AHRQ Search | Home Page

ReCASTing the RCA: an improved model for performing root cause analyses. | PSNet

psnet.ahrq.gov/issue/recasting-rca-improved-model-performing-root-cause-analyses

November 10, 2010 - Commentary ReCASTing the RCA: an improved model for performing root cause analyses. Citation Text: 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…

Errors associated with oxytocin use: a multi-organization analysis by ISMP and ISMP Canada. | PSNet

psnet.ahrq.gov/issue/errors-associated-oxytocin-use-multi-organization-analysis-ismp-and-ismp-canada

February 23, 2022 - Newspaper/Magazine Article Errors associated with oxytocin use: a multi-organization analysis by ISMP and ISMP Canada. Citation Text: Errors associated with oxytocin use: a multi-organization analysis by ISMP and ISMP Canada. ISMP Medication Safety Alert! Acute care edition. Februar…

Making healthcare safer by understanding, designing and buying better IT. | PSNet

psnet.ahrq.gov/issue/making-healthcare-safer-understanding-designing-and-buying-better-it

February 20, 2019 - Commentary Making healthcare safer by understanding, designing and buying better IT. Citation Text: Thimbleby H, Lewis A, Williams J. Making healthcare safer by understanding, designing and buying better IT. Clin Med (Lond). 2015;15(3):258-62. doi:10.7861/clinmedicine.15-3-258. Copy Ci…

Changing the patient safety mindset: can safety cases help? | PSNet

psnet.ahrq.gov/issue/changing-patient-safety-mindset-can-safety-cases-help

July 14, 2021 - Commentary Changing the patient safety mindset: can safety cases help? Citation Text: Sujan M, Habli I. Changing the patient safety mindset: can safety cases help? BMJ Qual Saf. 2024;33(3):145-148. doi:10.1136/bmjqs-2023-016652. Copy Citation Format: DOI Google Scholar BibT…

Under-mined. | PSNet

psnet.ahrq.gov/issue/under-mined

October 27, 2010 - Newspaper/Magazine Article Under-mined. Citation Text: Greene J. Under-mined. Hospitals & health networks. 2006;80(12):38-40, 42, 44, 1. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId RIS Download Citation …

Differential impact of a crew resource management program according to professional specialty. | PSNet

psnet.ahrq.gov/issue/differential-impact-crew-resource-management-program-according-professional-specialty

July 31, 2013 - Study Differential impact of a crew resource management program according to professional specialty. Citation Text: Suva D, Haller G, Lübbeke A, et al. Differential impact of a crew resource management program according to professional specialty. Am J Med Qual. 2012;27(4):313-20. doi:1…

Failure mode and effects analysis application to critical care medicine. | PSNet

psnet.ahrq.gov/issue/failure-mode-and-effects-analysis-application-critical-care-medicine

June 10, 2013 - Review Failure mode and effects analysis application to critical care medicine. Citation Text: Duwe B, Fuchs BD, Hansen-Flaschen J. Failure mode and effects analysis application to critical care medicine. Crit Care Clin. 2005;21(1):21-30, vii. Copy Citation Format: Google…

Medical error identification, disclosure, and reporting: do emergency medicine provider groups differ? | PSNet

psnet.ahrq.gov/issue/medical-error-identification-disclosure-and-reporting-do-emergency-medicine-provider-groups

April 11, 2011 - Study Medical error identification, disclosure, and reporting: do emergency medicine provider groups differ? Citation Text: Hobgood C, Weiner B, Tamayo-Sarver JH. Medical error identification, disclosure, and reporting: do emergency medicine provider groups differ? Acad Emerg Med. 2006…

Reevaluation of diagnosis in adults with physician-diagnosed asthma. | PSNet

psnet.ahrq.gov/issue/reevaluation-diagnosis-adults-physician-diagnosed-asthma

March 15, 2017 - Study Reevaluation of diagnosis in adults with physician-diagnosed asthma. Citation Text: Aaron SD, Vandemheen KL, FitzGerald M, et al. Reevaluation of Diagnosis in Adults With Physician-Diagnosed Asthma. JAMA. 2017;317(3):269-279. doi:10.1001/jama.2016.19627. Copy Citation Format:…

Retained surgical items and minimally invasive surgery. | PSNet

psnet.ahrq.gov/issue/retained-surgical-items-and-minimally-invasive-surgery

April 28, 2021 - Commentary Retained surgical items and minimally invasive surgery. Citation Text: Gibbs VC. Retained surgical items and minimally invasive surgery. World J Surg. 2011;35(7):1532-9. doi:10.1007/s00268-011-1060-4. Copy Citation Format: DOI Google Scholar PubMed BibTeX EndNo…

Priority patient safety issues identified by perioperative nurses. | PSNet

psnet.ahrq.gov/issue/priority-patient-safety-issues-identified-perioperative-nurses

June 19, 2013 - Study Priority patient safety issues identified by perioperative nurses. Citation Text: Steelman VM, Graling PR, Perkhounkova Y. Priority patient safety issues identified by perioperative nurses. AORN J. 2013;97(4):402-18. doi:10.1016/j.aorn.2012.06.016. Copy Citation Format: …

Barriers and facilitators to communicating nursing errors in long-term care settings. | PSNet

psnet.ahrq.gov/issue/barriers-and-facilitators-communicating-nursing-errors-long-term-care-settings

March 27, 2018 - Study Barriers and facilitators to communicating nursing errors in long-term care settings. Citation Text: Wagner LM, Damianakis T, Pho L, et al. Barriers and facilitators to communicating nursing errors in long-term care settings. J Patient Saf. 2013;9(1):1-7. doi:10.1097/PTS.0b013e31…

Core competencies for patient safety research: a cornerstone for global capacity strengthening. | PSNet

psnet.ahrq.gov/issue/core-competencies-patient-safety-research-cornerstone-global-capacity-strengthening

September 15, 2021 - Commentary Core competencies for patient safety research: a cornerstone for global capacity strengthening. Citation Text: Andermann A, Ginsburg L, Norton P, et al. Core competencies for patient safety research: a cornerstone for global capacity strengthening. BMJ Qual Saf. 2011;20(1):9…

High reliability leadership: a conceptual framework. | PSNet

psnet.ahrq.gov/issue/high-reliability-leadership-conceptual-framework

March 09, 2022 - Commentary High reliability leadership: a conceptual framework. Citation Text: Martínez-Córcoles M. High reliability leadership: A conceptual framework. J Contingencies Crisis Manage. 2017;26(2):237-246. doi:10.1111/1468-5973.12187. Copy Citation Format: DOI Google Scholar …

Committed to Safety: Ten Case Studies on Reducing Harm to Patients. | PSNet

psnet.ahrq.gov/issue/committed-safety-ten-case-studies-reducing-harm-patients

July 31, 2012 - Book/Report Committed to Safety: Ten Case Studies on Reducing Harm to Patients. Citation Text: Committed to Safety: Ten Case Studies on Reducing Harm to Patients. McCarthy D, Blumenthal D. New York, NY: Commonwealth Fund; 2006. Copy Citation Save Save to you…

Medication safety in emergency medical services: approaching an evidence-based method of verification to reduce errors. | PSNet

psnet.ahrq.gov/issue/medication-safety-emergency-medical-services-approaching-evidence-based-method-verification

September 28, 2022 - Study Medication safety in emergency medical services: approaching an evidence-based method of verification to reduce errors. Citation Text: Misasi P, Keebler JR. Medication safety in emergency medical services: approaching an evidence-based method of verification to reduce errors. Ther …

The effects of on-duty napping on intern sleep time and fatigue. | PSNet

psnet.ahrq.gov/issue/effects-duty-napping-intern-sleep-time-and-fatigue

February 03, 2011 - Study The effects of on-duty napping on intern sleep time and fatigue. Citation Text: Arora V, Dunphy C, Chang VY, et al. The effects of on-duty napping on intern sleep time and fatigue. Ann Intern Med. 2006;144(11):792-8. Copy Citation Format: Google Scholar PubMed BibTe…

Medication safety in the operating room: literature and expert-based recommendations. | PSNet

psnet.ahrq.gov/issue/medication-safety-operating-room-literature-and-expert-based-recommendations

October 19, 2022 - Review Medication safety in the operating room: literature and expert-based recommendations. Citation Text: Wahr JA, Abernathy JH, Lazarra EH, et al. Medication safety in the operating room: literature and expert-based recommendations. Br J Anaesth. 2017;118(1):32-43. doi:10.1093/bja/aew…

Independent Mortality Review of Cardiac Surgery at St George’s University Hospitals NHS Foundation Trust. | PSNet

psnet.ahrq.gov/issue/independent-mortality-review-cardiac-surgery-st-georges-university-hospitals-nhs-foundation

May 24, 2023 - Book/Report Independent Mortality Review of Cardiac Surgery at St George’s University Hospitals NHS Foundation Trust. Citation Text: Independent Mortality Review of Cardiac Surgery at St George’s University Hospitals NHS Foundation Trust. NHS Improvement. Independent Mortality Review of …

Unintended doses in radiotherapy—over, under and outside? | PSNet

psnet.ahrq.gov/issue/unintended-doses-radiotherapy-over-under-and-outside

August 27, 2009 - Commentary Unintended doses in radiotherapy—over, under and outside? Citation Text: Eaton DJ, Byrne JP, Cosgrove VP, et al. Unintended doses in radiotherapy-over, under and outside? Br J Radiol. 2018;91(1084):20170863. doi:10.1259/bjr.20170863. Copy Citation Format: DOI Goo…

Search AHRQ

Results