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psnet.ahrq.gov/node/72707/psn-pdf
February 03, 2021 - Identification and safe storage of look-alike, sound-alike
medicines in automated dispensing cabinets.
February 3, 2021
Ruutiainen HK, Kallio MM, Kuitunen SK. Identification and safe storage of look-alike, sound-alike medicines
in automated dispensing cabinets. Eur J Hosp Pharm. 2021;28(Suppl 2):e151-e156. doi:10.1…
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psnet.ahrq.gov/node/74181/psn-pdf
December 15, 2021 - Mitigating patient and consumer safety risks when using
conversational assistants for medical information:
exploratory mixed methods experiment.
December 15, 2021
Bickmore TW, Olafsson S, O'Leary TK. Mitigating patient and consumer safety risks when using
conversational assistants for medical information: explorat…
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psnet.ahrq.gov/node/38566/psn-pdf
April 15, 2009 - Contributions by the Agency for Healthcare Research and
Quality and Grantees.
April 15, 2009
Health Serv Res. 2009 Apr;44(2 Pt 2):623-776.
https://psnet.ahrq.gov/issue/contributions-agency-healthcare-research-and-quality-and-grantees
This special series of articles highlights the progress and current state of pati…
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psnet.ahrq.gov/node/45487/psn-pdf
July 21, 2020 - Annotated bibliography: an update to: "Understanding
ambulatory care practices in the context of patient safety
and quality improvement."
July 21, 2020
Kumar PR, Nash DB. Annotated Bibliography: An Update to “Understanding Ambulatory Care Practices in
the Context of Patient Safety and Quality Improvement”. Am J Me…
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psnet.ahrq.gov/node/851363/psn-pdf
July 12, 2023 - Health literacy and systemic racism—using clear
communication to reduce health care inequities.
July 12, 2023
Coleman C, Birk S, DeVoe J. Health literacy and systemic racism—using clear communication to reduce
health care inequities. JAMA Intern Med. 2023;183(8):753-754. doi:10.1001/jamainternmed.2023.2558.
https:…
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psnet.ahrq.gov/node/45193/psn-pdf
October 03, 2017 - Choice, transparency, coordination, and quality among
direct-to-consumer telemedicine websites and apps
treating skin disease.
October 3, 2017
Resneck JS, Abrouk M, Steuer M, et al. Choice, Transparency, Coordination, and Quality Among Direct-to-
Consumer Telemedicine Websites and Apps Treating Skin Disease. JAMA …
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psnet.ahrq.gov/node/45389/psn-pdf
September 27, 2016 - Prevalence of potentially inappropriate medication use in
older adults living in nursing homes: a systematic review.
September 27, 2016
Morin L, Laroche M-L, Texier G, et al. Prevalence of potentially inappropriate medication use in older adults
living in nursing homes: a systematic review. J Am Med Dir Assoc. 2016…
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psnet.ahrq.gov/node/73312/psn-pdf
May 26, 2021 - Healthcare professionals experience of psychological
safety, voice, and silence.
May 26, 2021
O'Donovan R, De Brún A, McAuliffe E. Healthcare professionals experience of psychological safety, voice,
and silence. Front Psychol. 2021;12:626689. doi:10.3389/fpsyg.2021.626689.
https://psnet.ahrq.gov/issue/healthcare-p…
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psnet.ahrq.gov/node/865707/psn-pdf
May 01, 2024 - Department of anesthesiology skilled peer support
program outcomes: second victim perceptions.
May 1, 2024
Bursch B, Ziv K, Marchese S, et al. Department of anesthesiology skilled peer support program outcomes:
second victim perceptions. Jt Comm J Qual Patient Saf. 2024;50(6):442-448.
doi:10.1016/j.jcjq.2024.03.00…
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psnet.ahrq.gov/node/45482/psn-pdf
September 14, 2016 - 'America's other drug problem': copious prescriptions for
hospitalized elderly.
September 14, 2016
Gorman A. Kaiser Health News. August 30, 2016.
https://psnet.ahrq.gov/issue/americas-other-drug-problem-copious-prescriptions-hospitalized-elderly
Older patients are particularly vulnerable to medication errors, as t…
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psnet.ahrq.gov/node/73085/psn-pdf
January 01, 2022 - Multiple meanings of resilience: health professionals'
experiences of a dual element training intervention
designed to help them prepare for coping with error.
March 31, 2021
Janes G, Harrison R, Johnson J, et al. Multiple meanings of resilience: health professionals' experiences of
a dual element training interve…
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psnet.ahrq.gov/node/72657/psn-pdf
January 20, 2021 - Establishing a multi-institutional quality and patient
safety consortium: collaboration across affiliates in a
community-based medical school.
January 20, 2021
Hillman E, Paul J, Neustadt M, et al. Establishing a multi-institutional quality and patient safety consortium:
collaboration across affiliates in a commun…
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psnet.ahrq.gov/node/73143/psn-pdf
April 14, 2021 - The incidence and preventability of adverse events in
older acutely admitted patients: a longitudinal study with
4292 patient records.
April 14, 2021
Schouten B, Merten H, Spreeuwenberg PMM, et al. The incidence and preventability of adverse events in
older acutely admitted patients: a longitudinal study with 4292…
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psnet.ahrq.gov/node/74701/psn-pdf
January 26, 2022 - Non-conveyance of older adult patients and association
with subsequent clinical and adverse events after initial
assessment by ambulance clinicians: a cohort analysis.
January 26, 2022
Lederman J, Lindström V, Elmqvist C, et al. Non-conveyance of older adult patients and association with
subsequent clinical and ad…
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psnet.ahrq.gov/node/46869/psn-pdf
April 11, 2018 - Opioid prescribing practices from 2010 through 2015
among dentists in the United States: what do claims data
tell us?
April 11, 2018
Gupta N, Vujicic M, Blatz A. Opioid prescribing practices from 2010 through 2015 among dentists in the
United States: What do claims data tell us? J Am Dent Assoc. 2018;149(4):237-24…
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psnet.ahrq.gov/node/47996/psn-pdf
January 01, 2021 - Building an ambulatory safety program at an academic
health system.
May 15, 2019
Desai S, Fiumara K, Kachalia A. Building an Ambulatory Safety Program at an Academic Health System. J
Patient Saf. 2021;17(2):e84-e90. doi:10.1097/PTS.0000000000000594.
https://psnet.ahrq.gov/issue/building-ambulatory-safety-program-a…
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psnet.ahrq.gov/node/73679/psn-pdf
September 08, 2021 - Why an open disclosure procedure is and is not followed
after an avoidable adverse event.
September 8, 2021
Carrillo I, Mira JJ, Guilabert M, et al. Why an open disclosure procedure is and is not followed after an
avoidable adverse event. J Patient Saf. 2021;17(6):e529-e533. doi:10.1097/pts.0000000000000405.
https…
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psnet.ahrq.gov/node/47554/psn-pdf
November 07, 2018 - Diagnostic Excellence Initiative.
November 7, 2018
Gordon and Betty Moore Foundation.
https://psnet.ahrq.gov/issue/diagnostic-excellence-improving-experience-and-outcomes-patient-care
Missed or delayed diagnoses lead to delays in care and significant preventable harm for patients. Despite
an increasing focus on di…
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psnet.ahrq.gov/node/837892/psn-pdf
January 01, 2023 - Teamwork before and during COVID-19: the good, the
same, and the ugly….
August 24, 2022
Rehder KJ, Adair KC, Eckert E, et al. Teamwork before and during COVID-19: the good, the same, and the
ugly…. J Patient Saf. 2023;19(1):36-41. doi:10.1097/pts.0000000000001070.
https://psnet.ahrq.gov/issue/teamwork-and-during-c…
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psnet.ahrq.gov/node/838252/psn-pdf
October 05, 2022 - A longitudinal study of a multifaceted intervention to
reduce newborn falls while preserving rooming-in on a
mother-baby unit.
October 5, 2022
Whatley C, Schlogl J, Whalen BL, et al. A longitudinal study of a multifaceted intervention to reduce
newborn falls while preserving rooming-in on a mother-baby unit. Jt Co…