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psnet.ahrq.gov/issue/association-simulation-training-rates-medical-malpractice-claims-among-obstetrician
December 02, 2020 - Study
Association of simulation training with rates of medical malpractice claims among obstetrician-gynecologists.
Citation Text:
Schaffer AC, Babayan A, Einbinder JS, et al. Association of simulation training with rates of medical malpractice claims among obstetrician-gynecologists. Ob…
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psnet.ahrq.gov/issue/medical-errors-and-patient-safety-palliative-care-review-current-literature
December 04, 2016 - Review
Medical errors and patient safety in palliative care: a review of current literature.
Citation Text:
Dietz I, Borasio GD, Schneider G, et al. Medical errors and patient safety in palliative care: a review of current literature. J Palliat Med. 2010;13(12):1469-74. doi:10.1089/jpm.2…
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psnet.ahrq.gov/issue/liability-associated-obstetric-anesthesia-closed-claims-analysis
July 13, 2010 - Study
Liability associated with obstetric anesthesia: a closed claims analysis.
Citation Text:
Davies JM, Posner KL, Lee LA, et al. Liability associated with obstetric anesthesia: a closed claims analysis. Anesthesiology. 2009;110(1):131-139. doi:10.1097/ALN.0b013e318190e16a.
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psnet.ahrq.gov/issue/surgical-programs-veterans-health-administration-maintain-briefing-and-debriefing-following
October 24, 2018 - Study
Surgical programs in the Veterans Health Administration maintain briefing and debriefing following medical team training.
Citation Text:
West P, Neily J, Warner L, et al. Surgical programs in the Veterans Health Administration maintain briefing and debriefing following medical team…
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psnet.ahrq.gov/issue/diagnostic-error-pediatric-hospital-narrative-review
November 16, 2022 - Review
Diagnostic error in the pediatric hospital: a narrative review.
Citation Text:
Sawicki JG, Nystrom DT, Purtell R, et al. Diagnostic error in the pediatric hospital: a narrative review. Hosp Pract (1995). 2021;49((supp1):437-444. doi:10.1080/21548331.2021.2004040.
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…
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psnet.ahrq.gov/issue/measuring-patient-safety-medicare-patient-safety-monitoring-system-past-present-and-future
December 18, 2014 - Review
Measuring patient safety: the Medicare Patient Safety Monitoring System (past, present, and future).
Citation Text:
Classen D, Munier W, Verzier N, et al. Measuring Patient Safety: The Medicare Patient Safety Monitoring System (Past, Present, and Future). J Patient Saf. 2021;17(3)…
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psnet.ahrq.gov/issue/conversations-diagnostic-uncertainty-and-its-management-among-pediatric-acute-care-physicians
March 17, 2021 - Study
Conversations on diagnostic uncertainty and its management among pediatric acute care physicians.
Citation Text:
Patel SJ, Ipsaro A, Brady PW. Conversations on diagnostic uncertainty and its management among pediatric acute care physicians. Hosp Pediatr. 2022;12(3):317-324. doi:10.…
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psnet.ahrq.gov/issue/danger-discharge-summaries-abbreviations-create-confusion-both-author-and-recipient
March 15, 2017 - Study
Danger in discharge summaries: abbreviations create confusion for both author and recipient.
Citation Text:
Coghlan A, Turner S, Coverdale S. Danger in discharge summaries: abbreviations create confusion for both author and recipient. Intern Med J. 2023;53(4):550-558. doi:10.1111/i…
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psnet.ahrq.gov/issue/assessing-patient-safety-culture-hospital-settings
August 18, 2021 - Review
Assessing patient safety culture in hospital settings.
Citation Text:
Azyabi A. Assessing patient safety culture in hospital settings. Int J Environ Res Public Health. 2021;18(5):2466. doi:10.3390/ijerph18052466.
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DOI Google Scholar BibTeX EndNot…
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psnet.ahrq.gov/issue/negative-behaviours-health-care-prevalence-and-strategies
May 01, 2024 - Study
Negative behaviours in health care: prevalence and strategies.
Citation Text:
Layne DM, Nemeth LS, Mueller M, et al. Negative behaviours in health care: Prevalence and strategies. J Nurs Manag. 2019;27(1):154-160. doi:10.1111/jonm.12660.
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Format:
DOI Goog…
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psnet.ahrq.gov/issue/meta-review-methods-measuring-and-monitoring-safety-primary-care
November 03, 2021 - Review
A meta-review of methods of measuring and monitoring safety in primary care.
Citation Text:
O’Connor P, Madden C, O’Dowd E, et al. A meta-review of methods of measuring and monitoring safety in primary care. Int J Qual Health Care. 2021;33(3):mzab117. doi:10.1093/intqhc/mzab117.
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psnet.ahrq.gov/node/33893/psn-pdf
February 19, 2010 - The revolutionary.
February 19, 2010
Swidey N.
https://psnet.ahrq.gov/issue/revolutionary
An introduction to Donald Berwick, CEO of Boston's Institute for Healthcare Improvement, and his vision for
reshaping health care to improve patient safety and quality.
https://psnet.ahrq.gov/issue/revolutionary
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psnet.ahrq.gov/node/867656/psn-pdf
February 26, 2025 - In Conversation with Lucy Savitz about Learning Health
Systems for Patient Safety
February 26, 2025
Savitz LA, Sousane Z, Mossburg SE. In Conversation with Lucy Savitz about Learning Health Systems for
Patient Safety. PSNet [internet]. 2025.
https://psnet.ahrq.gov/perspective/conversation-lucy-savitz-about-learnin…
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psnet.ahrq.gov/perspective/errors-and-near-misses-what-health-care-could-learn-aviation
September 01, 2006 - Errors and Near Misses: What Health Care Could Learn From Aviation
Carl Macrae, PhD | December 1, 2016
Also Read a Conversation
View more articles from the same authors.
Citation Text:
Macrae C. Errors and Near Misses: What Health Care Could Learn From Aviation…
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psnet.ahrq.gov/node/836876/psn-pdf
May 16, 2022 - Identifying Safety Events in the Prehospital Setting
May 16, 2022
Crowe RP, Mossburg SE, Dowell P. Identifying Safety Events in the Prehospital Setting. PSNet [internet].
2022.
https://psnet.ahrq.gov/perspective/identifying-safety-events-prehospital-setting
Introduction
Measuring and monitoring patient safety in …
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psnet.ahrq.gov/sites/default/files/2020-01/final_spotlight_near_miss_transfusion_01082020_tocme.pdf
January 01, 2020 - Spotlight
Spotlight
“This is the wrong patient’s blood!”:
Evaluating a Near-Miss Wrong
Transfusion Event
Source and Credits
• This presentation is based on the January 2020 AHRQ WebM&M
Spotlight Case
• Commentary by: Sarah Barnhard MD
o Medical Director of Transfusion Services at UC-Davis Health
o Editors in …
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psnet.ahrq.gov/node/33671/psn-pdf
July 01, 2008 - The Soil, Not the Seed: The Real Problem with Root
Cause Analysis
July 1, 2008
Spath P, Minogue W. The Soil, Not the Seed: The Real Problem with Root Cause Analysis. PSNet
[internet]. 2008.
https://psnet.ahrq.gov/perspective/soil-not-seed-real-problem-root-cause-analysis
Perspective
Throughout most of his life, …
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psnet.ahrq.gov/primer/wrong-site-wrong-procedure-and-wrong-patient-surgery
September 15, 2024 - Wrong-Site, Wrong-Procedure, and Wrong-Patient Surgery
Citation Text:
Wrong-Site, Wrong-Procedure, and Wrong-Patient Surgery. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2019.
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Format:
Google Scholar Bib…
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psnet.ahrq.gov/node/49817/psn-pdf
January 01, 2018 - Slow Down: Right Drug, Wrong Formulation
January 1, 2018
Amato MG, Schiff G. Slow Down: Right Drug, Wrong Formulation. PSNet [internet]. 2018.
https://psnet.ahrq.gov/web-mm/slow-down-right-drug-wrong-formulation
The Case
A 65-year-old man presented to his primary care clinic for follow-up after a recent hospitaliz…
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psnet.ahrq.gov/perspective/conversation-witheric-coleman-md-mph
December 01, 2007 - In Conversation with...Eric Coleman, MD, MPH
December 1, 2007
Also Read an Essay
Citation Text:
In Conversation with..Eric Coleman, MD, MPH. PSNet [internet]. 2007.In Conversation with...Eric Coleman, MD, MPH. PSNet [internet]. Rockville (MD): Agency for Healthca…