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psnet.ahrq.gov/node/46955/psn-pdf
May 30, 2018 - Governing the quality and safety of healthcare: a
conceptual framework.
May 30, 2018
Brown A, Dickinson H, Kelaher M. Governing the quality and safety of healthcare: A conceptual framework.
Soc Sci Med. 2018;202:99-107. doi:10.1016/j.socscimed.2018.02.020.
https://psnet.ahrq.gov/issue/governing-quality-and-safety-…
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psnet.ahrq.gov/node/60628/psn-pdf
July 14, 2020 - The Power to Predict: Leveraging Medical Malpractice
Data to Reduce Patient Harm and Financial Loss.
June 24, 2020
Cambridge, MA; CRICO Strategies: July 14, 2020.
https://psnet.ahrq.gov/issue/power-predict-leveraging-medical-malpractice-data-reduce-patient-harm-and-
financial-loss
Malpractice claims can generate …
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psnet.ahrq.gov/node/43585/psn-pdf
July 16, 2015 - At risk care plans: a way to reduce readmissions and
adverse events.
July 16, 2015
Bahle J, Majercik C, Ludwick R, et al. At Risk Care Plans: a way to reduce readmissions and adverse
events. J Nurs Care Qual. 2015;30(3):200-4. doi:10.1097/NCQ.0000000000000106.
https://psnet.ahrq.gov/issue/risk-care-plans-way-reduc…
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psnet.ahrq.gov/node/50936/psn-pdf
February 26, 2020 - Sitters as a patient safety strategy to reduce hospital
falls: a systematic review.
February 26, 2020
Greeley AM, Tanner EP, Mak S, et al. Sitters as a Patient Safety Strategy to Reduce Hospital Falls. Ann
Intern Med. 2020;172(5):317-324. doi:10.7326/m19-2628.
https://psnet.ahrq.gov/issue/sitters-patient-safety-st…
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psnet.ahrq.gov/node/46784/psn-pdf
January 11, 2023 - Patient Safety Learning Laboratories: Advancing Patient
Safety through Design, Systems Engineering, and Health
Services Research (R18 Clinical Trial Optional).
January 11, 2023
Rockville, MD: Agency for Healthcare Research and Quality. PA-21-266.
https://psnet.ahrq.gov/issue/patient-safety-learning-laboratories-ad…
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psnet.ahrq.gov/node/50629/psn-pdf
November 06, 2019 - Lack of association between intraoperative handoff of
care and postoperative complications: a retrospective
observational study.
November 6, 2019
O'Reilly-Shah VN, Melanson VG, Sullivan CL, et al. Lack of association between intraoperative handoff of
care and postoperative complications: a retrospective observatio…
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psnet.ahrq.gov/node/35038/psn-pdf
January 02, 2017 - Using Six Sigma to reduce medication errors in a home-
delivery pharmacy service.
January 2, 2017
Castle L, Franzblau-Isaac E, Paulsen J. Using Six Sigma to reduce medication errors in a home-delivery
pharmacy service. Jt Comm J Qual Patient Saf. 2005;31(6):319-24.
https://psnet.ahrq.gov/issue/using-six-sigma-redu…
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psnet.ahrq.gov/node/46693/psn-pdf
December 20, 2017 - Coupling policymaking with evaluation—the case of the
opioid crisis.
December 20, 2017
Barnett ML, Gray J, Zink A, et al. Coupling Policymaking with Evaluation - The Case of the Opioid Crisis.
New Engl J Med. 2017;377(24):2306-2309. doi:10.1056/NEJMp1710014.
https://psnet.ahrq.gov/issue/coupling-policymaking-evalu…
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psnet.ahrq.gov/node/45068/psn-pdf
August 15, 2017 - Missed ischemic stroke diagnosis in the emergency
department by emergency medicine and neurology
services.
August 15, 2017
Arch AE, Weisman DC, Coca S, et al. Missed Ischemic Stroke Diagnosis in the Emergency Department by
Emergency Medicine and Neurology Services. Stroke. 2016;47(3):668-73.
doi:10.1161/STROKEAHA…
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psnet.ahrq.gov/node/855426/psn-pdf
November 15, 2023 - Anesthesia workspaces for safe medication practices:
design guidelines.
November 15, 2023
MohammadiGorji S, Joseph A, Mihandoust S, et al. Anesthesia workspaces for safe medication practices:
design guidelines. HERD. 2024;17(1):64-83. doi:10.1177/19375867231190646.
https://psnet.ahrq.gov/issue/anesthesia-workspace…
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psnet.ahrq.gov/node/865880/psn-pdf
May 15, 2024 - Racial and ethnic harm in patient care is a patient safety
issue.
May 15, 2024
Rosario N, Kiles TM, M. Jewell T'B, et al. Racial and ethnic harm in patient care is a patient safety issue.
Res Social Adm Pharm. 2024;20(7):670-677. doi:10.1016/j.sapharm.2024.04.012.
https://psnet.ahrq.gov/issue/racial-and-ethnic-har…
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psnet.ahrq.gov/node/36244/psn-pdf
June 13, 2012 - With Safety in Mind: Mental Health Services and Patient
Safety.
June 13, 2012
Scobie S, Minghella E, Dale C, et al. London, UK: National Patient Safety Agency; 2006.
https://psnet.ahrq.gov/issue/safety-mind-mental-health-services-and-patient-safety
This report, the second in a series from the United Kingdom's Nati…
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psnet.ahrq.gov/node/854259/psn-pdf
January 01, 2024 - The power of written word: reflection reduces errors of
omission.
October 4, 2023
Rao A, Heidemann LA, Hartley S, et al. The power of written word: reflection reduces errors of omission.
Clin Teach. 2024;21(1):e13630. doi:10.1111/tct.13630.
https://psnet.ahrq.gov/issue/power-written-word-reflection-reduces-errors-…
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psnet.ahrq.gov/node/44125/psn-pdf
May 28, 2015 - AHRQ focuses on ambulatory patient safety.
May 28, 2015
Ricciardi R. AHRQ Focuses on Ambulatory Patient Safety. J Nurs Care Qual. 2015;30(3):193-6.
doi:10.1097/NCQ.0000000000000124.
https://psnet.ahrq.gov/issue/ahrq-focuses-ambulatory-patient-safety
AHRQ has generated funding and educational opportunities toward u…
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psnet.ahrq.gov/node/44521/psn-pdf
July 03, 2016 - Crib of horrors: one hospital's approach to promoting a
culture of safety.
July 3, 2016
Korah N, Zavalkoff S, Dubrovsky AS. Crib of Horrors: One Hospital's Approach to Promoting a Culture of
Safety. Pediatrics. 2015;136(1):4-5. doi:10.1542/peds.2014-3843.
https://psnet.ahrq.gov/issue/crib-horrors-one-hospitals-app…
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psnet.ahrq.gov/node/47091/psn-pdf
March 19, 2019 - Provider interruptions and patient perceptions of care: an
observational study in the emergency department.
March 19, 2019
Schneider A, Wehler M, Weigl M. Provider interruptions and patient perceptions of care: an observational
study in the emergency department. BMJ Qual Saf. 2019;28(4):296-304. doi:10.1136/bmjqs-2…
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psnet.ahrq.gov/node/866555/psn-pdf
August 21, 2024 - Using behavioral insights to strengthen strategies for
change. Practical applications for quality improvement in
healthcare.
August 21, 2024
Johansen RLR, Tulloch S. Using behavioral insights to strengthen strategies for change. Practical
applications for quality improvement in healthcare. J Patient Saf. 2024;20(5…
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psnet.ahrq.gov/node/45032/psn-pdf
July 21, 2016 - From tokenism to empowerment: progressing patient and
public involvement in healthcare improvement.
July 21, 2016
Ocloo J, Matthews R. From tokenism to empowerment: progressing patient and public involvement in
healthcare improvement. BMJ Qual Saf. 2016;25(8):626-32. doi:10.1136/bmjqs-2015-004839.
https://psnet.ah…
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psnet.ahrq.gov/node/46755/psn-pdf
May 30, 2018 - Innovative approach to reconstruct bedside handoff:
using simple rules of complexity science to promote
partnership with patients.
May 30, 2018
Anthony MK, Kloos J, Beam P, et al. Innovative Approach to Reconstruct Bedside Handoff: Using Simple
Rules of Complexity Science to Promote Partnership With Patients. J Nu…
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psnet.ahrq.gov/node/42002/psn-pdf
May 10, 2013 - National efforts to improve health information system
safety in Canada, the United States of America and
England.
May 10, 2013
Kushniruk AW, Bates DW, Bainbridge M, et al. National efforts to improve health information system safety
in Canada, the United States of America and England. Int J Med Inform. 2013;82(5):…