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psnet.ahrq.gov/node/837627/psn-pdf
July 06, 2022 - Distinguishing high-performing from low-performing
hospitals for severe maternal morbidity: a focus on
quality and equity.
July 6, 2022
Howell EA, Sofaer S, Balbierz A, et al. Distinguishing high-performing from low-performing hospitals for
severe maternal morbidity: a focus on quality and equity. Obstet Gynecol. …
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psnet.ahrq.gov/node/849595/psn-pdf
May 31, 2023 - Effect of an emergency department process improvement
package on suicide prevention: the ED-SAFE 2 cluster
randomized clinical trial.
May 31, 2023
Boudreaux ED, Larkin C, Vallejo Sefair A, et al. Effect of an emergency department process improvement
package on suicide prevention: the ED-SAFE 2 cluster randomized c…
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psnet.ahrq.gov/node/73397/psn-pdf
June 16, 2021 - Safe opioid prescribing: a prognostic machine learning
approach to predicting 30-day risk after an opioid
dispensation in Alberta, Canada.
June 16, 2021
Sharma V, Kulkarni V, Eurich DT, et al. Safe opioid prescribing: a prognostic machine learning approach to
predicting 30-day risk after an opioid dispensation in …
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psnet.ahrq.gov/node/47526/psn-pdf
January 16, 2019 - US national trends in pediatric deaths from prescription
and illicit opioids, 1999–2016.
January 16, 2019
Gaither JR, Shabanova V, Leventhal JM. US National Trends in Pediatric Deaths From Prescription and
Illicit Opioids, 1999-2016. JAMA Netw Open. 2018;1(8):e186558.
doi:10.1001/jamanetworkopen.2018.6558.
https:…
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psnet.ahrq.gov/node/43346/psn-pdf
August 02, 2015 - Diffusion of surgical innovations, patient safety, and
minimally invasive radical prostatectomy.
August 2, 2015
Parsons K, Messer K, Palazzi K, et al. Diffusion of surgical innovations, patient safety, and minimally
invasive radical prostatectomy. JAMA Surg. 2014;149(8):845-51. doi:10.1001/jamasurg.2014.31.
https:…
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psnet.ahrq.gov/node/45471/psn-pdf
September 21, 2016 - Vital signs: epidemiology of sepsis: prevalence of health
care factors and opportunities for prevention.
September 21, 2016
Novosad SA, Sapiano MRP, Grigg C, et al. Vital Signs: Epidemiology of Sepsis: Prevalence of Health Care
Factors and Opportunities for Prevention. MMWR Morb Mortal Wkly Rep. 2016;65(33):864-869…
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psnet.ahrq.gov/node/47063/psn-pdf
November 19, 2018 - I-PASS handoff program: use of a campaign to effect
transformational change.
November 19, 2018
Rosenbluth G, Destino LA, Starmer AJ, et al. I-PASS Handoff Program: Use of a Campaign to Effect
Transformational Change. Ped Qual Saf. 2018;3(4):e088. doi:10.1097/pq9.0000000000000088.
https://psnet.ahrq.gov/issue/i-pas…
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psnet.ahrq.gov/node/43859/psn-pdf
May 28, 2015 - Point prevalence of surgical checklist use in Europe:
relationship with hospital mortality.
May 28, 2015
Jammer I, Ahmad T, Aldecoa C, et al. Point prevalence of surgical checklist use in Europe: relationship
with hospital mortality. Br J Anaesth. 2015;114(5):801-807. doi:10.1093/bja/aeu460.
https://psnet.ahrq.gov…
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psnet.ahrq.gov/node/43064/psn-pdf
January 01, 2015 - Leadership, safety climate, and continuous quality
improvement: impact on process quality and patient
safety.
December 12, 2014
McFadden KL, Stock GN, Gowen CR. Leadership, safety climate, and continuous quality improvement:
impact on process quality and patient safety. Health Care Manage Rev. 2015;40(1):24-34.
d…
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psnet.ahrq.gov/node/47973/psn-pdf
July 18, 2019 - Transition planning for the senior surgeon: guidance and
recommendations from the Society of Surgical Chairs.
July 18, 2019
Rosengart TK, Doherty G, Higgins R, et al. Transition Planning for the Senior Surgeon: Guidance and
Recommendations From the Society of Surgical Chairs. JAMA Surg. 2019;154(7):647-653.
doi:10…
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psnet.ahrq.gov/node/46700/psn-pdf
November 19, 2018 - Promising practices for improving hospital patient safety
culture.
November 19, 2018
Campione J, Famolaro T. Promising Practices for Improving Hospital Patient Safety Culture. Jt Comm J
Qual Patient Saf. 2018;44(1):23-32. doi:10.1016/j.jcjq.2017.09.001.
https://psnet.ahrq.gov/issue/promising-practices-improving-ho…
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psnet.ahrq.gov/node/43697/psn-pdf
March 26, 2015 - Establishing an international baseline for medication
safety in oncology: findings from the 2012 ISMP
International Medication Safety Self Assessment for
Oncology.
March 26, 2015
Greenall J, Shastay A, Vaida AJ, et al. Establishing an international baseline for medication safety in
oncology: Findings from the 201…
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psnet.ahrq.gov/node/41168/psn-pdf
February 29, 2012 - Evaluation of organizational culture among different
levels of healthcare staff participating in the Institute for
Healthcare Improvement's 100,000 Lives Campaign.
February 29, 2012
Sinkowitz-Cochran R, Garcia-Williams A, Hackbarth AD, et al. Evaluation of organizational culture among
different levels of healthcar…
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psnet.ahrq.gov/node/38563/psn-pdf
March 23, 2011 - Market-based control mechanisms for patient safety.
March 23, 2011
Coiera E, Braithwaite J. Market-based control mechanisms for patient safety. Qual Saf Health Care.
2009;18(2):99-103. doi:10.1136/qshc.2007.025833.
https://psnet.ahrq.gov/issue/market-based-control-mechanisms-patient-safety
Efforts to improve patie…
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psnet.ahrq.gov/node/46679/psn-pdf
December 22, 2018 - Are parents who feel the need to watch over their
children's care better patient safety partners?
December 22, 2018
Cox E, Hansen K, Rajamanickam VP, et al. Are Parents Who Feel the Need to Watch Over Their
Children's Care Better Patient Safety Partners? Hosp Pediatr. 2017;7(12):716-722.
doi:10.1542/hpeds.2017-003…
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psnet.ahrq.gov/node/43254/psn-pdf
May 01, 2015 - Investigating the long-term consequences of adverse
medical events among older adults.
May 1, 2015
Carter MW, Zhu M, Xiang J, et al. Investigating the long-term consequences of adverse medical events
among older adults. Inj Prev. 2014;20(6):408-15. doi:10.1136/injuryprev-2013-041043.
https://psnet.ahrq.gov/issue/i…
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psnet.ahrq.gov/node/43851/psn-pdf
March 13, 2015 - Systematic review of the effectiveness of strategies to
encourage patients to remind healthcare professionals
about their hand hygiene.
March 13, 2015
Davis R, Parand A, Pinto A, et al. Systematic review of the effectiveness of strategies to encourage
patients to remind healthcare professionals about their hand hy…
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psnet.ahrq.gov/web-mm/forgotten-drip
April 01, 2014 - The Forgotten Drip
Citation Text:
Josephson AS. The Forgotten Drip. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2008.
Copy Citation
Format:
Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId R…
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psnet.ahrq.gov/node/73554/psn-pdf
July 28, 2021 - EMS Patient Safety in the Field
July 28, 2021
Augustine JJ, Fitall E, Hall KK, et al. EMS Patient Safety in the Field. PSNet [internet]. 2021.
https://psnet.ahrq.gov/perspective/ems-patient-safety-field
Introduction
Emergency medical services (EMS) personnel serve a critical role within the care continuum. They ar…
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psnet.ahrq.gov/node/49389/psn-pdf
February 01, 2003 - Procedural Mishap: Learning Curve?
February 1, 2003
Gibbs VC, Leape L. Procedural Mishap: Learning Curve? PSNet [internet]. 2003.
https://psnet.ahrq.gov/web-mm/procedural-mishap-learning-curve
The Case
A 28-year-old multiparous obese female presented for laparoscopic tubal ligation. The patient had
undesired fert…