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psnet.ahrq.gov/node/60868/psn-pdf
September 02, 2020 - Association between implementing comprehensive
learning collaborative strategies in a statewide
collaborative and changes in hospital safety culture.
September 2, 2020
Yuce TK, Yang AD, Johnson JK, et al. Association between implementing comprehensive learning
collaborative strategies in a statewide collaborative …
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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/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/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/33559/psn-pdf
December 15, 2024 - Medication Reconciliation
December 15, 2024
Medication Reconciliation. PSNet [internet]. 2019.
https://psnet.ahrq.gov/primer/medication-reconciliation
PSNet primers are regularly reviewed and updated by the UC Davis PSNet Editorial Team to ensure that
they reflect current research and practice in the patient safet…
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psnet.ahrq.gov/node/846922/psn-pdf
March 29, 2023 - Enhancing Support for Patients’ Social Needs to Reduce
Hospital Readmissions and Improve Health Outcomes
March 29, 2023
https://psnet.ahrq.gov/innovation/enhancing-support-patients-social-needs-reduce-hospital-readmissions-
and-improve-health
Summary
With increasing recognition that health is linked to the condit…
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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/837194/psn-pdf
January 01, 2023 - National improvements in resident physician-reported
patient safety after limiting first-year resident physicians'
extended duration work shifts: a pooled analysis of
prospective cohort studies.
May 25, 2022
Weaver MD, Landrigan CP, Sullivan JP, et al. National improvements in resident physician-reported patient
…
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psnet.ahrq.gov/issue/becoming-hand-hygiene-heroes-implementation-infection-prevention-and-control-campaign-patient
June 15, 2016 - Study
Becoming Hand Hygiene Heroes: implementation of an infection prevention and control campaign for patient and family hospital safety.
Citation Text:
Cheng B, Chan M, Abi-Farrage D, et al. Becoming hand hygiene heroes: implementation of an infection prevention and control campaign fo…
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psnet.ahrq.gov/issue/implementation-science-neglected-opportunity-accelerate-improvements-safety-and-quality
February 14, 2018 - Review
Implementation science: a neglected opportunity to accelerate improvements in the safety and quality of surgical care.
Citation Text:
Hull L, Athanasiou T, Russ S. Implementation Science: A Neglected Opportunity to Accelerate Improvements in the Safety and Quality of Surgical Care…
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psnet.ahrq.gov/issue/implementation-high-reliability-organization-framework-large-integrated-health-care-system
July 14, 2018 - Study
Implementation of a high-reliability organization framework in a large integrated health care system: a pre-post quasi-experimental quality improvement project.
Citation Text:
Sawyer AM, Thiyarajan S, Essen KE, et al. Implementation of a high-reliability organization framework in a…
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psnet.ahrq.gov/issue/improving-quality-insulin-prescribing-people-diabetes-being-discharged-hospital
November 16, 2022 - Journal Article
Improving the quality of insulin prescribing for people with diabetes being discharged from hospital
Citation Text:
Bain A, Silcock J, Kavanagh S, et al. Improving the quality of insulin prescribing for people with diabetes being discharged from hospital. BMJ Open Qual. 2…
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psnet.ahrq.gov/issue/recommendations-improve-usability-drug-drug-interaction-clinical-decision-support-alerts
February 14, 2024 - Commentary
Recommendations to improve the usability of drug–drug interaction clinical decision support alerts.
Citation Text:
Payne TH, Hines LE, Chan RC, et al. Recommendations to improve the usability of drug-drug interaction clinical decision support alerts. J Am Med Inform Assoc. 201…
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psnet.ahrq.gov/issue/publication-inspection-frameworks-qualitative-study-exploring-impact-quality-improvement-and
August 10, 2022 - Study
Publication of inspection frameworks: a qualitative study exploring the impact on quality improvement and regulation in three healthcare settings.
Citation Text:
Weenink J-W, Wallenburg I, Leistikow I, et al. Publication of inspection frameworks: a qualitative study exploring the i…
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psnet.ahrq.gov/issue/analysis-structure-and-content-dashboards-used-monitor-patient-safety-inpatient-setting
March 09, 2022 - Study
An analysis of the structure and content of dashboards used to monitor patient safety in the inpatient setting.
Citation Text:
Kuznetsova M, Frits ML, Dulgarian S, et al. An analysis of the structure and content of dashboards used to monitor patient safety in the inpatient setting.…
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psnet.ahrq.gov/issue/beyond-find-and-fix-improving-quality-and-safety-through-resilient-healthcare-systems
August 04, 2021 - Study
Beyond 'find and fix': improving quality and safety through resilient healthcare systems.
Citation Text:
Anderson JE, Ross AJ, Back J, et al. Beyond ‘find and fix’: improving quality and safety through resilient healthcare systems. Int J Qual Health Care. 2020;32(3):204-211. doi:10…
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psnet.ahrq.gov/issue/measuring-adverse-events-and-levels-harm-pediatric-inpatients-global-trigger-tool
December 18, 2013 - Study
Measuring adverse events and levels of harm in pediatric inpatients with the Global Trigger Tool.
Citation Text:
Kirkendall E, Kloppenborg E, Papp J, et al. Measuring adverse events and levels of harm in pediatric inpatients with the Global Trigger Tool. Pediatrics. 2012;130(5):e12…
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psnet.ahrq.gov/issue/qualitative-analysis-outpatient-medication-use-community-settings-observed-safety
October 26, 2022 - Study
A qualitative analysis of outpatient medication use in community settings: observed safety vulnerabilities and recommendations for improved patient safety.
Citation Text:
Lyson HC, Sharma AE, Cherian R, et al. A Qualitative Analysis of Outpatient Medication Use in Community Setting…
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psnet.ahrq.gov/issue/final-report-prioritization-patient-safety-practices-new-rapid-review-or-rapid-response
December 21, 2022 - Book/Report
Final Report on Prioritization of Patient Safety Practices for a New Rapid Review or Rapid Response. Making Healthcare Safer IV Series.
Citation Text:
Final Report on Prioritization of Patient Safety Practices for a New Rapid Review or Rapid Response. Making Healthcare Safer …