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psnet.ahrq.gov/issue/safety-measurement-and-monitoring-healthcare-framework-guide-clinical-teams-and-healthcare
September 24, 2018 - Review
Safety measurement and monitoring in healthcare: a framework to guide clinical teams and healthcare organisations in maintaining safety.
Citation Text:
Vincent CA, Burnett S, Carthey J. Safety measurement and monitoring in healthcare: a framework to guide clinical teams and health…
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psnet.ahrq.gov/issue/improving-resident-education-and-patient-safety-method-balance-initial-caseloads-academic
January 27, 2016 - Study
Improving resident education and patient safety: a method to balance initial caseloads at academic year-end transfer.
Citation Text:
Young JQ, Niehaus B, Lieu SC, et al. Improving resident education and patient safety: a method to balance initial caseloads at academic year-end tran…
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psnet.ahrq.gov/issue/impact-implementation-family-initiated-escalation-care-deteriorating-patient-hospital
December 21, 2018 - Review
The impact of implementation of family-initiated escalation of care for the deteriorating patient in hospital: a systematic review.
Citation Text:
Gill FJ, Leslie GD, Marshall AP. The Impact of Implementation of Family-Initiated Escalation of Care for the Deteriorating Patient in …
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psnet.ahrq.gov/issue/ensuring-safe-and-equitable-discharge-quality-improvement-initiative-individuals-hypertensive
October 19, 2022 - Study
Ensuring safe and equitable discharge: a quality improvement initiative for individuals with hypertensive disorders of pregnancy.
Citation Text:
Zacherl KM, Sterrett EC, Hughes BL, et al. Ensuring safe and equitable discharge: a quality improvement initiative for individuals with h…
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psnet.ahrq.gov/issue/surgical-intraoperative-handoff-initiative-standardizing-operating-room-communication-using
October 04, 2023 - Study
Surgical intraoperative handoff initiative: standardizing operating room communication using SHRIMPS.
Citation Text:
Stephens WA, Anderson MJ, Levy BE, et al. Surgical intraoperative handoff initiative: standardizing operating room communication using SHRIMPS. J Am Coll Surg. 2024;…
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psnet.ahrq.gov/issue/roxane-laboratories-initiates-nationwide-voluntary-recall-single-manufacturing-lot
June 22, 2011 - Press Release/Announcement
Roxane Laboratories initiates a nationwide voluntary recall of a single manufacturing lot of Azathioprine tablets in the U.S. and Puerto Rico.
Citation Text:
Roxane Laboratories initiates a nationwide voluntary recall of a single manufacturing lot of Azathiop…
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psnet.ahrq.gov/issue/patient-safety-culture-transformation-childrens-hospital-interprofessional-approach
January 16, 2010 - Study
Patient safety culture transformation in a children's hospital: an interprofessional approach.
Citation Text:
Nagelkerk J, Peterson T, Pawl BL, et al. Patient safety culture transformation in a children's hospital: an interprofessional approach. J Interprof Care. 2014;28(4):358-64.…
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psnet.ahrq.gov/issue/patient-hand-initiation-and-evaluation-phone-study-randomized-trial-patient-handoff-methods
December 20, 2023 - Study
Patient Hand-Off iNitiation and Evaluation (PHONE) study: a randomized trial of patient handoff methods.
Citation Text:
Clanton J, Gardner A, Subichin M, et al. Patient Hand-Off iNitiation and Evaluation (PHONE) study: A randomized trial of patient handoff methods. Am J Surg. 2017;…
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psnet.ahrq.gov/issue/briefing-and-debriefing-operating-room-using-fighter-pilot-crew-resource-management
May 29, 2024 - Study
Briefing and debriefing in the operating room using fighter pilot crew resource management.
Citation Text:
McGreevy JM, Otten TD. Briefing and debriefing in the operating room using fighter pilot crew resource management. J Am Coll Surg. 2007;205(1):169-76.
Copy Citation
Fo…
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psnet.ahrq.gov/issue/quality-management-and-patient-safety-survey-results-102-hungarian-hospitals
September 16, 2015 - Study
Quality management and patient safety: survey results from 102 Hungarian hospitals.
Citation Text:
Makai P, Klazinga NS, Wagner C, et al. Quality management and patient safety: survey results from 102 Hungarian hospitals. Health Policy (New York). 2009;90(2-3):175-80. doi:10.1016/…
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psnet.ahrq.gov/issue/teaching-medication-reconciliation-through-simulation-patient-safety-initiative-second-year
May 04, 2010 - Commentary
Teaching medication reconciliation through simulation: a patient safety initiative for second year medical students.
Citation Text:
Lindquist LA, Gleason KM, McDaniel MR, et al. Teaching medication reconciliation through simulation: a patient safety initiative for second yea…
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psnet.ahrq.gov/issue/patient-safety-obstetrics-what-aviators-firefighters-and-others-can-teach-us
January 22, 2017 - Commentary
Patient safety in obstetrics: what aviators, firefighters and others can teach us.
Citation Text:
Guise J-M, Lowe NK, Connell L. Patient Safety in Obstetrics: What Aviators, Firefighters and Others Can Teach Us. Nurs Womens Health. 2008;12(3):208-215. doi:10.1111/j.1751-486x…
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psnet.ahrq.gov/issue/food-and-drug-administrations-initiative-safe-design-and-effective-use-home-medical-equipment
August 18, 2010 - Commentary
The Food and Drug Administration's initiative for safe design and effective use of home medical equipment.
Citation Text:
Weick-Brady M, Singh S. The Food and Drug Administration's initiative for safe design and effective use of home medical equipment. Home Healthc Nurse. 2014…
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psnet.ahrq.gov/issue/implementing-interprofessional-patient-safety-learning-initiative-insights-participants
August 14, 2014 - Study
Implementing an interprofessional patient safety learning initiative: insights from participants, project leads and steering committee members.
Citation Text:
Jeffs L, Abramovich IA, Hayes C, et al. Implementing an interprofessional patient safety learning initiative: insights fr…
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psnet.ahrq.gov/issue/effect-computerized-physician-order-entry-radiologic-examination-order-indication-quality
June 13, 2015 - Study
Effect of computerized physician order entry on radiologic examination order indication quality.
Citation Text:
Schneider E, Franz W, Spitznagel R, et al. Effect of computerized physician order entry on radiologic examination order indication quality. Arch Intern Med. 2011;171(11…
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psnet.ahrq.gov/issue/impact-hospital-wide-hand-hygiene-initiative-healthcare-associated-infections-results
September 20, 2011 - Study
Impact of a hospital-wide hand hygiene initiative on healthcare-associated infections: results of an interrupted time series.
Citation Text:
Kirkland KB, Homa KA, Lasky RA, et al. Impact of a hospital-wide hand hygiene initiative on healthcare-associated infections: results of an i…
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psnet.ahrq.gov/issue/chemotherapy-medication-errors-pediatric-cancer-treatment-center-prospective-characterization
January 22, 2017 - Study
Chemotherapy medication errors in a pediatric cancer treatment center: prospective characterization of error types and frequency and development of a quality improvement initiative to lower the error rate.
Citation Text:
Watts RG, Parsons K. Chemotherapy medication errors in a pe…
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psnet.ahrq.gov/sites/default/files/2023-09/a_missed_bowel_perforation_-_the_importance_of_diagnostic_reasoning.pdf
January 01, 2023 - Microsoft PowerPoint - Spotlight Case_A Missed Bowel Perforation - SLIDES_FINAL.pptx
Spotlight
A Missed Bowel Perforation – the Importance of
Diagnostic Reasoning
Source and Credits
• This presentation is based on the September 2023 AHRQ WebM&M
Spotlight Case
o See the full article at https://psnet.ahrq.gov/web…
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psnet.ahrq.gov/issue/hospital-initiated-transitional-care-interventions-patient-safety-strategy-systematic-review
August 12, 2014 - Review
Hospital-initiated transitional care interventions as a patient safety strategy: a systematic review.
Citation Text:
Rennke S, Nguyen OK, Shoeb MH, et al. Hospital-initiated transitional care interventions as a patient safety strategy: a systematic review. Ann Intern Med. 2013;15…
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psnet.ahrq.gov/node/838238/psn-pdf
October 05, 2022 - Spreading a strategy to prevent suicide after psychiatric
hospitalization: results of a quality improvement spread
initiative.
October 5, 2022
Riblet NB, Varela M, Ashby W, et al. Spreading a strategy to prevent suicide after psychiatric
hospitalization: results of a quality improvement spread initiative. Jt Comm …