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Psn-Pdf (pdf file)
psnet.ahrq.gov/node/73090/psn-pdfMarch 31, 2021 - Learning from safety incidents in high reliability organizations: a systematic review of learning tools that could be adapted and used in healthcare. March 31, 2021 Serou N, Sahota LM, Husband AK, et al. Learning from safety incidents in high-reliability organizations: a systematic review of learning tools that co… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/867752/psn-pdfMarch 12, 2025 - Analyzing and mitigating the risks of patient harm during operating room to intensive care unit patient handoffs. March 12, 2025 Martins NRS, Martinez EZ, Simões CM, et al. Analyzing and mitigating the risks of patient harm during operating room to intensive care unit patient handoffs. Int J Qual Health Care. 2025;… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/44961/psn-pdfMay 09, 2017 - Parent-reported errors and adverse events in hospitalized children. May 9, 2017 Khan A, Furtak SL, Melvin P, et al. Parent-reported errors and adverse events in hospitalized children. JAMA Pediatr. 2016;170(4):e154608. doi:10.1001/jamapediatrics.2015.4608. https://psnet.ahrq.gov/issue/parent-reported-errors-and-ad… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/867594/psn-pdfJanuary 22, 2025 - A systematic review on the evidence of misdiagnosis in dementia and its impact on accessing dementia care. January 22, 2025 Giebel C, Silva?Ribeiro W, Watson J, et al. A systematic review on the evidence of misdiagnosis in dementia and its impact on accessing dementia care. Int J Geriat Psychiatry. 2024;39(10):e615… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/836916/psn-pdfApril 13, 2022 - Implementing a robust process improvement program in the neonatal intensive care unit to reduce harm. April 13, 2022 Nether KG, Thomas EJ, Khan A, et al. Implementing a robust process improvement program in the neonatal intensive care unit to reduce harm. J Healthc Qual. 2022;44(1):23-30. doi:10.1097/jhq.000000000… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/73132/psn-pdfApril 14, 2021 - Association of clinician diagnostic performance with machine learning–based decision support systems: a systematic review. April 14, 2021 Vasey B, Ursprung S, Beddoe B, et al. Association of clinician diagnostic performance with machine learning–based decision support systems: a systematic review. JAMA Netw Open. … -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/36804/psn-pdfAugust 26, 2011 - Patterns of communication breakdowns resulting in injury to surgical patients. August 26, 2011 Greenberg CC, Regenbogen SE, Studdert DM, et al. Patterns of communication breakdowns resulting in injury to surgical patients. J Am Coll Surg. 2007;204(4):533-40. https://psnet.ahrq.gov/issue/patterns-communication-brea… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/46391/psn-pdfFebruary 08, 2018 - Nature of blame in patient safety incident reports: mixed methods analysis of a national database. February 8, 2018 Cooper J, Edwards A, Williams H, et al. Nature of Blame in Patient Safety Incident Reports: Mixed Methods Analysis of a National Database. Ann Fam Med. 2017;15(5):455-461. doi:10.1370/afm.2123. https… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/47007/psn-pdfMay 02, 2018 - Workarounds to intended use of health information technology: a narrative review of the human factors engineering literature. May 2, 2018 Patterson ES. Workarounds to Intended Use of Health Information Technology: A Narrative Review of the Human Factors Engineering Literature. Hum Factors. 2018;60(3):281-292. doi… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/865817/psn-pdfMay 08, 2024 - Using Healthcare Failure Mode and Effect Analysis in prospective medication safety risk management in secondary care inpatient wards. May 8, 2024 Sova PM, Holmström A-R, Airaksinen M, et al. Using Healthcare Failure Mode and Effect Analysis in prospective medication safety risk management in secondary care inpatie… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/846707/psn-pdfMarch 29, 2023 - Effect of patient safety education interventions on patient safety culture of health care professionals: systematic review and meta-analysis. March 29, 2023 Agbar F, Zhang S, Wu Y, et al. Effect of patient safety education interventions on patient safety culture of health care professionals: Systematic review and … -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/42619/psn-pdfJanuary 23, 2019 - High-reliability health care: getting there from here. January 23, 2019 Chassin MR, Loeb JM. High-reliability health care: getting there from here. Milbank Q. 2013;91(3):459-490. doi:10.1111/1468-0009.12023. https://psnet.ahrq.gov/issue/high-reliability-health-care-getting-there-here Aviation is often cited as an … -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/867440/psn-pdfJanuary 08, 2025 - How can specialist investigation agencies inform system- wide learning for patient safety? A qualitative study of perspectives on the early years of the English Healthcare Safety Investigation Branch. January 8, 2025 Crompton A, Waring J, Macrae C, et al. How can specialist investigation agencies inform system-wid… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/867445/psn-pdfJanuary 08, 2025 - Using human factors methods to mitigate bias in artificial intelligence-based clinical decision support. January 8, 2025 Militello LG, Diiulio J, Wilson DL, et al. Using human factors methods to mitigate bias in artificial intelligence-based clinical decision support. J Am Med Inform Assoc. 2025;32(2):398-403. doi… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/851928/psn-pdfAugust 02, 2023 - Patient Experience as a Source for Understanding the Origins, Impact, and Remediation of Diagnostic Errors. August 2, 2023 Schlesinger M, Grob R, Gleason K, et al. Rockville, MD: Agency for Healthcare Research and Quality; July 2023. https://psnet.ahrq.gov/issue/patient-experience-source-understanding-origins-impa… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/838186/psn-pdfSeptember 28, 2022 - Understanding teamwork in rapidly deployed interprofessional teams in intensive and acute care: a systematic review of reviews. September 28, 2022 Schilling S, Armaou M, Morrison Z, et al. Understanding teamwork in rapidly deployed interprofessional teams in intensive and acute care: a systematic review of reviews… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/841152/psn-pdfDecember 07, 2022 - Interprofessional clinical event debriefing-does it make a difference? Attitudes of emergency department care providers to INFO clinical event debriefings. December 7, 2022 Rose SC, Ashari NA, Davies JM, et al. Interprofessional clinical event debriefing-does it make a difference? Attitudes of emergency department… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/45631/psn-pdfJuly 02, 2017 - Implementation science: a neglected opportunity to accelerate improvements in the safety and quality of surgical care. July 2, 2017 Hull L, Athanasiou T, Russ S. Implementation Science: A Neglected Opportunity to Accelerate Improvements in the Safety and Quality of Surgical Care. Ann Surg. 2017;265(6):1104-1112. … -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/860390/psn-pdfJanuary 10, 2024 - Key factors for effective implementation of healthcare workers support interventions after patient safety incidents in health organisations: a scoping review. January 10, 2024 Guerra-Paiva S, Lobão MJ, Simões DG, et al. Key factors for effective implementation of healthcare workers support interventions after pati… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/42724/psn-pdfDecember 06, 2013 - Adverse drug events after hospital discharge in older adults: types, severity, and involvement of Beers criteria medications. December 6, 2013 Kanaan AO, Donovan JL, Duchin NP, et al. Adverse drug events after hospital discharge in older adults: types, severity, and involvement of Beers Criteria Medications. J Am …
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