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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/38737/psn-pdf
    July 13, 2009 - Reengineering hospital discharge: a protocol to improve patient safety, reduce costs, and boost patient satisfaction. July 13, 2009 Clancy CM. Reengineering hospital discharge: a protocol to improve patient safety, reduce costs, and boost patient satisfaction. Am J Med Qual. 2009;24(4):344-6. doi:10.1177/106286060…
  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/857446/psn-pdf
    December 06, 2023 - Community Health Systems’ ongoing journey to zero preventable harm. December 6, 2023 Simon LT, Van Buren T. Community Health Systems’ ongoing journey to zero preventable harm. NEJM Catal Innov Care Deliv. 2023;4(12). doi:10.1056/cat.23.0250. https://psnet.ahrq.gov/issue/community-health-systems-ongoing-journey-zer…
  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/854834/psn-pdf
    January 01, 2024 - Bringing the equity lens to patient safety event reporting. October 25, 2023 Gandhi TK, Schulson LB, Thomas AD. Bringing the equity lens to patient safety event reporting. Jt Comm J Qual Patient Saf. 2024;50(1):87-89. doi:10.1016/j.jcjq.2023.09.003. https://psnet.ahrq.gov/issue/bringing-equity-lens-patient-safety-e…
  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44871/psn-pdf
    April 22, 2016 - Making checklists work: South Carolina's statewide experiment. April 22, 2016 Rice S. MAKING CHECKLISTS WORK. Modern healthcare. 2016;46(4):14-6. https://psnet.ahrq.gov/issue/making-checklists-work-south-carolinas-statewide-experiment Although checklist implementation as a safety strategy has achieved some success…
  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47827/psn-pdf
    February 27, 2019 - Improving Usability, Safety and Patient Outcomes With Health Information Technology. February 27, 2019 Lau F, Bartle-Clar JA, Bliss G, et al, eds. Stud Health Technol Inform. 2019;257:1-539. ISBN: 9781614999508. https://psnet.ahrq.gov/issue/improving-usability-safety-and-patient-outcomes-health-information-technol…
  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43819/psn-pdf
    July 16, 2015 - Intercepting wrong-patient orders in a computerized provider order entry system. July 16, 2015 Green RA, Hripcsak G, Salmasian H, et al. Intercepting wrong-patient orders in a computerized provider order entry system. Ann Emerg Med. 2015;65(6):679-686.e1. doi:10.1016/j.annemergmed.2014.11.017. https://psnet.ahrq.g…
  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/34646/psn-pdf
    July 01, 2015 - The attributes of medical event reporting systems. July 1, 2015 Battles JB, Kaplan HS, van der Schaaf TW, et al. The attributes of medical event-reporting systems: experience with a prototype medical event-reporting system for transfusion medicine. Arch Pathol Lab Med. 1998;122(3):231-8. https://psnet.ahrq.gov/iss…
  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/839814/psn-pdf
    January 01, 2023 - Influencing a culture of quality and safety through huddles. November 9, 2022 McCain N, Ferguson T, Barry Hultquist T, et al. Influencing a culture of quality and safety through huddles. J Nurs Care Qual. 2023;38(1):26-32. doi:10.1097/ncq.0000000000000642. https://psnet.ahrq.gov/issue/influencing-culture-quality-a…
  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/764411/psn-pdf
    March 02, 2022 - Nowhere is safe: record number of patients contracted Covid in the hospital in January. March 2, 2022 Levy R, Vestal AJ. Politico. February 19, 2022. https://psnet.ahrq.gov/issue/nowhere-safe-record-number-patients-contracted-covid-hospital-january Transmission of COVID-19 in the health care setting continues to b…
  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/837077/psn-pdf
    May 11, 2022 - At US hospitals, a drug mix-up is just a few keystrokes away. May 11, 2022 Kelman B. Kaiser Health News. April 29, 2022. https://psnet.ahrq.gov/issue/us-hospitals-drug-mix-just-few-keystrokes-away Technological solutions harbor unique risks that can result in patient harm. This article shares a response to report…
  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/846762/psn-pdf
    March 29, 2023 - Hospital ‘black boxes’ put surgical practices under the microscope. March 29, 2023 Sadick B. Wall Street Journal. March 19, 2023. https://psnet.ahrq.gov/issue/hospital-black-boxes-put-surgical-practices-under-microscope Safety information systems that track action in real time can reveal a trove of data about how …
  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46005/psn-pdf
    July 11, 2018 - The 2016 John M. Eisenberg Patient Safety and Quality Awards. July 11, 2018 Jt Comm J Qual Patient Saf. 2017;43:315-337. https://psnet.ahrq.gov/issue/2016-john-m-eisenberg-patient-safety-and-quality-awards Spotlighting the accomplishments of the 2016 recipients of the John M. Eisenberg Patient Safety and Quality …
  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42971/psn-pdf
    February 26, 2014 - Reducing central line–associated bloodstream infections in North Carolina NICUs. February 26, 2014 Fisher D, Cochran KM, Provost LP, et al. Reducing central line-associated bloodstream infections in North Carolina NICUs. Pediatrics. 2013;132(6):e1664-71. doi:10.1542/peds.2013-2000. https://psnet.ahrq.gov/issue/red…
  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/39695/psn-pdf
    July 21, 2010 - The impact of the 80-hour work week on appropriate resident case coverage. July 21, 2010 Shin S, Britt R, Doviak M, et al. The Impact of the 80-Hour Work Week on Appropriate Resident Case Coverage. Journal of Surgical Research. 2009;162(1). doi:10.1016/j.jss.2009.12.003. https://psnet.ahrq.gov/issue/impact-80-hour…
  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45257/psn-pdf
    July 27, 2016 - Exploring approaches to patient safety: the case of spinal manipulation therapy. July 27, 2016 Rozmovits L, Mior S, Boon H. Exploring approaches to patient safety: the case of spinal manipulation therapy. BMC Complement Altern Med. 2016;16:164. doi:10.1186/s12906-016-1149-2. https://psnet.ahrq.gov/issue/exploring-…
  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/39789/psn-pdf
    August 25, 2010 - Using evidence, rigorous measurement, and collaboration to eliminate central catheter-associated bloodstream infections. August 25, 2010 Sawyer M, Weeks K, Goeschel CA, et al. Using evidence, rigorous measurement, and collaboration to eliminate central catheter-associated bloodstream infections. Crit Care Med. 201…
  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/38555/psn-pdf
    April 15, 2009 - Standardized sign-out reduces intern perception of medical errors on the general internal medicine ward. April 15, 2009 Salerno SM, Arnett M, Domanski JP. Standardized sign-out reduces intern perception of medical errors on the general internal medicine ward. Teach Learn Med. 2009;21(2):121-6. doi:10.1080/10401330…
  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/72535/psn-pdf
    December 02, 2020 - Learning from influenza vaccine errors to prepare for COVID-19 vaccination campaigns. December 2, 2020 ISMP Medication Safety Alert! Acute care edition. November 19, 2020;25(23):1-6. https://psnet.ahrq.gov/issue/learning-influenza-vaccine-errors-prepare-covid-19-vaccination-campaigns Safety professionals enco…
  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/36224/psn-pdf
    October 19, 2010 - Nonpunitive medication error reporting: 3-year findings from one hospital's primum non nocere initiative. October 19, 2010 Potylycki MJ, Kimmel SR, Ritter M, et al. Nonpunitive medication error reporting: 3-year findings from one hospital's Primum Non Nocere initiative. J Nurs Adm. 2006;36(7-8):370-376. https://ps…
  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41559/psn-pdf
    August 01, 2012 - Design and trial of a new ambulance-to-emergency department handover protocol: 'IMIST-AMBO.' August 1, 2012 Iedema R, Ball C, Daly B, et al. Design and trial of a new ambulance-to-emergency department handover protocol: 'IMIST-AMBO'. BMJ Qual Saf. 2012;21(8):627-33. doi:10.1136/bmjqs-2011-000766. https://psnet.ahr…

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