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psnet.ahrq.gov/node/39782/psn-pdf
August 25, 2010 - Developing a common language for evaluation questions
in quality and safety improvement.
August 25, 2010
Lambert MF; Shearer H.
https://psnet.ahrq.gov/issue/developing-common-language-evaluation-questions-quality-and-safety-
improvement
This commentary discusses several frameworks for evaluating patient safety an…
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psnet.ahrq.gov/node/41089/psn-pdf
January 25, 2012 - Improving patient safety: lessons from rock climbing.
January 25, 2012
Robertson N. Improving patient safety: lessons from rock climbing. Clin Teach. 2012;9(1):41-4.
doi:10.1111/j.1743-498X.2011.00485.x.
https://psnet.ahrq.gov/issue/improving-patient-safety-lessons-rock-climbing
This commentary proposes that apply…
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psnet.ahrq.gov/node/41477/psn-pdf
June 27, 2012 - Surgical safety checklists: do they improve outcomes?
June 27, 2012
Walker IA, Reshamwalla S, Wilson IH. Surgical safety checklists: do they improve outcomes? Br J
Anaesth. 2012;109(1):47-54. doi:10.1093/bja/aes175.
https://psnet.ahrq.gov/issue/surgical-safety-checklists-do-they-improve-outcomes
This review discus…
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psnet.ahrq.gov/node/35956/psn-pdf
August 02, 2010 - Patient Guide: 10 Ways to Improve Communication with
Your Doctor.
August 2, 2010
Patient Guide: 10 Ways to Improve Communication With Your Doctor. J Patient Saf. 2008;1(4).
doi:10.1097/01.jps.0000199856.82316.50.
https://psnet.ahrq.gov/issue/patient-guide-10-ways-improve-communication-your-doctor
This article lis…
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psnet.ahrq.gov/node/42187/psn-pdf
April 10, 2013 - Insurers' Medical Loss Ratios and Quality Improvement
Spending in 2011.
April 10, 2013
Hall M, McCue MJ. New York, NY: The Commonwealth Fund; March 22, 2013.
https://psnet.ahrq.gov/issue/insurers-medical-loss-ratios-and-quality-improvement-spending-2011
This report found that insurance companies spend on average $…
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psnet.ahrq.gov/node/39147/psn-pdf
January 13, 2010 - Following the patient journey to improve medicines
management and reduce errors.
January 13, 2010
Crocker C. Following the patient journey to improve medicines management and reduce errors. Nursing
times. 2009;105(46):12-5.
https://psnet.ahrq.gov/issue/following-patient-journey-improve-medicines-management-and-red…
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psnet.ahrq.gov/node/35100/psn-pdf
November 04, 2015 - Patient Safety Improvement Corps: An AHRQ/VA
partnership.
November 4, 2015
AHRQ; Agency for Healthcare Research and Quality.
https://psnet.ahrq.gov/issue/patient-safety-improvement-corps-ahrqva-partnership
The Agency for Healthcare Research and Quality announces the 2007–2008 Patient Safety Improvement
Corps (PSI…
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psnet.ahrq.gov/issue/experiences-lean-six-sigma-improvement-strategy-reduce-parenteral-medication-administration
October 13, 2021 - Commentary
Experiences with Lean Six Sigma as improvement strategy to reduce parenteral medication administration errors and associated potential risk of harm.
Citation Text:
van de Plas A, Slikkerveer M, Hoen S, et al. Experiences with Lean Six Sigma as improvement strategy to reduce pa…
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psnet.ahrq.gov/issue/using-incident-reporting-improve-patient-safety-conceptual-model
June 29, 2009 - Commentary
Using incident reporting to improve patient safety: a conceptual model.
Citation Text:
Pronovost PJ, Holzmueller CG, Young J, et al. Using Incident Reporting to Improve Patient Safety. J Patient Saf. 2008;3(1). doi:10.1097/pts.0b013e318030ca05.
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Format:
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psnet.ahrq.gov/issue/national-pediatric-anesthesia-safety-quality-improvement-program-united-states
March 03, 2011 - Study
National pediatric anesthesia safety quality improvement program in the United States.
Citation Text:
Kurth D, Tyler D, Heitmiller ES, et al. National pediatric anesthesia safety quality improvement program in the United States. Anesth Analg. 2014;119(1):112-21. doi:10.1213/ANE.000…
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psnet.ahrq.gov/issue/preventable-harm-index-effective-motivator-facilitate-drive-zero
January 15, 2014 - Commentary
The Preventable Harm Index: an effective motivator to facilitate the drive to zero.
Citation Text:
Brilli RJ, McClead RE, Davis T, et al. The Preventable Harm Index: an effective motivator to facilitate the drive to zero. J Pediatr. 2010;157(4):681-3. doi:10.1016/j.jpeds.201…
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psnet.ahrq.gov/issue/executivesenior-leader-checklist-improve-culture-and-reduce-central-line-associated
August 25, 2010 - Commentary
Executive/senior leader checklist to improve culture and reduce central line–associated bloodstream infections.
Citation Text:
Goeschel CA, Holzmueller CG, Berenholtz SM, et al. Executive/Senior Leader Checklist to improve culture and reduce central line-associated bloodstream…
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psnet.ahrq.gov/issue/latent-risk-assessment-tool-health-care-leaders
September 05, 2018 - Commentary
Latent risk assessment tool for health care leaders.
Citation Text:
Paine LA, Holzmueller CG, Elliott R, et al. Latent risk assessment tool for health care leaders. J Healthc Risk Manag. 2018;38(2):36-46. doi:10.1002/jhrm.21316.
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DOI Google S…
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psnet.ahrq.gov/issue/armstrong-institute-academic-institute-patient-safety-and-quality-improvement-research
September 27, 2017 - Commentary
The Armstrong Institute: an academic institute for patient safety and quality improvement, research, training, and practice.
Citation Text:
Pronovost P, Holzmueller CG, Molello NE, et al. The Armstrong Institute: An Academic Institute for Patient Safety and Quality Improvement…
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psnet.ahrq.gov/issue/ten-strategies-improve-management-abnormal-test-result-alerts-electronic-health-record
April 14, 2011 - Commentary
Ten strategies to improve management of abnormal test result alerts in the electronic health record.
Citation Text:
Singh H, Wilson L, Reis B, et al. Ten strategies to improve management of abnormal test result alerts in the electronic health record. J Patient Saf. 2010;6(2)…
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psnet.ahrq.gov/issue/state-science-and-future-directions-improve-diagnostic-safety-older-adults
January 22, 2025 - Book/Report
State of the Science and Future Directions to Improve Diagnostic Safety in Older Adults.
Citation Text:
Tran AK, Syed Q, Bierman AS, et al. State Of The Science And Future Directions To Improve Diagnostic Safety In Older Adults. Rockville, MD: Agency for Healthcare Research a…
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psnet.ahrq.gov/issue/improving-safety-culture-adult-medical-units-through-multidisciplinary-teamwork-and
February 18, 2011 - Study
Improving safety culture on adult medical units through multidisciplinary teamwork and communication interventions: the TOPS Project.
Citation Text:
Blegen MA, Sehgal NL, Alldredge BK, et al. Improving safety culture on adult medical units through multidisciplinary teamwork and c…
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psnet.ahrq.gov/issue/tension-between-needing-improve-care-and-knowing-how-do-it
June 03, 2010 - Commentary
Classic
The tension between needing to improve care and knowing how to do it.
Citation Text:
Auerbach AD, Landefeld S, Shojania KG. The tension between needing to improve care and knowing how to do it. N Engl J Med. 2007;357(6):608-13.
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psnet.ahrq.gov/issue/quality-improvement-approach-standardization-and-sustainability-hand-process
May 15, 2019 - Commentary
A quality improvement approach to standardization and sustainability of the hand-off process.
Citation Text:
Fryman C, Hamo C, Raghavan S, et al. A Quality Improvement Approach to Standardization and Sustainability of the Hand-off Process. BMJ Qual Improv Rep. 2017;6(1). doi:1…
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psnet.ahrq.gov/issue/patient-safety-culture-transformation-childrens-hospital-interprofessional-approach
January 16, 2010 - Study
Patient safety culture transformation in a children's hospital: an interprofessional approach.
Citation Text:
Nagelkerk J, Peterson T, Pawl BL, et al. Patient safety culture transformation in a children's hospital: an interprofessional approach. J Interprof Care. 2014;28(4):358-64.…