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psnet.ahrq.gov/node/35989/psn-pdf
September 17, 2010 - Using preprinted medication order forms to improve the
safety of investigational drug use.
September 17, 2010
Tamer H, Shehab N. Using preprinted medication order forms to improve the safety of investigational drug
use. Am J Health Syst Pharm. 2006;63(11):1022, 1025-1026, 1028.
https://psnet.ahrq.gov/issue/using-p…
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psnet.ahrq.gov/node/40374/psn-pdf
April 13, 2011 - Better off not knowing: improving clinical care by limiting
physician access to unsolicited diagnostic information.
April 13, 2011
Volk ML, Ubel PA. Better off not knowing: improving clinical care by limiting physician access to unsolicited
diagnostic information. Arch Intern Med. 2011;171(6):487-8. doi:10.1001/arc…
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psnet.ahrq.gov/node/36050/psn-pdf
January 02, 2017 - Improving the safety of intravenous admixtures: lessons
learned from a Pentostam® overdose.
January 2, 2017
Just S, Schepers G, Piotrowski MM, et al. Improving the safety of intravenous admixtures: lessons learned
from a Pentostam overdose. Jt Comm J Qual Patient Saf. 2006;32(7):366-72.
https://psnet.ahrq.gov/issu…
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psnet.ahrq.gov/node/39863/psn-pdf
January 04, 2011 - Improving the quality of drug error reporting.
January 4, 2011
Armitage G, Newell R, Wright J. Improving the quality of drug error reporting. J Eval Clin Pract.
2010;16(6):1189-97. doi:10.1111/j.1365-2753.2009.01293.x.
https://psnet.ahrq.gov/issue/improving-quality-drug-error-reporting
This analysis of voluntarily…
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psnet.ahrq.gov/node/42581/psn-pdf
July 12, 2016 - Partnering with Patients to Drive Shared Decisions, Better
Value, and Care Improvement—Workshop Proceedings.
July 12, 2016
Roundtable on Value and Science Driven Healthcare; Institute of Medicine. Washington, DC: National
Academies Press; 2013. ISBN: 9780309288965.
https://psnet.ahrq.gov/issue/partnering-patients-…
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psnet.ahrq.gov/node/40331/psn-pdf
July 31, 2012 - Keeping the Commitment: A Progress Report on Four
Early Leaders in Patient Safety Improvement.
July 31, 2012
McCarthy D, Klein S. New York, NY: The Commonwealth Fund; March 15, 2011.
https://psnet.ahrq.gov/issue/keeping-commitment-progress-report-four-early-leaders-patient-safety-
improvement
Updating a previous …
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psnet.ahrq.gov/node/35090/psn-pdf
June 22, 2009 - Improving end of life care: an information systems
approach to reducing medical errors.
June 22, 2009
Tamang S, Kopec D, Shagas G, et al. Improving end of life care: an information systems approach to
reducing medical errors. Stud Health Technol Inform. 2005;114:93-104.
https://psnet.ahrq.gov/issue/improving-end-l…
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psnet.ahrq.gov/node/39500/psn-pdf
January 03, 2017 - Using in situ simulation to improve in-hospital
cardiopulmonary resuscitation.
January 3, 2017
Lighthall GK, Poon T, Harrison K. Using in situ simulation to improve in-hospital cardiopulmonary
resuscitation. Jt Comm J Qual Patient Saf. 2010;36(5):209-16.
https://psnet.ahrq.gov/issue/using-situ-simulation-improve-h…
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psnet.ahrq.gov/node/39558/psn-pdf
May 26, 2010 - ReCASTing the RCA: an improved model for performing
root cause analyses.
May 26, 2010
Pham JC, Kim GR, Natterman JP, et al. ReCASTing the RCA: An Improved Model for Performing Root
Cause Analyses. American Journal of Medical Quality. 2010;25(3). doi:10.1177/1062860609359533.
https://psnet.ahrq.gov/issue/recasting-…
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psnet.ahrq.gov/node/35310/psn-pdf
January 02, 2017 - Using the AHRQ Quality Indicators to improve health care
quality.
January 2, 2017
Elixhauser A, Pancholi M, Clancy CM. Using the AHRQ Quality Indicators to Improve Health Care Quality.
Jt Comm J Qual Patient Saf. 2016;31(9):533-538. doi:10.1016/s1553-7250(05)31069-5.
https://psnet.ahrq.gov/issue/using-ahrq-quality…
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psnet.ahrq.gov/node/40036/psn-pdf
November 24, 2010 - Integrating CUSP and TRIP to improve patient safety.
November 24, 2010
Romig M, Goeschel CA, Pronovost P, et al. Integrating CUSP and TRIP to improve patient safety. Hosp
Pract (1995). 2010;38(4):114-21. doi:10.3810/hp.2010.11.348.
https://psnet.ahrq.gov/issue/integrating-cusp-and-trip-improve-patient-safety
This …
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psnet.ahrq.gov/node/41499/psn-pdf
December 29, 2014 - Strategies for sustaining a quality improvement
collaborative and its patient safety gains.
December 29, 2014
Parand A, Benn J, Burnett S, et al. Strategies for sustaining a quality improvement collaborative and its
patient safety gains. Int J Qual Health Care. 2012;24(4):380-90. doi:10.1093/intqhc/mzs030.
https:/…
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psnet.ahrq.gov/node/50939/psn-pdf
February 26, 2020 - Homecare safety virtual quality improvement
collaboratives
February 26, 2020
Miller W, Asselbergs M, Bank J, et al. Homecare safety virtual quality improvement collaboratives. Healthc
Q. 2020;22(SP). doi:10.12927/hcq.2020.26042.
https://psnet.ahrq.gov/issue/homecare-safety-virtual-quality-improvement-collaborative…
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psnet.ahrq.gov/node/42304/psn-pdf
November 21, 2016 - Strategies for improving family engagement during
family-centered rounds.
November 21, 2016
Kelly MM, Xie A, Carayon P, et al. Strategies for improving family engagement during family-centered
rounds. J Hosp Med. 2013;8(4):201-7. doi:10.1002/jhm.2022.
https://psnet.ahrq.gov/issue/strategies-improving-family-engage…
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psnet.ahrq.gov/node/36557/psn-pdf
July 14, 2010 - Adoption of technology to improve medication safety:
perspectives of pharmacy directors.
July 14, 2010
Bussard BE, McAlearney AS, Pedersen CA, et al. Adoption of Technology to Improve Medication Safety. J
Patient Saf. 2008;2(4). doi:10.1097/01.jps.0000236914.48955.99.
https://psnet.ahrq.gov/issue/adoption-technolo…
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psnet.ahrq.gov/node/43603/psn-pdf
October 15, 2014 - Coaching to improve the quality of communication during
briefings and debriefings.
October 15, 2014
Kleiner C, Link T, Maynard T, et al. Coaching to improve the quality of communication during briefings and
debriefings. AORN J. 2014;100(4):358-68. doi:10.1016/j.aorn.2014.03.012.
https://psnet.ahrq.gov/issue/coachi…
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psnet.ahrq.gov/node/73480/psn-pdf
December 17, 2024 - Improving Patient Safety with Human Factors Methods.
December 17, 2024
Armstrong Institute for Patient Safety and Quality, Baltimore, MD. April 17-18, 2025.
https://psnet.ahrq.gov/issue/improving-patient-safety-human-factors-methods
Human factors engineering (HFE) is a primary strategy for advancing safety in healt…
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psnet.ahrq.gov/node/36072/psn-pdf
July 05, 2006 - VA Health Care: Steps Taken to Improve Practitioner
Screening, but Facility Compliance with Screening
Requirements is Poor.
July 5, 2006
Washington DC; Government Accountability Office; May 2006. Report no GAO-06-544.
https://psnet.ahrq.gov/issue/va-health-care-steps-taken-improve-practitioner-screening-facility-c…
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psnet.ahrq.gov/node/38137/psn-pdf
October 15, 2008 - Ethical and legal issues in the use of health information
technology to improve patient safety.
October 15, 2008
Berner ES. Ethical and legal issues in the use of health information technology to improve patient safety.
HEC Forum. 2008;20(3):243-58. doi:10.1007/s10730-008-9074-5.
https://psnet.ahrq.gov/issue/ethic…
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psnet.ahrq.gov/node/41484/psn-pdf
September 26, 2012 - An institution-wide handoff task force to standardise and
improve physician handoffs.
September 26, 2012
Horwitz LI, Schuster KM, Thung SF, et al. An institution-wide handoff task force to standardise and improve
physician handoffs. BMJ Qual Saf. 2012;21(10):863-71.
https://psnet.ahrq.gov/issue/institution-wide-ha…