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  1. Decreasing clinically significant adverse events using feedback to emergency physicians of telephone follow-up outcomes. | PSNet

    psnet.ahrq.gov/issue/decreasing-clinically-significant-adverse-events-using-feedback-emergency-physicians
    January 21, 2015 - Study Decreasing clinically significant adverse events using feedback to emergency physicians of telephone follow-up outcomes. Citation Text: Chern C-H, How C-K, Wang L-M, et al. Decreasing clinically significant adverse events using feedback to emergency physicians of telephone follow-…

  2. Examining the meaning of the language used to communicate the nursing hand-off. | PSNet

    psnet.ahrq.gov/issue/examining-meaning-language-used-communicate-nursing-hand
    July 07, 2021 - Study Examining the meaning of the language used to communicate the nursing hand-off. Citation Text: Galatzan BJ, Carrington JM. Examining the meaning of the language used to communicate the nursing hand‐off. Res Nurs Health. 2021;44(5):833-843. doi:10.1002/nur.22175. Copy Citation …

  3. Identifying and mapping measures of medication safety during transfer of care in a digital era: a scoping literature review. | PSNet

    psnet.ahrq.gov/issue/identifying-and-mapping-measures-medication-safety-during-transfer-care-digital-era-scoping
    July 24, 2024 - Review Identifying and mapping measures of medication safety during transfer of care in a digital era: a scoping literature review. Citation Text: Leon C, Hogan H, Jani YH. Identifying and mapping measures of medication safety during transfer of care in a digital era: a scoping literatur…

  4. Patient Safety Awareness Week 2024 | Agency for Healthcare Research and Quality

    www.ahrq.gov/patient-safety/news-events/psaw-2024/index.html
    March 01, 2024 - Patient Safety Awareness Week 2024 As we celebrate Patient Safety Awareness Week 2024, the Agency for Healthcare Research and Quality (AHRQ) also marks its 35th anniversary. This milestone, under the banner "Today's Research, Tomorrow's Healthcare," highlights our dedication to transforming healthcare through…

  5. Organizational culture: an important context for addressing and improving hospital to community patient discharge. | PSNet

    psnet.ahrq.gov/issue/organizational-culture-important-context-addressing-and-improving-hospital-community-patient
    December 30, 2014 - Study Organizational culture: an important context for addressing and improving hospital to community patient discharge. Citation Text: Hesselink G, Vernooij-Dassen M, Pijnenborg L, et al. Organizational culture: an important context for addressing and improving hospital to community pa…

  6. Evaluation of a predevelopment service delivery intervention: an application to improve clinical handovers. | PSNet

    psnet.ahrq.gov/issue/evaluation-predevelopment-service-delivery-intervention-application-improve-clinical
    March 06, 2013 - Study Evaluation of a predevelopment service delivery intervention: an application to improve clinical handovers. Citation Text: Yao GL, Novielli N, Manaseki-Holland S, et al. Evaluation of a predevelopment service delivery intervention: an application to improve clinical handovers. BMJ …

  7. Consumer-directed technologies to improve medication management and safety. | PSNet

    psnet.ahrq.gov/issue/consumer-directed-technologies-improve-medication-management-and-safety
    December 29, 2014 - Commentary Consumer-directed technologies to improve medication management and safety. Citation Text: Andrade AQ, Roughead EE. Consumer-directed technologies to improve medication management and safety. Med J Aust. 2019;210(suppl 6):S24-S27. doi:10.5694/mja2.50029. Copy Citation Fo…

  8. Speaking up and taking action: psychological safety and joint problem-solving orientation in safety improvement. | PSNet

    psnet.ahrq.gov/issue/speaking-and-taking-action-psychological-safety-and-joint-problem-solving-orientation-safety
    October 21, 2020 - Study Speaking up and taking action: psychological safety and joint problem-solving orientation in safety improvement. Citation Text: Bahadurzada H, Kerrissey M, Edmondson AC. Speaking up and taking action: psychological safety and joint problem-solving orientation in safety improvement.…

  9. Balancing patient-centered and safe pain care for nonsurgical inpatients: clinical and managerial perspectives. | PSNet

    psnet.ahrq.gov/issue/balancing-patient-centered-and-safe-pain-care-nonsurgical-inpatients-clinical-and-managerial
    March 12, 2025 - Study Balancing patient-centered and safe pain care for nonsurgical inpatients: clinical and managerial perspectives. Citation Text: Mazurenko O, Andraka-Christou BT, Bair MJ, et al. Balancing Patient-Centered and Safe Pain Care for Nonsurgical Inpatients: Clinical and Managerial Perspec…

  10. Five strategies for how patients and families can improve patient safety: World Patient Safety Day 2023. | PSNet

    psnet.ahrq.gov/issue/five-strategies-how-patients-and-families-can-improve-patient-safety-world-patient-safety-day
    July 07, 2021 - Commentary Five strategies for how patients and families can improve patient safety: World Patient Safety Day 2023. Citation Text: Wu AW, Papieva I, Sheridan S, et al. Five strategies for how patients and families can improve patient safety: World Patient Safety Day 2023. J Patient Saf R…

  11. Implementation of a mock root cause analysis to provide simulated patient safety training. | PSNet

    psnet.ahrq.gov/issue/implementation-mock-root-cause-analysis-provide-simulated-patient-safety-training
    January 12, 2022 - Commentary Implementation of a mock root cause analysis to provide simulated patient safety training. Citation Text: Murphy M, Duff J, Whitney J, et al. Implementation of a mock root cause analysis to provide simulated patient safety training. BMJ Open Qual. 2017;6(2). doi:10.1136/bmjoq-…

  12. Diagnostic safety: needs assessment and informed curriculum at an academic children's hospital. | PSNet

    psnet.ahrq.gov/issue/diagnostic-safety-needs-assessment-and-informed-curriculum-academic-childrens-hospital
    June 28, 2023 - Study Diagnostic safety: needs assessment and informed curriculum at an academic children's hospital. Citation Text: Congdon M, Rasooly IR, Toto RL, et al. Diagnostic safety: needs assessment and informed curriculum at an academic children's hospital. Pediatr Qual Saf. 2024;9(6):e773. do…

  13. Addressing racial and ethnic bias in pulse oximeters—a wicked problem. | PSNet

    psnet.ahrq.gov/issue/addressing-racial-and-ethnic-bias-pulse-oximeters-wicked-problem
    April 18, 2019 - Commentary Addressing racial and ethnic bias in pulse oximeters—a wicked problem. Citation Text: Shachar C, Drabo EF, Iwashyna TJ, et al. Addressing racial and ethnic bias in pulse oximeters—a wicked problem. JAMA. 2025;333(7):563-564. doi:10.1001/jama.2024.25443. Copy Citation For…

  14. Improving maternal safety at scale with the mentor model of collaborative improvement. | PSNet

    psnet.ahrq.gov/issue/improving-maternal-safety-scale-mentor-model-collaborative-improvement
    March 31, 2021 - Study Improving maternal safety at scale with the mentor model of collaborative improvement. Citation Text: Main EK, Dhurjati R, Cape V, et al. Improving Maternal Safety at Scale with the Mentor Model of Collaborative Improvement. Jt Comm J Qual Patient Saf. 2018;44(5):250-259. doi:10.10…

  15. Transforming healthcare: a safety imperative. | PSNet

    psnet.ahrq.gov/issue/transforming-healthcare-safety-imperative
    June 26, 2019 - Commentary Classic Transforming healthcare: a safety imperative. Citation Text: Leape L, Berwick D, Clancy C, et al. Transforming healthcare: a safety imperative. Qual Saf Health Care. 2009;18(6):424-8. doi:10.1136/qshc.2009.036954. Copy Citation Format: …

  16. Nurse well-being: a concept analysis. | PSNet

    psnet.ahrq.gov/issue/nurse-well-being-concept-analysis
    August 25, 2021 - Study Nurse well-being: a concept analysis. Citation Text: Patrician PA, Bakerjian D, Billings R, et al. Nurse well-being: a concept analysis. Nurs Outlook. 2022;70(4):639-650. doi:10.1016/j.outlook.2022.03.014. Copy Citation Format: DOI Google Scholar BibTeX EndNote X3 XML…

  17. Variations by state in physician disciplinary actions by US medical licensure boards. | PSNet

    psnet.ahrq.gov/issue/variations-state-physician-disciplinary-actions-us-medical-licensure-boards
    March 12, 2025 - Study Variations by state in physician disciplinary actions by US medical licensure boards. Citation Text: Harris JA, Byhoff E. Variations by state in physician disciplinary actions by US medical licensure boards. BMJ Qual Saf. 2017;26(3):200-208. doi:10.1136/bmjqs-2015-004974. Copy Ci…

  18. Identifying patients whose symptoms are underrecognized during treatment with breast radiotherapy. | PSNet

    psnet.ahrq.gov/issue/identifying-patients-whose-symptoms-are-underrecognized-during-treatment-breast-radiotherapy
    May 25, 2022 - Study Identifying patients whose symptoms are underrecognized during treatment with breast radiotherapy. Citation Text: doi:10.1001/jamaoncol.2022.0114. Copy Citation Format: DOI BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId RIS Download Citation …

  19. 3W8Wr9Wwayaqujwmjo Bl- (pdf file)

    www.uspreventiveservicestaskforce.org/home/getfilebytoken/3w8Wr9wwAyAqUJWmJo_bL-
    February 01, 2014 - Risk Assessment, Genetic Counseling, and Genetic Testing for BRCA-Related Cancer in Women: A Systematic Review to Update the U.S. Preventive Services Task Force Recommendation Heidi D. Nelson, MD, MPH; Miranda Pappas, MA; Bernadette Zakher, MBBS; Jennifer Priest Mitchell, BA; Leila Okinaka-Hu, MD; and Rongwei Fu, PhD …

  20. Putoolssect7 (doc file)

    www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/pressureulcertoolkit/putoolssect7.docx
    February 16, 2011 - Section 7. Tools and Resources 0A: Introductory Executive Summary for Stakeholders 1A: Clinical Staff Attitudes Towards Pressure Ulcer Prevention 1B: Stakeholder Analysis 1C: Leadership Support Assessment 1D: Business Case Form 1E: Resource Needs Assessment 2A: Multidisciplinary Team 2B: Quality Improvement Process 2C…
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