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psnet.ahrq.gov/issue/situation-background-assessment-and-recommendation-guided-huddles-improve-communication-and
September 23, 2020 - Study
Situation, background, assessment, and recommendation–guided huddles improve communication and teamwork in the emergency department.
Citation Text:
Martin HA, Ciurzynski SM. Situation, Background, Assessment, and Recommendation-Guided Huddles Improve Communication and Teamwork in t…
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psnet.ahrq.gov/issue/surgical-ward-round-checklist-improving-patient-safety-and-clinical-documentation
March 17, 2021 - Study
The surgical ward round checklist: improving patient safety and clinical documentation.
Citation Text:
Krishnamohan N, Maitra I, Shetty VD. The surgical ward round checklist: improving patient safety and clinical documentation. J Multidiscip Healthc. 2019;12:789-794. doi:10.2147/JM…
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psnet.ahrq.gov/issue/surgeon-agreement-time-handover-prospective-cohort-study
July 19, 2010 - Study
Surgeon agreement at the time of handover, a prospective cohort study.
Citation Text:
Hilsden R, Moffat B, Knowles S, et al. Surgeon agreement at the time of handover, a prospective cohort study. World J Emerg Surg. 2016;11:11. doi:10.1186/s13017-016-0065-6.
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psnet.ahrq.gov/issue/avoiding-unintended-consequences-growth-medical-care-how-might-more-be-worse
April 24, 2018 - Commentary
Classic
Avoiding the unintended consequences of growth in medical care: how might more be worse?
Citation Text:
Fisher ES, Welch HG. Avoiding the unintended consequences of growth in medical care: how might more be worse? JAMA. 1999;281(5):446-53.
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psnet.ahrq.gov/issue/ihinpsf-lucian-leape-institute
July 12, 2017 - Multi-use Website
IHI Lucian Leape Institute.
Citation Text:
IHI Lucian Leape Institute. Institute for Healthcare Improvement.
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psnet.ahrq.gov/node/46296/psn-pdf
September 24, 2017 - Perception of safety of surgical practice among operating
room personnel from survey data is associated with all-
cause 30-day postoperative death rate in South Carolina.
September 24, 2017
Molina G, Berry WR, Lipsitz S, et al. Perception of Safety of Surgical Practice Among Operating Room
Personnel From Survey Da…
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psnet.ahrq.gov/node/45218/psn-pdf
June 15, 2016 - Patient Safety and Quality Improvement Act of 2005--HHS
guidance regarding patient safety work product and
providers' external obligations.
June 15, 2016
Agency for Healthcare Research and Quality. Fed Regist. 2016;81(100);32655-32660.
https://psnet.ahrq.gov/issue/patient-safety-and-quality-improvement-act-2005-hh…
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psnet.ahrq.gov/node/43681/psn-pdf
June 03, 2016 - Learning from failure: the need for independent safety
investigation in healthcare.
June 3, 2016
Macrae C, Vincent CA. Learning from failure: the need for independent safety investigation in healthcare. J
R Soc Med. 2014;107(11):439-443. doi:10.1177/0141076814555939.
https://psnet.ahrq.gov/issue/learning-failure-n…
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psnet.ahrq.gov/node/46793/psn-pdf
February 28, 2018 - Patient safety movement: history and future directions.
February 28, 2018
Lark ME, Kirkpatrick K, Chung KC. Patient Safety Movement: History and Future Directions. J Hand Surg
Am. 2018;43(2). doi:10.1016/j.jhsa.2017.11.006.
https://psnet.ahrq.gov/issue/patient-safety-movement-history-and-future-directions
The pati…
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psnet.ahrq.gov/node/46146/psn-pdf
June 07, 2017 - Increasing patient safety event reporting in an emergency
medicine residency.
June 7, 2017
Steen S, Jaeger C, Price L, et al. Increasing Patient Safety Event Reporting in an Emergency Medicine
Residency. BMJ Qual Improv Rep. 2017;6(1). doi:10.1136/bmjquality.u223876.w5716.
https://psnet.ahrq.gov/issue/increasing-p…
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psnet.ahrq.gov/node/36476/psn-pdf
December 14, 2009 - 10 Patient Safety Tips for Hospitals.
December 14, 2009
Rockville, MD: Agency for Healthcare Research and Quality; December 2009. AHRQ Publication No. 10-
M008.
https://psnet.ahrq.gov/issue/10-patient-safety-tips-hospitals
This tip sheet provides 10 practical steps hospitals can undertake to improve patient safety…
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psnet.ahrq.gov/node/46113/psn-pdf
July 12, 2017 - Optimizing a Business Case for Safe Health Care: An
Integrated Approach to Safety and Finance.
July 12, 2017
Institute for Healthcare Improvement, National Patient Safety Foundation. Cambridge, MA: Institute for
Healthcare Improvement; 2017.
https://psnet.ahrq.gov/issue/optimizing-business-case-safe-health-care-in…
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psnet.ahrq.gov/node/44962/psn-pdf
March 09, 2016 - Patient Safety: Hospitals Face Challenges Implementing
Evidence-Based Practices.
March 9, 2016
Washington, DC: United States Government Accountability Office; February 2016. Publication GAO-16-
308.
https://psnet.ahrq.gov/issue/patient-safety-hospitals-face-challenges-implementing-evidence-based-
practices
Despi…
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psnet.ahrq.gov/node/73063/psn-pdf
March 24, 2021 - Clinical data sharing improves quality measurement and
patient safety.
March 24, 2021
D’Amore JD, McCrary LK, Denson J, et al. Clinical data sharing improves quality measurement and patient
safety. J Am Med Inform Assoc. 2021;28(7):1534-1542. doi:10.1093/jamia/ocab039.
https://psnet.ahrq.gov/issue/clinical-data-sh…
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psnet.ahrq.gov/node/852459/psn-pdf
August 16, 2023 - Reimagining Healthcare Teams: Leveraging the Patient-
Clinician-AI Triad To Improve Diagnostic Safety.
August 16, 2023
James C, Singh K, Valley TS, et al. Rockville, MD; Agency for Healthcare Research and Quality; July 2023.
AHRQ Publication No. 23-0040-4-EF.
https://psnet.ahrq.gov/issue/reimagining-healthcare-tea…
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psnet.ahrq.gov/node/849607/psn-pdf
May 31, 2023 - Use of technology to improve the adherence to surgical
safety checklists in the operating room.
May 31, 2023
Pati AB, Mishra TS, Chappity P, et al. Use of technology to improve the adherence to surgical safety
checklists in the operating room. Jt Comm J Qual Patient Saf. 2023;49(10):572-577.
doi:10.1016/j.jcjq.202…
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psnet.ahrq.gov/node/34848/psn-pdf
February 17, 2011 - Improving patient safety—five years after the IOM report.
February 17, 2011
Altman DE, Clancy CM, Blendon RJ. Improving Patient Safety — Five Years after the IOM Report. New
Engl J Med. 2004;351(20):2041-2043. doi:10.1056/nejmp048243.
https://psnet.ahrq.gov/issue/improving-patient-safety-five-years-after-iom-report…
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psnet.ahrq.gov/node/45283/psn-pdf
June 29, 2016 - Goals and Priorities for Health Care Organizations to
Improve Safety Using Health IT. Revised Report.
June 29, 2016
Graber ML, Bailey R, Johnston D. RTI International; Washington, DC: US Department of Health and
Human Services, Office of the National Coordinator for Health Information Technology; 2016.
https://psn…
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psnet.ahrq.gov/node/47542/psn-pdf
January 16, 2019 - Utilizing a Systems and Design Thinking Approach for
Improving Well-Being Within Health Professional
Education and Health Care.
January 16, 2019
Kreitzer MJ, Carter K, Coffey DS, et al. NAM Perspectives. Washington, DC: National Academy of
Medicine; 2019.
https://psnet.ahrq.gov/issue/utilizing-systems-and-design-…
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psnet.ahrq.gov/node/43201/psn-pdf
May 21, 2014 - New HHS Data Shows Major Strides Made in Patient
Safety, Leading to Improved Care and Savings.
May 21, 2014
Washington, DC: US Department of Health and Human Services; May 7, 2014.
https://psnet.ahrq.gov/issue/new-hhs-data-shows-major-strides-made-patient-safety-leading-improved-
care-and-savings
Comparing safety…