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psnet.ahrq.gov/issue/prevention-medical-accidents-caused-defective-surgical-instruments
July 31, 2019 - Study
Prevention of medical accidents caused by defective surgical instruments.
Citation Text:
Yasuhara H, Fukatsu K, Komatsu T, et al. Prevention of medical accidents caused by defective surgical instruments. Surgery. 2012;151(2):153-61. doi:10.1016/j.surg.2011.06.029.
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psnet.ahrq.gov/issue/misunderstanding-safety-culture-and-its-relationship-safety-management
May 10, 2014 - Commentary
(Mis)understanding safety culture and its relationship to safety management.
Citation Text:
Guldenmund FW. (Mis)understanding Safety Culture and Its Relationship to Safety Management. Risk Anal. 2010;30(10):1466-80. doi:10.1111/j.1539-6924.2010.01452.x.
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psnet.ahrq.gov/issue/help-your-patient-get-what-you-just-said-health-literacy-guide
December 18, 2014 - Commentary
Help your patient "get" what you just said: a health literacy guide.
Citation Text:
Roett MA, Wessel L. Help your patient "get" what you just said: a health literacy guide. J Family Pract. 2012;61(4):190-196.
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psnet.ahrq.gov/issue/error-blame-and-law-health-care-antipodean-perspective
August 02, 2015 - Commentary
Error, blame, and the law in health care—an antipodean perspective.
Citation Text:
Runciman WB, Merry A, Tito F. Error, blame, and the law in health care--an antipodean perspective. Ann Intern Med. 2003;138(12):974-9.
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psnet.ahrq.gov/issue/teaching-smart-people-learn
September 05, 2012 - Study
Classic
Teaching smart people how to learn.
Citation Text:
Teaching smart people how to learn. Argyris C. Harvard Business Review. 1991:69(May-June):99+.
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psnet.ahrq.gov/issue/decreasing-30-day-readmission-rates
July 19, 2018 - Commentary
Decreasing 30-day readmission rates.
Citation Text:
Lacker C. Decreasing 30-day readmission rates. Am J Nurs. 2011;111(11):65-69. doi:10.1097/01.NAJ.0000407308.53587.02.
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psnet.ahrq.gov/issue/identifying-violation-provoking-conditions-healthcare-setting
April 18, 2011 - Study
Identifying violation-provoking conditions in a healthcare setting.
Citation Text:
Phipps D, Parker D, Pals EJM, et al. Identifying violation-provoking conditions in a healthcare setting. Ergonomics. 2008;51(11):1625-42. doi:10.1080/00140130802331617.
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psnet.ahrq.gov/issue/misdiagnosis-dangerous-help-your-doctor-get-it-right
August 03, 2022 - Newspaper/Magazine Article
Misdiagnosis is dangerous. Help your doctor get it right.
Citation Text:
Terry K. Misdiagnosis is dangerous. Help your doctor get it right. WebMD. November 11, 2024;
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psnet.ahrq.gov/issue/barbers-civility
October 07, 2015 - Commentary
Barbers of civility.
Citation Text:
Klein AS, Forni PM. Barbers of civility. Arch Surg. 2011;146(7):774-7. doi:10.1001/archsurg.2011.150.
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psnet.ahrq.gov/issue/standardizing-hospital-discharge-planning-mayo-clinic
October 19, 2022 - Study
Standardizing hospital discharge planning at the Mayo Clinic.
Citation Text:
Holland DE, Hemann MA. Standardizing hospital discharge planning at the Mayo Clinic. Jt Comm J Qual Patient Saf. 2011;37(1):29-36.
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psnet.ahrq.gov/issue/assessing-teamwork-and-communication-authentic-patient-care-learning-environment
July 02, 2014 - Commentary
Assessing teamwork and communication in the authentic patient care learning environment.
Citation Text:
Haftel HM, Hicks PJ. Assessing teamwork and communication in the authentic patient care learning environment. Pediatrics. 2011;127(4):601-3. doi:10.1542/peds.2010-3767.
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psnet.ahrq.gov/issue/detecting-medication-administration-errors
August 17, 2022 - Commentary
Detecting medication administration errors.
Citation Text:
Durham ML, Jankiewicz A. Detecting Medication Administration Errors. J Patient Saf. 2019;15(3):181-183. doi:10.1097/PTS.0000000000000384.
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psnet.ahrq.gov/issue/interview-peter-pronovost
July 01, 2017 - Award Recipient
An interview with Peter Pronovost
Citation Text:
Pronovost P. An interview with Peter Pronovost. Jt Comm J Qual Saf. 2004;30(12):659-64.
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psnet.ahrq.gov/issue/physicians-personal-experiences-cancer-neck-patient-errors-my-care
August 25, 2021 - Commentary
A physician's personal experiences as a cancer of the neck patient: errors in my care.
Citation Text:
Brook I. A Physician’s Personal Experiences as a Cancer of the Neck Patient: Errors in My Care. Am J Med Qual. 2011;26(1):73-74. doi:10.1177/1062860610381917.
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psnet.ahrq.gov/issue/ask-me-if-i-cleaned-my-hands
December 07, 2022 - Commentary
Ask me if I cleaned my hands.
Citation Text:
Gordon SC. A piece of my mind. Ask me if I cleaned my hands. JAMA. 2012;307(15):1591-2. doi:10.1001/jama.2012.474.
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psnet.ahrq.gov/issue/record-avoiding-pitfalls-going-electronic
October 25, 2017 - Commentary
Off the record — avoiding the pitfalls of going electronic.
Citation Text:
Hartzband P, Groopman J. Off the record--avoiding the pitfalls of going electronic. N Engl J Med. 2008;358(16):1656-8. doi:10.1056/NEJMp0802221.
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psnet.ahrq.gov/issue/joint-commission-offers-warnings-advice-adopting-new-health-care-it-systems
September 12, 2016 - Newspaper/Magazine Article
Joint Commission offers warnings, advice on adopting new health care IT systems.
Citation Text:
Mitka M. Joint commission offers warnings, advice on adopting new health care IT systems. JAMA. 2009;301(6):587-9. doi:10.1001/jama.2009.37.
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psnet.ahrq.gov/issue/fallacious-reasoning-and-complexity-root-causes-clinical-inertia
June 17, 2020 - Commentary
Fallacious reasoning and complexity as root causes of clinical inertia.
Citation Text:
Miles RW. Fallacious reasoning and complexity as root causes of clinical inertia. J Am Med Dir Assoc. 2007;8(6):349-54.
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psnet.ahrq.gov/issue/ahrq-focuses-ambulatory-patient-safety
January 31, 2024 - Commentary
AHRQ focuses on ambulatory patient safety.
Citation Text:
Ricciardi R. AHRQ Focuses on Ambulatory Patient Safety. J Nurs Care Qual. 2015;30(3):193-6. doi:10.1097/NCQ.0000000000000124.
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psnet.ahrq.gov/issue/guideline-prevention-unintentionally-retained-surgical-items
August 01, 2018 - Commentary
Guideline for Prevention of Unintentionally Retained Surgical Items.
Citation Text:
Croke L. Guideline for prevention of unintentionally retained surgical items. AORN J. 2021;114(6):4-6. doi:10.1002/aorn.13579.
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