AHRQ Search | Home Page

Preventing patient harm via adverse event review: An APSA survey regarding the role of morbidity and mortality (M&M) conference. | PSNet

psnet.ahrq.gov/issue/preventing-patient-harm-adverse-event-review-apsa-survey-regarding-role-morbidity-and

May 22, 2019 - Study Preventing patient harm via adverse event review: An APSA survey regarding the role of morbidity and mortality (M&M) conference. Citation Text: Berman L, Ottosen M, Renaud E, et al. Preventing patient harm via adverse event review: An APSA survey regarding the role of morbidity and…

Front-line staff perspectives on opportunities for improving the safety and efficiency of hospital work systems. | PSNet

psnet.ahrq.gov/issue/front-line-staff-perspectives-opportunities-improving-safety-and-efficiency-hospital-work

February 04, 2009 - Study Front-line staff perspectives on opportunities for improving the safety and efficiency of hospital work systems. Citation Text: Tucker AL, Singer SJ, Hayes J, et al. Front-line staff perspectives on opportunities for improving the safety and efficiency of hospital work systems. H…

Application of human factors methods to ensure appropriate infant identification and abduction prevention within the hospital setting. | PSNet

psnet.ahrq.gov/issue/application-human-factors-methods-ensure-appropriate-infant-identification-and-abduction

April 27, 2022 - Commentary Application of human factors methods to ensure appropriate infant identification and abduction prevention within the hospital setting. Citation Text: Webster KLW, Stikes R, Bunnell L, et al. Application of human factors methods to ensure appropriate infant identification and a…

Understanding and responding when things go wrong: key principles for primary care educators. | PSNet

psnet.ahrq.gov/issue/understanding-and-responding-when-things-go-wrong-key-principles-primary-care-educators

January 23, 2017 - Study Understanding and responding when things go wrong: key principles for primary care educators. Citation Text: McNab D, Bowie P, Ross A, et al. Understanding and responding when things go wrong: key principles for primary care educators. Educ Prim Care. 2016;27(4):258-66. doi:10.1080…

Can asking emergency physicians whether or not they would have done something differently (WYHDSD) be a useful screening tool to identify emergency department error? | PSNet

psnet.ahrq.gov/issue/can-asking-emergency-physicians-whether-or-not-they-would-have-done-something-differently

July 01, 2016 - Study Can asking emergency physicians whether or not they would have done something differently (WYHDSD) be a useful screening tool to identify emergency department error? Citation Text: Arastehmanesh D, Mangino A, Eshraghi N, et al. Can asking emergency physicians whether or not they wo…

Teamwork, clinical leadership skills and environmental factors that influence missed nursing care - a qualitative study on hospital wards. | PSNet

psnet.ahrq.gov/issue/teamwork-clinical-leadership-skills-and-environmental-factors-influence-missed-nursing-care

August 04, 2010 - Study Teamwork, clinical leadership skills and environmental factors that influence missed nursing care - a qualitative study on hospital wards. Citation Text: Beiboer C, Andela R, Hafsteinsdóttir TB, et al. Teamwork, clinical leadership skills and environmental factors that influence mi…

How can we improve the recognition, reporting and resolution of medical device-related incidents in hospitals? A qualitative study of physicians and registered nurses. | PSNet

psnet.ahrq.gov/issue/how-can-we-improve-recognition-reporting-and-resolution-medical-device-related-incidents

May 06, 2015 - Study How can we improve the recognition, reporting and resolution of medical device-related incidents in hospitals? A qualitative study of physicians and registered nurses. Citation Text: Polisena J, Gagliardi AR, Clifford T. How can we improve the recognition, reporting and resolution …

Safety in fragile, conflict-affected, and vulnerable settings: An evidence scanning approach for identifying patient safety interventions. | PSNet

psnet.ahrq.gov/issue/safety-fragile-conflict-affected-and-vulnerable-settings-evidence-scanning-approach

January 12, 2022 - Review Safety in fragile, conflict-affected, and vulnerable settings: An evidence scanning approach for identifying patient safety interventions. Citation Text: O’Brien N, Shaw A, Flott K, et al. Safety in fragile, conflict-affected, and vulnerable settings: an evidence scanning approach…

Factors associated with hospital admission after outpatient surgery in the Veterans Health Administration. | PSNet

psnet.ahrq.gov/issue/factors-associated-hospital-admission-after-outpatient-surgery-veterans-health-administration

August 17, 2018 - Study Factors associated with hospital admission after outpatient surgery in the Veterans Health Administration. Citation Text: Mull HJ, Rosen AK, O'Brien WJ, et al. Factors Associated with Hospital Admission after Outpatient Surgery in the Veterans Health Administration. Health Serv Res…

Incidence of wrong-site surgery list errors for a 2-year period in a single national health service board. | PSNet

psnet.ahrq.gov/issue/incidence-wrong-site-surgery-list-errors-2-year-period-single-national-health-service-board

March 27, 2019 - Study Incidence of wrong-site surgery list errors for a 2-year period in a single national health service board. Citation Text: Geraghty A, Ferguson L, McIlhenny C, et al. Incidence of wrong-site surgery list errors for a 2-year period in a single national health service board. J Patient…

Patient safety in palliative care: a mixed-methods study of reports to a national database of serious incidents. | PSNet

psnet.ahrq.gov/issue/patient-safety-palliative-care-mixed-methods-study-reports-national-database-serious

May 16, 2018 - Study Emerging Classic Patient safety in palliative care: a mixed-methods study of reports to a national database of serious incidents. Citation Text: Yardley I, Yardley S, Williams H, et al. Patient safety in palliative care: A mixed-methods study of reports to…

Quality improvements in decreasing medication administration errors made by nursing staff in an academic medical center hospital: a trend analysis during the journey to Joint Commission International accreditation and in the post-accreditation era. | PSNet

psnet.ahrq.gov/issue/quality-improvements-decreasing-medication-administration-errors-made-nursing-staff-academic

March 24, 2019 - Study Quality improvements in decreasing medication administration errors made by nursing staff in an academic medical center hospital: a trend analysis during the journey to Joint Commission International accreditation and in the post-accreditation era. Citation Text: Wang H-F, Jin J-F,…

Learning from patient safety incidents: The Green Cross method. | PSNet

psnet.ahrq.gov/issue/learning-patient-safety-incidents-green-cross-method

June 14, 2023 - Study Learning from patient safety incidents: The Green Cross method. Citation Text: Jacobsen HK, Ballangrud R, Birkeli GH. Learning from patient safety incidents: the Green Cross method. Nurs Crit Care. 2024;Epub Jun 26. doi:10.1111/nicc.13114. Copy Citation Format: DOI Go…

When work harms: how better understanding of avoidable employee harm can improve employee safety, patient safety and healthcare quality. | PSNet

psnet.ahrq.gov/issue/when-work-harms-how-better-understanding-avoidable-employee-harm-can-improve-employee-safety

December 16, 2015 - Commentary When work harms: how better understanding of avoidable employee harm can improve employee safety, patient safety and healthcare quality. Citation Text: Jones A, Neal A, Bailey S, et al. When work harms: how better understanding of avoidable employee harm can improve employee s…

Designing and pilot testing of a leadership intervention to improve quality and safety in nursing homes and home care (the SAFE-LEAD intervention). | PSNet

psnet.ahrq.gov/issue/designing-and-pilot-testing-leadership-intervention-improve-quality-and-safety-nursing-homes

April 29, 2020 - Study Designing and pilot testing of a leadership intervention to improve quality and safety in nursing homes and home care (the SAFE-LEAD intervention). Citation Text: Johannessen T, Ree E, Strømme T, et al. Designing and pilot testing of a leadership intervention to improve quality and…

Lessons learned from a national hospital antibiotic stewardship implementation project. | PSNet

psnet.ahrq.gov/issue/lessons-learned-national-hospital-antibiotic-stewardship-implementation-project

July 20, 2022 - Study Lessons learned from a national hospital antibiotic stewardship implementation project. Citation Text: Cosgrove SE, Ahn R, Dullabh P, et al. Lessons learned from a national hospital antibiotic stewardship implementation project. Jt Comm J Qual Patient Saf. 2024;50(6):435-441. doi:1…

The e-Autopsy/e-Biopsy: a systematic chart review to increase safety and diagnostic accuracy. | PSNet

psnet.ahrq.gov/issue/e-autopsye-biopsy-systematic-chart-review-increase-safety-and-diagnostic-accuracy

May 12, 2021 - Commentary The e-Autopsy/e-Biopsy: a systematic chart review to increase safety and diagnostic accuracy. Citation Text: Kanter MH, Ghobadi A, Lurvey LD, et al. The e-Autopsy/e-Biopsy: a systematic chart review to increase safety and diagnostic accuracy. Diagnosis (Berl). 2022;9(4):430-43…

Six major steps to make investigations of suicide valuable for learning and prevention. | PSNet

psnet.ahrq.gov/issue/six-major-steps-make-investigations-suicide-valuable-learning-and-prevention

December 07, 2022 - Review Six major steps to make investigations of suicide valuable for learning and prevention. Citation Text: Fröding E, Vincent C, Andersson-Gäre B, et al. Six major steps to make investigations of suicide valuable for learning and prevention. Arch Suicide Res. 2024;28(1):1-19. doi:10.1…

Implementation of the trigger review method in Scottish general practices: patient safety outcomes and potential for quality improvement. | PSNet

psnet.ahrq.gov/issue/implementation-trigger-review-method-scottish-general-practices-patient-safety-outcomes-and

November 07, 2011 - Study Implementation of the trigger review method in Scottish general practices: patient safety outcomes and potential for quality improvement. Citation Text: de Wet C, Black C, Luty S, et al. Implementation of the trigger review method in Scottish general practices: patient safety outco…

Using four-phased unit-based patient safety walkrounds to uncover correctable system flaws. | PSNet

psnet.ahrq.gov/issue/using-four-phased-unit-based-patient-safety-walkrounds-uncover-correctable-system-flaws

October 05, 2022 - Study Using four-phased unit-based patient safety walkrounds to uncover correctable system flaws. Citation Text: Taylor AM, Chuo J, Figueroa-Altmann A, et al. Using four-phased unit-based patient safety walkrounds to uncover correctable system flaws. Jt Comm J Qual Patient Saf. 2013;39…

Search AHRQ

Results