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psnet.ahrq.gov/innovation/critical-radiology-alert-process
November 16, 2022 - Critical Radiology Alert Process
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October 30, 2024
View more articles from the same authors.
Innovation
Contact
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psnet.ahrq.gov/node/867655/psn-pdf
February 26, 2025 - Learning Health Systems for Patient Safety
February 26, 2025
Savitz LA, Sousane Z, Mossburg SE. Learning Health Systems for Patient Safety. PSNet [internet]. 2025.
https://psnet.ahrq.gov/perspective/learning-health-systems-patient-safety
Despite an observable decrease in adverse events in health care over time, rat…
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psnet.ahrq.gov/node/33640/psn-pdf
September 01, 2006 - What Can the Rest of the Health Care System Learn from
the VA's Quality and Safety Transformation?
September 1, 2006
Jha AK. What Can the Rest of the Health Care System Learn from the VA's Quality and Safety
Transformation? PSNet [internet]. 2006.
https://psnet.ahrq.gov/perspective/what-can-rest-health-care-system…
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psnet.ahrq.gov/node/867850/psn-pdf
February 26, 2025 - In Conversation with Timothy Vogus about High
Reliability Organization (HRO) Principles and Patient
Safety
February 26, 2025
Vogus T, Lee M, Mossburg SE. In Conversation with Timothy Vogus about High Reliability Organization
(HRO) Principles and Patient Safety. PSNet [internet]. 2025.
https://psnet.ahrq.gov/persp…
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psnet.ahrq.gov/node/73102/psn-pdf
July 01, 2022 - Care Managers Use Software-Aided Medication Review
Protocol for Frail, Community-Dwelling Seniors, Leading
to More Appropriate Medication Use
March 31, 2021
https://psnet.ahrq.gov/innovation/care-managers-use-software-aided-medication-review-protocol-frail-
community-dwelling
Summary
Care management staff (such …
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psnet.ahrq.gov/perspective/beyond-pandemic-creating-total-systems-safety
August 30, 2023 - Beyond the Pandemic: Creating Total Systems Safety
Patricia McGaffigan, MS, RN, CPPS; Cindy Manaoat Van, MHSA, CPPS; Sarah E. Mossburg, RN, PhD
| August 30, 2023
Also Read the Conversation
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Citation Text:
Van CM, Mossb…
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psnet.ahrq.gov/perspective/conversation-patricia-mcgaffigan-about-beyond-pandemic-creating-total-systems-safety
August 30, 2023 - In Conversation with... Patricia McGaffigan about Beyond the Pandemic: Creating Total Systems Safety
Patricia McGaffigan, MS, RN, CPPS; Cindy Manaoat Van, MHSA, CPPS; Sarah E. Mossburg, RN, PhD
| August 30, 2023
Also Read the Essay
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psnet.ahrq.gov/node/49660/psn-pdf
August 01, 2012 - capabilities of an ideal laboratory results
management systems are shown in the Table.(16,17)
Additionally, implementing
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psnet.ahrq.gov/perspective/context-intervention
August 05, 2020 - The Context Is the Intervention
Dr. John Øvretveit | October 1, 2011
View more articles from the same authors.
Citation Text:
Øvretveit J. The Context Is the Intervention. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department …
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psnet.ahrq.gov/node/50930/psn-pdf
February 21, 2020 - Pharmacist Role in Patient Safety
February 21, 2020
Dopp AL, Hall KK. Pharmacist Role in Patient Safety. PSNet [internet]. 2020.
https://psnet.ahrq.gov/perspective/pharmacist-role-patient-safety
Background: The Evolving Role of the Pharmacist
Medication errors are highly pervasive across all settings of care,[1] w…
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psnet.ahrq.gov/perspective/annual-perspective-topics-medication-safety
April 27, 2022 - In reality, though, there are several known barriers to implementing a deprescribing process.
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psnet.ahrq.gov/node/849661/psn-pdf
June 28, 2023 - include pertinent medications may provide additional benefit, as it would allow the teams to practice
implementing
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psnet.ahrq.gov/node/42338/psn-pdf
November 18, 2015 - Patient Safety Resource Centre.
November 18, 2015
The Health Foundation.
https://psnet.ahrq.gov/issue/patient-safety-resource-centre
This Web site offers resources to support safety improvement in the United Kingdom, including
implementation guidelines and case studies.
https://psnet.ahrq.gov/issue/patient-safety…
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psnet.ahrq.gov/node/33751/psn-pdf
January 01, 2014 - of the
HITECH Act of 2009, which will provide more than $20 billion to hospitals and physicians for implementing
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psnet.ahrq.gov/node/36618/psn-pdf
July 24, 2008 - Software for symptoms.
July 24, 2008
Borzo J. Wall Street Journal. May 23, 2005.
https://psnet.ahrq.gov/issue/software-symptoms
This article discusses decision support system implementation and use, and its role in preventing physician
misdiagnosis.
https://psnet.ahrq.gov/issue/software-symptoms
https://psnet.ahr…
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psnet.ahrq.gov/node/35459/psn-pdf
December 10, 2014 - Death by handwriting.
December 10, 2014
Glabman M. Death by handwriting. Trustee : the journal for hospital governing boards. 2005;58(9):29-32.
https://psnet.ahrq.gov/issue/death-handwriting
This article discusses several strategies implemented by hospitals to improve the legibility of physicians'
medication order…
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psnet.ahrq.gov/web-mm/spinal-epidural-abscess
November 13, 2019 - References
Related Resources From the Same Author(s)
Reflections on implementing
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psnet.ahrq.gov/web-mm/failure-rescue-mother
September 23, 2020 - blood product replacement and to either prevent or correct disseminated intravascular coagulation.( 4 ) Implementing
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psnet.ahrq.gov/node/49608/psn-pdf
August 01, 2010 - psnet.ahrq.gov//#references
https://psnet.ahrq.gov//#references
Many resources are available to assist EDs in implementing
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psnet.ahrq.gov/innovations-video
August 09, 2025 - Learn About the Submit an Innovation Process
PSNet’s Submit an Innovation feature allows organizations to share successfully implemented innovative practices and/or interventions that have resulted in improved patient safety and reduced harm. Watch the video below to learn more about the Submit an Innovation process…