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psnet.ahrq.gov/issue/hospital-progress-reducing-error-impact-external-interventions
December 04, 2016 - Study
Hospital progress in reducing error: the impact of external interventions.
Citation Text:
Hosford SB. Hospital progress in reducing error: the impact of external interventions. Hosp Top. 2008;86(1):9-19. doi:10.3200/HTPS.86.1.9-20.
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psnet.ahrq.gov/issue/surgeon-commitment-trauma-care-decreases-missed-injuries
June 15, 2012 - Study
Surgeon commitment to trauma care decreases missed injuries.
Citation Text:
Lin Y-K, Lin C-J, Chan H-M, et al. Surgeon commitment to trauma care decreases missed injuries. Injury. 2014;45(1):83-7. doi:10.1016/j.injury.2012.10.019.
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psnet.ahrq.gov/issue/implementation-mock-root-cause-analysis-provide-simulated-patient-safety-training
January 12, 2022 - Commentary
Implementation of a mock root cause analysis to provide simulated patient safety training.
Citation Text:
Murphy M, Duff J, Whitney J, et al. Implementation of a mock root cause analysis to provide simulated patient safety training. BMJ Open Qual. 2017;6(2). doi:10.1136/bmjoq-…
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psnet.ahrq.gov/issue/challenges-and-opportunities-improving-patient-safety-through-human-factors-and-systems
September 11, 2019 - Commentary
Emerging Classic
Challenges and opportunities for improving patient safety through human factors and systems engineering.
Citation Text:
Carayon P, Wooldridge A, Hose B-Z, et al. Challenges And Opportunities For Improving Patient Safety Through Human …
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psnet.ahrq.gov/issue/complexity-science-challenge-complexity-health-care
March 13, 2013 - Commentary
Classic
Complexity science: the challenge of complexity in health care.
Citation Text:
Plsek PE, Greenhalgh T. Complexity science: The challenge of complexity in health care. BMJ. 2001;323(7313):625-628.
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psnet.ahrq.gov/issue/medical-error-second-victim
March 23, 2011 - Commentary
Classic
Medical error: the second victim.
Citation Text:
Wu AW. Medical error: the second victim. The doctor who makes the mistake needs help too. BMJ. 2000;320(7237):726-727.
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psnet.ahrq.gov/issue/expert-consensus-currently-accepted-measures-harm
January 25, 2023 - Commentary
Expert consensus on currently accepted measures of harm.
Citation Text:
Logan MS, Myers LC, Salmasian H, et al. Expert consensus on currently accepted measures of harm. J Patient Saf. 2021;17(8):e1726-e1731. doi:10.1097/pts.0000000000000754.
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psnet.ahrq.gov/issue/minimising-treatment-associated-risks-systemic-cancer-therapy
December 22, 2021 - Review
Minimising treatment-associated risks in systemic cancer therapy.
Citation Text:
Jaehde U, Liekweg A, Simons S, et al. Minimising treatment-associated risks in systemic cancer therapy. Pharm World Sci. 2008;30(2):161-8.
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psnet.ahrq.gov/issue/necessary-leadership-skillsets-high-reliability-organization-framework-adoption-within-acute
March 23, 2022 - Study
The necessary leadership skillsets for the high-reliability organization framework adoption within acute healthcare organizations.
Citation Text:
Logan‐Athmer AL. The necessary leadership skillsets for the high‐reliability organization framework adoption within acute healthcare org…
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psnet.ahrq.gov/issue/maximizing-ability-health-it-and-ai-improve-patient-safety
May 22, 2015 - Commentary
Maximizing the ability of health IT and AI to improve patient safety.
Citation Text:
Singh H, Sittig DF, Classen DC. Maximizing the ability of health IT and AI to improve patient safety. JAMA Intern Med. 2025;185(1):10-12. doi:10.1001/jamainternmed.2024.4343.
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psnet.ahrq.gov/issue/flaw-medicine-addressing-racial-and-gender-disparities-critical-care
June 16, 2010 - Commentary
The flaw of medicine: addressing racial and gender disparities in critical care.
Citation Text:
Hilton EJ, Goff KL, Sreedharan R, et al. The flaw of medicine: addressing racial and gender disparities in critical care. Anesthesiol Clin. 2020;38(2):357-368. doi:10.1016/j.anclin.…
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psnet.ahrq.gov/issue/understanding-factors-influencing-safety-and-team-functionality-operative-vaginal-birth
September 01, 2016 - Study
Understanding factors influencing safety and team functionality at operative vaginal birth through multidisciplinary perspectives: a mixed methods study.
Citation Text:
Skinner SM, Kippen E, Rolnik DL, et al. Understanding factors influencing safety and team functionality at operat…
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psnet.ahrq.gov/issue/improving-maternal-safety-scale-mentor-model-collaborative-improvement
March 31, 2021 - Study
Improving maternal safety at scale with the mentor model of collaborative improvement.
Citation Text:
Main EK, Dhurjati R, Cape V, et al. Improving Maternal Safety at Scale with the Mentor Model of Collaborative Improvement. Jt Comm J Qual Patient Saf. 2018;44(5):250-259. doi:10.10…
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psnet.ahrq.gov/issue/improving-diagnosis-health-care
September 12, 2018 - Book/Report
Classic
Improving Diagnosis in Health Care.
Citation Text:
Improving Diagnosis in Health Care. Committee on Diagnostic Error in Health Care, National Academies of Science, Engineering, and Medicine. Washington, DC: National Academies Press; 2015. ISB…
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psnet.ahrq.gov/issue/diagnostic-error-pediatrics-narrative-review
June 08, 2022 - Review
Diagnostic error in pediatrics: a narrative review.
Citation Text:
Marshall TL, Rinke ML, Olson APJ, et al. Diagnostic error in pediatrics: a narrative review. Pediatrics. 2022;149(Suppl 3):e2020045948D. doi:10.1542/peds.2020-045948d.
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psnet.ahrq.gov/issue/critical-need-nursing-education-address-diagnostic-process
June 08, 2022 - Commentary
The critical need for nursing education to address the diagnostic process.
Citation Text:
Gleason KT, Harkless G, Stanley J, et al. The critical need for nursing education to address the diagnostic process. Nurs Outlook. 2021;69(3):362-369. doi:10.1016/j.outlook.2020.12.005.
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psnet.ahrq.gov/issue/perspectives-patient-and-family-engagement-reduction-harm-forgotten-voice
December 01, 2011 - Study
Perspectives on patient and family engagement with reduction in harm: the forgotten voice.
Citation Text:
Schenk EC, Bryant RA, Van Son CR, et al. Perspectives on Patient and Family Engagement With Reduction in Harm: The Forgotten Voice. J Nurs Care Qual. 2019;34(1):73-79. doi:10.1…
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psnet.ahrq.gov/issue/anesthesia-patient-safety-foundation-stoelting-conference-2019-perioperative-deterioration
October 19, 2022 - Meeting/Conference Proceedings
The Anesthesia Patient Safety Foundation Stoelting Conference 2019: perioperative deterioration--early recognition, rapid intervention, and the end of failure-to-rescue.
Citation Text:
Lin D, Peden CJ, Langness SM, et al. The Anesthesia Patient Safety Found…
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psnet.ahrq.gov/issue/seips-101-and-seven-simple-seips-tools
October 03, 2013 - Commentary
SEIPS 101 and seven simple SEIPS tools.
Citation Text:
Holden RJ, Carayon P. SEIPS 101 and seven simple SEIPS tools. BMJ Qual Saf. 2021;30(11):901-910. doi:10.1136/bmjqs-2020-012538.
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psnet.ahrq.gov/issue/step-toward-high-reliability-implementation-daily-safety-brief-childrens-hospital
August 23, 2023 - Study
A step toward high reliability: implementation of a daily safety brief in a children's hospital.
Citation Text:
Saysana M, McCaskey M, Cox E, et al. A Step Toward High Reliability: Implementation of a Daily Safety Brief in a Children's Hospital. J Patient Saf. 2017;13(3):149-152. d…