 2018
Kornmehl H, Singh S, Adler BL, et al. Characteristics of Medical Liability Claims Against Dermatologists
From 1991 Through 2015. JAMA Dermatol. 2018;154(2):160-166. doi:10.1001/jamadermatol.2017.3713.
https://…
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psnet.ahrq.gov/node/46740/psn-pdf
January 01, 2021 - High-alert medication stratification tool-revised: an
exploratory study of an objective, standardized
medication safety tool.
March 28, 2018
Washburn NC, Dossett HA, Fritschle AC, et al. High-Alert Medication Stratification Tool-Revised: An
Exploratory Study of an Objective, Standardized Medication Safety Tool. J …
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psnet.ahrq.gov/node/47013/psn-pdf
April 07, 2019 - An electronic intervention to improve safety for pain
patients co-prescribed chronic opioids and
benzodiazepines.
April 7, 2019
Zaman T, Rife TL, Batki SL, et al. An electronic intervention to improve safety for pain patients co-
prescribed chronic opioids and benzodiazepines. Subst Abus. 2018;39(4):441-448.
doi:…
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psnet.ahrq.gov/node/47869/psn-pdf
April 17, 2019 - Minimizing Opioid Prescribing in Surgery (MOPiS)
initiative: an analysis of implementation barriers.
April 17, 2019
Coughlin JM, Shallcross ML, Schäfer WLA, et al. Minimizing Opioid Prescribing in Surgery (MOPiS)
Initiative: An Analysis of Implementation Barriers. J Surg Res. 2019;239:309-319.
doi:10.1016/j.jss.20…
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psnet.ahrq.gov/node/73968/psn-pdf
October 13, 2021 - Institution of just culture physician peer review in an
academic medical center.
October 13, 2021
Volkar JK, Phrampus P, English D, et al. Institution of just culture physician peer review in an academic
medical center. J Patient Saf. 2021;17(7):e689-e693. doi:10.1097/pts.0000000000000449.
https://psnet.ahrq.gov/i…
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psnet.ahrq.gov/node/45420/psn-pdf
December 04, 2016 - Patients' perception of types of errors in palliative
care—results from a qualitative interview study.
December 4, 2016
Kiesewetter I, Schulz CM, Bausewein C, et al. Patients' perception of types of errors in palliative care -
results from a qualitative interview study. BMC Palliat Care. 2016;15(1):75. doi:10.1186/…