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psnet.ahrq.gov/issue/electronic-health-record-related-events-medical-malpractice-claims
April 03, 2018 - Study
Classic
Electronic health record–related events in medical malpractice claims.
Citation Text:
Graber ML, Siegal D, Riah H, et al. Electronic Health Record-Related Events in Medical Malpractice Claims. J Patient Saf. 2019;15(2):77-85. doi:10.1097/PTS.000000…
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psnet.ahrq.gov/issue/multi-facetted-patient-safety-resource-qualitative-interview-study-hospital-managers
September 20, 2023 - Study
A multi-facetted patient safety resource--a qualitative interview study on hospital managers' perception of the nurse-led Rapid Response Team.
Citation Text:
Axelsen MS, Baumgarten M, Egholm CL, et al. A multi‐facetted patient safety resource—a qualitative interview study on hospit…
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psnet.ahrq.gov/issue/national-trends-hospital-acquired-preventable-adverse-events-after-major-cancer-surgery-usa
September 12, 2016 - Study
National trends in hospital-acquired preventable adverse events after major cancer surgery in the USA.
Citation Text:
Sukumar S, Roghmann F, Trinh VQ, et al. National trends in hospital-acquired preventable adverse events after major cancer surgery in the USA. BMJ Open. 2013;3(6)…
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psnet.ahrq.gov/issue/improving-safety-recommendations-implementation-simulation-based-event-analysis-optimize
July 24, 2019 - Study
Improving safety recommendations before implementation: a simulation-based event analysis to optimize interventions designed to prevent recurrence of adverse events.
Citation Text:
Langevin M, Ward N, Fitzgibbons C, et al. Improving safety recommendations before implementation: a s…
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psnet.ahrq.gov/issue/prospective-evaluation-medication-related-clinical-decision-support-over-rides-intensive-care
April 07, 2019 - Study
Emerging Classic
Prospective evaluation of medication-related clinical decision support over-rides in the intensive care unit.
Citation Text:
Wong A, Amato MG, Seger DL, et al. Prospective evaluation of medication-related clinical decision support over-rid…
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psnet.ahrq.gov/issue/incidence-and-variables-associated-inconsistencies-opioid-prescribing-hospital-discharge-and
April 29, 2018 - Study
Incidence and variables associated with inconsistencies in opioid prescribing at hospital discharge and its associated adverse drug outcomes.
Citation Text:
Kurteva S, Habib B, Moraga T, et al. Incidence and variables associated with inconsistencies in opioid prescribing at hospita…
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psnet.ahrq.gov/issue/tipping-balance-systematic-review-and-meta-ethnography-unfold-complexity-surgical
August 04, 2021 - Review
Tipping the balance: a systematic review and meta-ethnography to unfold the complexity of surgical antimicrobial prescribing behavior in hospital settings.
Citation Text:
Parker H, Frost J, Day J, et al. Tipping the balance: a systematic review and meta-ethnography to unfold the c…
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psnet.ahrq.gov/issue/structural-racism-60-year-old-black-woman-breast-cancer
December 17, 2020 - Commentary
Emerging Classic
Structural racism--a 60-year-old black woman with breast cancer.
Citation Text:
Pallok K, De Maio F, Ansell DA. Structural racism--a 60-year-old black woman with breast cancer. N Engl J Med. 2019;380(16):1489-1493. doi:10.1056/nejmp18…
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psnet.ahrq.gov/issue/handshake-antimicrobial-stewardship-model-recognize-and-prevent-diagnostic-errors
September 29, 2021 - Study
Handshake antimicrobial stewardship as a model to recognize and prevent diagnostic errors.
Citation Text:
Searns JB, Williams MC, MacBrayne CE, et al. Handshake antimicrobial stewardship as a model to recognize and prevent diagnostic errors. Diagnosis (Berl). 2021;8(3):347-352. doi…
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psnet.ahrq.gov/issue/diagnostic-error-index-quality-improvement-initiative-identify-and-measure-diagnostic-errors
July 14, 2021 - Study
The Diagnostic Error Index: a quality improvement initiative to identify and measure diagnostic errors.
Citation Text:
Perry MF, Melvin JE, Kasick RT, et al. The Diagnostic Error Index: a quality improvement initiative to identify and measure diagnostic errors. J Pediatr. 2021;232:…
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psnet.ahrq.gov/issue/bedside-clinicians-perceptions-contributing-role-diagnostic-errors-acutely-ill-patient
May 26, 2021 - Study
Bedside clinicians' perceptions on the contributing role of diagnostic errors in acutely ill patient presentation: a survey of academic and community practice.
Citation Text:
Huang C, Barwise A, Soleimani J, et al. Bedside clinicians' perceptions on the contributing role of diagnos…
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psnet.ahrq.gov/issue/why-do-healthcare-professionals-fail-escalate-early-warning-system-ews-protocol-qualitative
August 25, 2021 - Review
Emerging Classic
Why do healthcare professionals fail to escalate as per the early warning system (EWS) protocol? A qualitative evidence synthesis of the barriers and facilitators of escalation.
Citation Text:
O’Neill SM, Clyne B, Bell M, et al. Why do h…
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psnet.ahrq.gov/issue/error-reduction-trauma-care-lessons-anonymized-national-multicenter-mortality-reporting
March 24, 2021 - Study
Error reduction in trauma care: lessons from an anonymized, national, multicenter mortality reporting system.
Citation Text:
Hamad DM, Mandell SP, Stewart RM, et al. Error reduction in trauma care: Lessons from an anonymized, national, multicenter mortality reporting system. J Trau…
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psnet.ahrq.gov/issue/assessing-safety-electronic-health-records-national-longitudinal-study-medication-related
July 29, 2020 - Study
Assessing the safety of electronic health records: a national longitudinal study of medication-related decision support.
Citation Text:
Holmgren J, Co Z, Newmark L, et al. Assessing the safety of electronic health records: a national longitudinal study of medication-related decisio…
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psnet.ahrq.gov/issue/do-telephone-call-interruptions-have-impact-radiology-resident-diagnostic-accuracy
July 19, 2023 - Study
Do telephone call interruptions have an impact on radiology resident diagnostic accuracy?
Citation Text:
Balint BJ, Steenburg SD, Lin H, et al. Do telephone call interruptions have an impact on radiology resident diagnostic accuracy? Acad Radiol. 2014;21(12):1623-8. doi:10.1016/j.a…
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psnet.ahrq.gov/issue/evaluation-medication-related-clinical-decision-support-alert-overrides-intensive-care-unit
July 02, 2019 - Study
Evaluation of medication-related clinical decision support alert overrides in the intensive care unit.
Citation Text:
Wong A, Amato MG, Seger DL, et al. Evaluation of medication-related clinical decision support alert overrides in the intensive care unit. J Crit Care. 2017;39:156-1…
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psnet.ahrq.gov/issue/follow-abnormal-screening-mammograms-among-low-income-ethnically-diverse-women-findings
May 12, 2021 - Study
Follow-up of abnormal screening mammograms among low-income ethnically diverse women: findings from a qualitative study.
Citation Text:
Allen JD, Shelton RC, Harden E, et al. Follow-up of abnormal screening mammograms among low-income ethnically diverse women: findings from a quali…
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psnet.ahrq.gov/issue/communication-during-interhospital-transfers-emergency-general-surgery-patients-qualitative
August 24, 2022 - Study
Communication during interhospital transfers of emergency general surgery patients: a qualitative study of challenges and opportunities.
Citation Text:
Alagoz E, Saucke M, Arroyo N, et al. Communication during interhospital transfers of emergency general surgery patients: a qualita…
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psnet.ahrq.gov/issue/mixed-methods-study-challenges-experienced-clinical-teams-measuring-improvement
February 20, 2019 - Study
A mixed-methods study of challenges experienced by clinical teams in measuring improvement.
Citation Text:
Woodcock T, Liberati EG, Dixon-Woods M. A mixed-methods study of challenges experienced by clinical teams in measuring improvement. BMJ Qual Saf. 2021;30(2):106-115. doi:10.11…
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psnet.ahrq.gov/issue/improving-communication-primary-care-physicians-time-hospital-discharge
November 16, 2022 - Study
Improving communication with primary care physicians at the time of hospital discharge.
Citation Text:
Destino LA, Dixit A, Pantaleoni JL, et al. Improving Communication with Primary Care Physicians at the Time of Hospital Discharge. Jt Comm J Qual Patient Saf. 2017;43(2):80-88. do…