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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/867690/psn-pdf
    March 05, 2025 - Trends of diagnostic adverse events in hospital deaths: longitudinal analyses of four retrospective record review studies. March 5, 2025 Hooftman J, Zwaan L, Sikkens JJ, et al. Trends of diagnostic adverse events in hospital deaths: longitudinal analyses of four retrospective record review studies. Diagnosis (Berl…

  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/837859/psn-pdf
    August 17, 2022 - The barriers and enhancers to trust in a just culture in hospital settings: a systematic review. August 17, 2022 van Marum S, Verhoeven D, de Rooy D. The barriers and enhancers to trust in a just culture in hospital settings: a systematic review. J Patient Saf. 2022;18(7):e1067-e1075. doi:10.1097/pts.00000000000010…

  3. The safety journal: lessons learned with an error reporting tool to stimulate systems thinking. | PSNet

    psnet.ahrq.gov/issue/safety-journal-lessons-learned-error-reporting-tool-stimulate-systems-thinking
    January 21, 2019 - Study The safety journal: lessons learned with an error reporting tool to stimulate systems thinking. Citation Text: Singh R, Naughton B, Singh A, et al. The Safety Journal. J Patient Saf. 2007;3(3):135-141. doi:10.1097/0b013e31814258db. Copy Citation Format: DOI Google S…

  4. OZIS and the politics of safety: using ICT to create a regionally accessible patient medication record. | PSNet

    psnet.ahrq.gov/issue/ozis-and-politics-safety-using-ict-create-regionally-accessible-patient-medication-record
    February 04, 2009 - Commentary OZIS and the politics of safety: using ICT to create a regionally accessible patient medication record. Citation Text: Stoop AP, Bal R, Berg M. OZIS and the politics of safety: using ICT to create a regionally accessible patient medication record. Int J Med Inform. 2007;76 S…

  5. Graphics for Section 5. Evidence or Other Justification for the Focus of the Measure (pdf file)

    www.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/fullreports/chipra-135-graphics-section-5.pdf
    November 26, 2013 - Graphics for Section 5. Evidence or Other Justification for the Focus of the Measure                                                                                                     Q‐METRIC Sickle Cell Disease Measure 2: Timeliness of Antibiotic …

  6. Reliability evaluation of the adapted National Coordinating Council Medication Error Reporting and Prevention (NCC MERP) index. | PSNet

    psnet.ahrq.gov/issue/reliability-evaluation-adapted-national-coordinating-council-medication-error-reporting-and
    July 14, 2010 - Study Reliability evaluation of the adapted National Coordinating Council Medication Error Reporting and Prevention (NCC MERP) index. Citation Text: Snyder RA, Abarca J, Meza JL, et al. Reliability evaluation of the adapted National Coordinating Council Medication Error Reporting and P…

  7. Using the medication error prioritization system to improve patient safety. | PSNet

    psnet.ahrq.gov/issue/using-medication-error-prioritization-system-improve-patient-safety
    May 01, 2020 - Commentary Using the medication error prioritization system to improve patient safety. Citation Text: Polnariev A. Using the Medication Error Prioritization System To Improve Patient Safety. P T. 2016;41(1):54-9. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3…

  8. Closed medical negligence claims can drive patient safety and reduce litigation. | PSNet

    psnet.ahrq.gov/issue/closed-medical-negligence-claims-can-drive-patient-safety-and-reduce-litigation
    February 05, 2020 - Review Closed medical negligence claims can drive patient safety and reduce litigation. Citation Text: Pegalis SE, Bal S. Closed medical negligence claims can drive patient safety and reduce litigation. Clin Orthop Relat Res. 2012;470(5):1398-404. doi:10.1007/s11999-012-2308-5. Copy …

  9. How radiation oncologists would disclose errors: results of a survey of radiation oncologists and trainees. | PSNet

    psnet.ahrq.gov/issue/how-radiation-oncologists-would-disclose-errors-results-survey-radiation-oncologists-and
    December 14, 2016 - Study How radiation oncologists would disclose errors: results of a survey of radiation oncologists and trainees. Citation Text: Evans SB, Yu JB, Chagpar A. How radiation oncologists would disclose errors: results of a survey of radiation oncologists and trainees. Int J Radiat Oncol Bi…

  10. A systems approach to address the impact of second victim phenomenon. | PSNet

    psnet.ahrq.gov/issue/systems-approach-address-impact-second-victim-phenomenon
    December 07, 2022 - Commentary A systems approach to address the impact of second victim phenomenon. Citation Text: Gamble B, Gamble KJ. A systems approach to address the impact of second victim phenomenon. Health Serv Manage Res. 2022;35(2):110-113. doi:10.1177/0951484820971455. Copy Citation Format:…

  11. What is the measure of a safe hospital? Medication errors missed by risk management, clinical staff, and surveyors. | PSNet

    psnet.ahrq.gov/issue/what-measure-safe-hospital-medication-errors-missed-risk-management-clinical-staff-and
    September 27, 2017 - Study What is the measure of a safe hospital? Medication errors missed by risk management, clinical staff, and surveyors. Citation Text: Grasso BC, Rothschild JM, Jordan CW, et al. What is the measure of a safe hospital? Medication errors missed by risk management, clinical staff, and su…

  12. Incidence of accidental awareness during general anaesthesia in obstetrics: a multicentre, prospective cohort study. | PSNet

    psnet.ahrq.gov/issue/incidence-accidental-awareness-during-general-anaesthesia-obstetrics-multicentre-prospective
    December 10, 2024 - Study Emerging Classic Incidence of accidental awareness during general anaesthesia in obstetrics: a multicentre, prospective cohort study. Citation Text: Incidence of accidental awareness during general anaesthesia in obstetrics: a multicentre, prospective coho…

  13. What is the effectiveness of reporting systems in promoting learning in healthcare? | PSNet

    psnet.ahrq.gov/issue/what-effectiveness-reporting-systems-promoting-learning-healthcare
    September 23, 2020 - Review What is the effectiveness of reporting systems in promoting learning in healthcare? Citation Text: Sehgal A. What is the effectiveness of reporting systems in promoting learning in healthcare? Br J Hosp Med (Lond). 2024;85(4):1-9. doi:10.12968/hmed.2023.0444. Copy Citation F…

  14. Electronic Health Record Programs: Participation Has Increased, but Action Needed to Achieve Goals, Including Improved Quality of Care. | PSNet

    psnet.ahrq.gov/issue/electronic-health-record-programs-participation-has-increased-action-needed-achieve-goals
    September 07, 2016 - Book/Report Electronic Health Record Programs: Participation Has Increased, but Action Needed to Achieve Goals, Including Improved Quality of Care. Citation Text: Electronic Health Record Programs: Participation Has Increased, but Action Needed to Achieve Goals, Including Improved Quali…

  15. Barriers to reporting medication errors: a measurement equivalence perspective. | PSNet

    psnet.ahrq.gov/issue/barriers-reporting-medication-errors-measurement-equivalence-perspective
    March 28, 2012 - Study Barriers to reporting medication errors: a measurement equivalence perspective. Citation Text: Etchegaray J, Throckmorton T. Barriers to reporting medication errors: a measurement equivalence perspective. Qual Saf Health Care. 2010;19(6):e14. doi:10.1136/qshc.2008.031534. Copy …

  16. Improving patient safety: the comparative views of patient-safety specialists, workforce staff and managers. | PSNet

    psnet.ahrq.gov/issue/improving-patient-safety-comparative-views-patient-safety-specialists-workforce-staff-and
    March 23, 2011 - Study Improving patient safety: the comparative views of patient-safety specialists, workforce staff and managers. Citation Text: Braithwaite J, Westbrook MT, Robinson M, et al. Improving patient safety: the comparative views of patient-safety specialists, workforce staff and managers.…

  17. Is there a benefit to multidisciplinary rounds in an open trauma intensive care unit regarding ventilator-associated pneumonia? | PSNet

    psnet.ahrq.gov/issue/there-benefit-multidisciplinary-rounds-open-trauma-intensive-care-unit-regarding-ventilator
    January 06, 2010 - Study Is there a benefit to multidisciplinary rounds in an open trauma intensive care unit regarding ventilator-associated pneumonia? Citation Text: Johnson V, Mangram A, Mitchell C, et al. Is there a benefit to multidisciplinary rounds in an open trauma intensive care unit regarding v…

  18. Reporting medication errors: residents with diabetes. | PSNet

    psnet.ahrq.gov/issue/reporting-medication-errors-residents-diabetes
    August 23, 2017 - Commentary Reporting medication errors: residents with diabetes. Citation Text: Milligan F, Gadsby R, Ghaleb MA, et al. Reporting medication errors: residents with diabetes. Nursing and Residential Care. 2014;16(11). doi:10.12968/nrec.2014.16.11.617. Copy Citation Format: D…

  19. Exploring the causes of adverse events in hospitals and potential prevention strategies. | PSNet

    psnet.ahrq.gov/issue/exploring-causes-adverse-events-hospitals-and-potential-prevention-strategies
    February 20, 2013 - Study Exploring the causes of adverse events in hospitals and potential prevention strategies. Citation Text: Smits M, Zegers M, Groenewegen PP, et al. Exploring the causes of adverse events in hospitals and potential prevention strategies. BMJ Qual Saf. 2010;19(5). doi:10.1136/qshc.20…

  20. Early readmissions to the department of medicine as a screening tool for monitoring quality of care problems. | PSNet

    psnet.ahrq.gov/issue/early-readmissions-department-medicine-screening-tool-monitoring-quality-care-problems
    April 06, 2022 - Study Early readmissions to the department of medicine as a screening tool for monitoring quality of care problems. Citation Text: Balla U, Malnick S, Schattner A. Early readmissions to the department of medicine as a screening tool for monitoring quality of care problems. Medicine (Ba…
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