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  1. psnet.ahrq.gov/issue/survey-medication-documentation-hospital-discharge-implications-patient-safety-and-continuity
    March 02, 2011 - Study Survey of medication documentation at hospital discharge: implications for patient safety and continuity of care. Citation Text: Grimes T, Delaney T, Duggan C, et al. Survey of medication documentation at hospital discharge: implications for patient safety and continuity of care.…
  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44568/psn-pdf
    October 21, 2015 - Developing and deploying a patient safety program in a large health care delivery system: you can't fix what you don't know about. October 21, 2015 Bagian JP, Lee C, Gosbee J, et al. Developing and deploying a patient safety program in a large health care delivery system: you can't fix what you don't know about. J…
  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43521/psn-pdf
    November 05, 2014 - From Science to Implementation: AHRQ's Program to Prevent HAIs—Results and Lessons. November 5, 2014 Battles JB, Cleeman JI, Kahn KL, Weinberg DA, eds. Am J Infect Control. 2014;42(suppl 10):S189-S296. https://psnet.ahrq.gov/issue/science-implementation-ahrqs-program-prevent-hais-results-and-lessons This companion…
  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47631/psn-pdf
    March 27, 2019 - Assessing the effectiveness of engaging patients and their families in the three-step fall prevention process across modalities of an evidence-based fall prevention toolkit: an implementation science study. March 27, 2019 Duckworth M, Adelman JS, Belategui K, et al. Assessing the Effectiveness of Engaging Patients…
  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/73107/psn-pdf
    April 07, 2021 - Crisis checklists in emergency medicine: another step forward for cognitive aids. April 7, 2021 Chen Y-YK, Arriaga AF. Crisis checklists in emergency medicine: another step forward for cognitive aids. BMJ Qual Saf. 2021;30(9):689-693. doi:10.1136/bmjqs-2021-013203. https://psnet.ahrq.gov/issue/crisis-checklists-em…
  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44459/psn-pdf
    October 06, 2016 - Examining the Relationship Between Health IT and Ambulatory Care Workflow Redesign. October 6, 2016 Zheng K, Ciemins EL, Lanham HJ, et al. Rockville, MD: Agency for Healthcare Research and Quality; July 2015. AHRQ Publication No. 15-0058-EF. https://psnet.ahrq.gov/issue/examining-relationship-between-health-it-and…
  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45640/psn-pdf
    September 01, 2018 - Case outcomes in a communication-and-resolution program in New York hospitals. September 1, 2018 Mello MM, Greenberg Y, Senecal SK, et al. Case Outcomes in a Communication-and-Resolution Program in New York Hospitals. Health Serv Res. 2016;51 Suppl 3:2583-2599. doi:10.1111/1475-6773.12594. https://psnet.ahrq.gov/i…
  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/36515/psn-pdf
    May 27, 2011 - Nurses' perceptions of causes of medication errors and barriers to reporting. May 27, 2011 Ulanimo VM, O'Leary-Kelley C, Connolly PM. Nurses' perceptions of causes of medication errors and barriers to reporting. J Nurs Care Qual. 2007;22(1):28-33. https://psnet.ahrq.gov/issue/nurses-perceptions-causes-medication-e…
  9. psnet.ahrq.gov/web-mm/written-signout-it-only-works-if-you-use-right-one
    April 24, 2018 - Written Signout: It Only Works If You Use The Right One Citation Text: Lewis K, Rosenbluth G. Written Signout: It Only Works If You Use The Right One. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2018. Copy Citation Format: …
  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45706/psn-pdf
    September 01, 2018 - Improving communication and resolution following adverse events using a patient-created simulation exercise. September 1, 2018 Gallagher TH, Etchegaray J, Bergstedt B, et al. Improving Communication and Resolution Following Adverse Events Using a Patient-Created Simulation Exercise. Health Serv Res. 2016;51 Suppl …
  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/837735/psn-pdf
    July 27, 2022 - A quality improvement initiative using peer audit and feedback to improve compliance with the surgical safety checklist. July 27, 2022 Fridrich A, Imhof A, Staender S, et al. A quality improvement initiative using peer audit and feedback to improve compliance. Int J Qual Health Care. 2022;34(3). doi:10.1093/intqhc…
  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/48019/psn-pdf
    June 26, 2019 - Please reconcile, not wait a while. June 26, 2019 Trivedi A, Sharma S, Ajitsaria R, et al. Please reconcile, not wait a while. Arch Dis Child Educ Pract Ed. 2019;105(2):122-126. doi:10.1136/archdischild-2018-316356. https://psnet.ahrq.gov/issue/please-reconcile-not-wait-while Medication reconciliation to ensure ac…
  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/855421/psn-pdf
    November 15, 2023 - Informatics tools in deprescribing and medication optimization in older adults: development and dissemination of VIONE methodology in a high reliability organization. November 15, 2023 Winter SG, Sedgwick C, Wallace-Lacey A, et al. Informatics tools in deprescribing and medication optimization in older adults: de…
  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/36843/psn-pdf
    January 05, 2017 - Improving medication reconciliation in the outpatient setting. January 5, 2017 Varkey P, Cunningham J, Bisping S. Improving medication reconciliation in the outpatient setting. Jt Comm J Qual Patient Saf. 2007;33(5):286-92. https://psnet.ahrq.gov/issue/improving-medication-reconciliation-outpatient-setting The Jo…
  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/72526/psn-pdf
    January 01, 2021 - How effective are electronic medication systems in reducing medication error rates and associated harm among hospital inpatients? A systematic review and meta-analysis. December 2, 2020 Gates PJ, Hardie R-A, Raban MZ, et al. How effective are electronic medication systems in reducing medication error rates and as…
  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47193/psn-pdf
    September 05, 2018 - Situation, background, assessment, recommendation (SBAR) communication tool for handoff in health care- a narrative review. September 5, 2018 Shahid S, Thomas S. Situation, background, assessment, recommendation (SBAR) communication tool for handoff in health care; a narrative review. Saf Health. 2018;4(7). doi:10…
  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/847543/psn-pdf
    April 12, 2023 - What works in medication reconciliation: an on-treatment and site analysis of the MARQUIS2 study. April 12, 2023 Schnipper JL, Reyes Nieva H, Yoon CS, et al. What works in medication reconciliation: an on-treatment and site analysis of the MARQUIS2 study. BMJ Qual Saf. 2023;32(8):457-469. doi:10.1136/bmjqs-2022- 0…
  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/38517/psn-pdf
    February 17, 2011 - Use of electronic health records in US hospitals. February 17, 2011 Jha AK, DesRoches CM, Campbell EG, et al. Use of electronic health records in U.S. hospitals. doi:10.1056/NEJMsa0900592. https://psnet.ahrq.gov/issue/use-electronic-health-records-us-hospitals Increasing the use of electronic health records (EHRs)…
  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45247/psn-pdf
    August 15, 2016 - Physician transition of care: benefits of I-PASS and an electronic handoff system in a community pediatric residency program. August 15, 2016 Walia J, Qayumi Z, Khawar N, et al. Physician Transition of Care: Benefits of I-PASS and an Electronic Handoff System in a Community Pediatric Residency Program. Acad Pediat…
  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/35802/psn-pdf
    January 02, 2017 - Reconciliation failures lead to medication errors. January 2, 2017 Santell JP. Reconciliation failures lead to medication errors. Jt Comm J Qual Patient Saf. 2006;32(4):225-9. https://psnet.ahrq.gov/issue/reconciliation-failures-lead-medication-errors Medication reconciliation represents an active effort of hospita…

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