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psnet.ahrq.gov/node/35124/psn-pdf
June 29, 2005 - JCAHO proposal for patient-centered care brings concept
to mainstream healthcare settings.
June 29, 2005
ECRI. Risk Management Reporter. June 2005.
https://psnet.ahrq.gov/issue/jcaho-proposal-patient-centered-care-brings-concept-mainstream-healthcare-
settings
This commentary provides a definition of patient-cent…
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psnet.ahrq.gov/node/38021/psn-pdf
August 27, 2008 - A review of the current evidence base for significant
event analysis.
August 27, 2008
Bowie P, Pope L, Lough M. A review of the current evidence base for significant event analysis. J Eval Clin
Pract. 2008;14(4):520-36. doi:10.1111/j.1365-2753.2007.00908.x.
https://psnet.ahrq.gov/issue/review-current-evidence-base…
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psnet.ahrq.gov/node/38344/psn-pdf
January 21, 2009 - The error of omission: a simple checklist approach for
improving operating room safety.
January 21, 2009
Rosenfield LK, Chang DS. The error of omission: a simple checklist approach for improving operating room
safety. Plast Reconstr Surg. 2009;123(1):399-402. doi:10.1097/PRS.0b013e318193472f.
https://psnet.ahrq.go…
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psnet.ahrq.gov/node/35018/psn-pdf
November 28, 2018 - Your company's secret change agents.
November 28, 2018
Pascale RT, Sternin J. Your company's secret change agents. Harv Bus Rev. 2005;83(5):72-81, 153.
https://psnet.ahrq.gov/issue/your-companys-secret-change-agents
The authors describe how to leverage "positive deviants," individuals within an organization who fin…
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psnet.ahrq.gov/node/36137/psn-pdf
September 29, 2010 - Rapid response teams: ten essentials leaders need to
know.
September 29, 2010
Dahlen GM, Benz BA. Rapid response teams. Ten essentials leaders need to know. Healthcare executive.
2006;21(4):28-32, 34.
https://psnet.ahrq.gov/issue/rapid-response-teams-ten-essentials-leaders-need-know
The authors list ten points fo…
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psnet.ahrq.gov/node/37860/psn-pdf
January 15, 2009 - Economic evaluations of maintaining patient safety
systems in teaching hospitals.
January 15, 2009
Fukuda H, Imanaka Y, Hirose M, et al. Economic evaluations of maintaining patient safety systems in
teaching hospitals. Health Policy (New York). 2008;88(2-3):381-91. doi:10.1016/j.healthpol.2008.04.004.
https://psne…
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psnet.ahrq.gov/node/46576/psn-pdf
October 25, 2017 - Curing our diagnostic disorder.
October 25, 2017
Laposata M. The Pathologist. September 2017;(34):18-27.
https://psnet.ahrq.gov/issue/curing-our-diagnostic-disorder
Diagnostic improvement is gaining recognition as an important goal in health care. This magazine article
reports on one pathologist's efforts to devel…
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psnet.ahrq.gov/node/42107/psn-pdf
January 01, 2015 - Creating a culture of safety by using checklists.
March 13, 2013
Huang LC, Kim R, Berry WR. Creating a culture of safety by using checklists. AORN J. 2013;97(3):365-8.
doi:10.1016/j.aorn.2012.12.019.
https://psnet.ahrq.gov/issue/creating-culture-safety-using-checklists
This commentary reveals how implementing peri…
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psnet.ahrq.gov/node/40719/psn-pdf
August 24, 2011 - New research highlights the role of patient safety culture
and safer care.
August 24, 2011
Clancy CM. New research highlights the role of patient safety culture and safer care. J Nurs Care Qual.
2011;26(3):193-6. doi:10.1097/NCQ.0b013e31821d0520.
https://psnet.ahrq.gov/issue/new-research-highlights-role-patient-sa…
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psnet.ahrq.gov/node/36173/psn-pdf
September 29, 2010 - The need for organizational change in patient safety
initiatives.
September 29, 2010
Anderson J, Ramanujam R, Hensel D, et al. The need for organizational change in patient safety initiatives.
Int J Med Inform. 2006;75(12):809-17.
https://psnet.ahrq.gov/issue/need-organizational-change-patient-safety-initiatives
…
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psnet.ahrq.gov/node/35068/psn-pdf
September 21, 2005 - Cleveland Clinic Health System: a comprehensive
framework for a health system patient safety initiative.
September 21, 2005
Nadzam DM; Atkins PM; Waggoner DM; Shonk R.
https://psnet.ahrq.gov/issue/cleveland-clinic-health-system-comprehensive-framework-health-system-
patient-safety
The authors describe seven strat…
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psnet.ahrq.gov/node/35371/psn-pdf
June 17, 2014 - 2005 Quest for Quality Prize.
June 17, 2014
Association AH, Pharmacists AS of H-S, Networks H and H. Medication Safety Issue Brief. Bar Code
implementation strategies. Hosp Health Netw. 2005;79(7):65-66.
https://psnet.ahrq.gov/issue/2005-quest-quality-prize
This article highlights successful practices of the 2005 …
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psnet.ahrq.gov/node/40751/psn-pdf
September 07, 2011 - Developing a programme for medication reconciliation at
the time of admission into hospital.
September 7, 2011
Manzorro ÁG, Zoni AC, Rieiro CR, et al. Developing a programme for medication reconciliation at the time
of admission into hospital. Int J Clin Pharm. 2011;33(4):603-9. doi:10.1007/s11096-011-9530-1.
http…
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psnet.ahrq.gov/node/35214/psn-pdf
June 24, 2009 - Using clinical simulation to teach patient safety in an
acute/critical care nursing course.
June 24, 2009
Henneman EA, Cunningham H. Using clinical simulation to teach patient safety in an acute/critical care
nursing course. Nurse Educ. 2005;30(4):172-177.
https://psnet.ahrq.gov/issue/using-clinical-simulation-tea…
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psnet.ahrq.gov/node/41620/psn-pdf
August 22, 2012 - Improving care transitions: optimizing medication
reconciliation.
August 22, 2012
Association AP, Pharmacists AS of H-S, Steeb D, et al. Improving care transitions: optimizing medication
reconciliation. J Am Pharm Assoc (2003). 2012;52(4):e43-e52. doi:10.1331/JAPhA.2012.12527.
https://psnet.ahrq.gov/issue/improvin…
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psnet.ahrq.gov/node/36594/psn-pdf
May 27, 2011 - Right tech dose helps medicine go down.
May 27, 2011
Patton S. CIO Magazine. July 12, 2006.
https://psnet.ahrq.gov/issue/right-tech-dose-helps-medicine-go-down
The author describes some common mistakes involving the design and launch of computerized physician
order entry (CPOE) initiatives and provides sugges…
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psnet.ahrq.gov/node/34940/psn-pdf
June 23, 2009 - Medication safety: look-alike/sound-alike drugs in home
care.
June 23, 2009
Friedman MMG. Medication safety: look-alike/sound-alike drugs in home care. Home Healthc Nurse.
2005;23(4):243-253.
https://psnet.ahrq.gov/issue/medication-safety-look-alikesound-alike-drugs-home-care
This article reviews the National Pat…
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psnet.ahrq.gov/node/35686/psn-pdf
December 23, 2016 - Using medication reconciliation to prevent errors.
December 23, 2016
Using medication reconciliation to prevent errors. Sentinel Event Alert. 2006;35(35):1-4.
https://psnet.ahrq.gov/issue/using-medication-reconciliation-prevent-errors
This alert emphasizes the importance of reconciling medications and supports impl…
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psnet.ahrq.gov/node/37157/psn-pdf
October 06, 2011 - Nurses' satisfaction with medication administration point-
of-care technology.
October 6, 2011
Hurley A, Bane A, Fotakis S, et al. Nurses' satisfaction with medication administration point-of-care
technology. J Nurs Adm. 2007;37(7-8):343-349.
https://psnet.ahrq.gov/issue/nurses-satisfaction-medication-administrati…
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psnet.ahrq.gov/node/42295/psn-pdf
May 29, 2013 - Medication reconciliation meets its MATCH.
May 29, 2013
Agency for Healthcare Research and Quality. Research Activities. May 2013:1, 3-4.
https://psnet.ahrq.gov/issue/medication-reconciliation-meets-its-match
This newsletter article describes the development of the Medications at Transitions and Clinical Handoffs
…