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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/34059/psn-pdf
    March 11, 2011 - Strategies for detecting adverse drug events among older persons in the ambulatory setting. March 11, 2011 Field T, Gurwitz JH, Harrold LR, et al. Strategies for detecting adverse drug events among older persons in the ambulatory setting. J Am Med Inform Assoc. 2004;11(6):492-8. https://psnet.ahrq.gov/issue/strate…
  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/36337/psn-pdf
    October 26, 2010 - Technology, governance and patient safety: systems issues in technology and patient safety. October 26, 2010 Balka E, Doyle-Waters M, Lecznarowicz D, et al. Technology, governance and patient safety: systems issues in technology and patient safety. Int J Med Inform. 2007;76 Suppl 1:S35-47. https://psnet.ahrq.gov/i…
  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/856641/psn-pdf
    January 01, 2009 - WebAIRS Anesthesia Incident Reporting System. January 1, 2009 Australian and New Zealand Tripartite Anaesthetic Data Committee. https://psnet.ahrq.gov/issue/webairs-anesthesia-incident-reporting-system Reporting errors in anesthesiology practice can motivate and inform safety improvement work. This website serves …
  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/34048/psn-pdf
    May 27, 2011 - Computerized physician order entry: helpful or harmful? May 27, 2011 Berger RG, Kichak JP. Computerized physician order entry: helpful or harmful? J Am Med Inform Assoc. 2004;11(2):100-3. https://psnet.ahrq.gov/issue/computerized-physician-order-entry-helpful-or-harmful The authors critically review the published …
  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/35178/psn-pdf
    April 23, 2014 - Computer visualisation of patient safety in primary care: a systems approach adapted from management science and engineering. April 23, 2014 Singh R, Singh A, Fox C, et al. Computer visualisation of patient safety in primary care: a systems approach adapted from management science and engineering. Inform Prim Care…
  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/839330/psn-pdf
    November 02, 2022 - Diagnosis: Reducing Errors and Improving Quality. November 2, 2022 Schiff G. Chapter In: Loscalzo J, Fauci A, Kasper D, et al, eds. Harrison's Principles of Internal Medicine, 21e. New York, NY: McGraw Hill; 2022 https://psnet.ahrq.gov/issue/diagnosis-reducing-errors-and-improving-quality The task of performing a …
  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/60719/psn-pdf
    July 22, 2020 - How real-time data can change the patient safety game. July 22, 2020 Diesing G. How real-time data can change the patient safety game. J AHIMA. 2020;July 1. https://psnet.ahrq.gov/issue/how-real-time-data-can-change-patient-safety-game Use of data can improve the response of clinicians to patient concerns and deter…
  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41040/psn-pdf
    January 04, 2012 - Implementing an electronic medical record with computerized prescriber order entry at a critical access hospital. January 4, 2012 Horning R. Implementing an electronic medical record with computerized prescriber order entry at a critical access hospital. Am J Health Syst Pharm. 2011;68(23):2288-92. doi:10.2146/ajh…
  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/838645/psn-pdf
    January 19, 2022 - LeDeR - Learning from Lives and Deaths. January 19, 2022 Norah Frye Centre for Disability Studies; Bristol, England. https://psnet.ahrq.gov/issue/leder-learning-lives-and-deaths People with a Learning Disability and autistic people (LeDeR) is a National Health Service-sponsored initiative that seeks to improve the…
  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44966/psn-pdf
    March 16, 2016 - Confidential Physician Feedback Reports: Designing for Optimal Impact on Performance. March 16, 2016 McNamara P, Shaller D, De La Mare J, Ivers N. Rockville, MD: Agency for Healthcare Research and Quality; March 2016. AHRQ Publication No. 16-0017-EF. https://psnet.ahrq.gov/issue/confidential-physician-feedback-rep…
  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/34607/psn-pdf
    June 12, 2018 - A clinician's guide to surgical fires: how they occur, how to prevent them, how to put them out. June 12, 2018 A clinician's guide to surgical fires. How they occur, how to prevent them, how to put them out. Health Devices. 2003;32(1):5-24. https://psnet.ahrq.gov/issue/clinicians-guide-surgical-fires-how-they-occu…
  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/36830/psn-pdf
    March 28, 2011 - Making use of mortality data to improve quality and safety in general practice: a review of current approaches. March 28, 2011 Baker R, Sullivan E, Camosso-Stefinovic J, et al. Making use of mortality data to improve quality and safety in general practice: a review of current approaches. Qual Saf Health Care. 2007;…
  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47144/psn-pdf
    June 13, 2018 - Canadian Anesthesia Incident Reporting System. June 13, 2018 Canadian Anaesthesiologists Society. https://psnet.ahrq.gov/issue/canadian-anesthesia-incident-reporting-system Reporting mistakes in anesthesiology practice can motivate and inform error reduction work. This website provides a secure tool for submitting…
  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42829/psn-pdf
    December 18, 2013 - To make hospitals less deadly, a dose of data. December 18, 2013 Rosenberg T. https://psnet.ahrq.gov/issue/make-hospitals-less-deadly-dose-data Preventable adverse events may result in more harm than previously thought. Highlighting inconsistencies in publicly reported hospital safety data, this newspaper article …
  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45086/psn-pdf
    July 02, 2019 - Half-life of a printed handoff document. July 2, 2019 Rosenbluth G, Jacolbia R, Milev D, et al. Half-life of a printed handoff document. BMJ Qual Saf. 2016;25(5):324-8. doi:10.1136/bmjqs-2015-004585. https://psnet.ahrq.gov/issue/half-life-printed-handoff-document Despite advances in handoff practices, printed sign…
  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44964/psn-pdf
    March 09, 2016 - EHRs in the ER: as doctors adapt, concerns emerge about medical errors. March 9, 2016 Luthra S. https://psnet.ahrq.gov/issue/ehrs-er-doctors-adapt-concerns-emerge-about-medical-errors Many emergency departments have recently implemented electronic health records, which has introduced new safety hazards. This news…
  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/60885/psn-pdf
    September 02, 2020 - Becoming a High Reliability Organization. September 2, 2020 VHA Forum. Summer 2020;1-12. https://psnet.ahrq.gov/issue/becoming-high-reliability-organization High reliability attainment is a stated goal for health care organizations. This special issue covers established initiatives at the United States Veterans He…
  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44223/psn-pdf
    November 22, 2016 - Patient Safety and Incident Management Toolkit. November 22, 2016 Edmonton, AB: Canadian Patient Safety Institute. June 2015. https://psnet.ahrq.gov/issue/patient-safety-and-incident-management-toolkit Engaging patients and families in safety can uncover concerns and inform improvement efforts. This three- compone…
  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44278/psn-pdf
    July 01, 2015 - When doctors don't talk to doctors. July 1, 2015 Bond A. https://psnet.ahrq.gov/issue/when-doctors-dont-talk-doctors Clinician communication with patients and families during transitions has been a focus of safety improvement efforts. This newspaper article describes insights from a resident physician regarding ho…
  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/39690/psn-pdf
    July 21, 2010 - Characteristics of quality and patient safety curricula in major teaching hospitals. July 21, 2010 Pingleton SK, Davis DA, Dickler RM. Characteristics of quality and patient safety curricula in major teaching hospitals. Am J Med Qual. 2010;25(4):305-11. doi:10.1177/1062860610367677. https://psnet.ahrq.gov/issue/ch…

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