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psnet.ahrq.gov/node/60623/psn-pdf
June 24, 2020 - Communication with health care workers regarding health
care-associated exposure to coronavirus 2019: a
checklist to facilitate disclosure.
June 24, 2020
Wickner PG, Hartley T, Salmasian H, et al. Communication with health care workers regarding health care-
associated exposure to coronavirus 2019: a checklist to …
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psnet.ahrq.gov/node/37480/psn-pdf
January 23, 2008 - Lost opportunities: how physicians communicate about
medical errors.
January 23, 2008
Garbutt J, Waterman AD, Kapp JM, et al. Lost Opportunities: How Physicians Communicate About Medical
Errors. Health Aff (Millwood). 2008;27(1):246-255. doi:10.1377/hlthaff.27.1.246.
https://psnet.ahrq.gov/issue/lost-opportunities…
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psnet.ahrq.gov/node/36457/psn-pdf
May 27, 2011 - Controversies surrounding use of order sets for clinical
decision support in computerized provider order entry.
May 27, 2011
Bobb AM, Payne TH, Gross PA. Viewpoint: controversies surrounding use of order sets for clinical decision
support in computerized provider order entry. J Am Med Inform Assoc. 2007;14(1):41-7.…
-
psnet.ahrq.gov/node/60524/psn-pdf
May 27, 2020 - Varying rates of patient identity verification when using
computerized provider order entry.
May 27, 2020
Fortman E, Hettinger AZ, Howe JL, et al. Varying rates of patient identity verification when using
computerized provider order entry. J Am Med Info Assoc. 2020;27(6):924-928. doi:10.1093/jamia/ocaa047.
https:/…
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psnet.ahrq.gov/node/46009/psn-pdf
September 13, 2017 - Use of standard risk screening and assessment forms to
prevent harm to older people in Australian hospitals: a
mixed methods study.
September 13, 2017
Redley B, Raggatt M. Use of standard risk screening and assessment forms to prevent harm to older
people in Australian hospitals: a mixed methods study. BMJ Qual Sa…
-
psnet.ahrq.gov/node/37655/psn-pdf
September 24, 2010 - Reducing anticoagulant medication adverse events and
avoidable patient harm.
September 24, 2010
Jennings HR, Miller EC, Williams TS, et al. Reducing anticoagulant medication adverse vents and
avoidable patient harm. Jt Comm J Qual Patient Saf. 2008;34(4):196-200.
https://psnet.ahrq.gov/issue/reducing-anticoagulant…
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psnet.ahrq.gov/node/42419/psn-pdf
July 17, 2013 - Health IT Patient Safety Action and Surveillance Plan.
July 17, 2013
Washington, DC: Office of the National Coordinator for Health Information Technology; July 2, 2013.
https://psnet.ahrq.gov/issue/health-it-patient-safety-action-and-surveillance-plan
This report from the Department of Health and Human Services (HH…
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psnet.ahrq.gov/node/44127/psn-pdf
September 28, 2017 - Overkill: An avalanche of unnecessary medical care is
harming patients physically and financially. What can we
do about it?
September 28, 2017
Gawande A. The New Yorker. May 2015
https://psnet.ahrq.gov/issue/overkill-avalanche-unnecessary-medical-care-harming-patients-physically-and-
financially-what
The overuse…
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psnet.ahrq.gov/node/36346/psn-pdf
April 11, 2011 - Incidence and nature of adverse events during pediatric
sedation/anesthesia for procedures outside the operating
room: report from the Pediatric Sedation Research
Consortium.
April 11, 2011
Cravero JP, Blike G, Beach M, et al. Incidence and nature of adverse events during pediatric
sedation/anesthesia for procedu…
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psnet.ahrq.gov/node/37849/psn-pdf
March 23, 2011 - The incidence and nature of in-hospital adverse events: a
systematic review.
March 23, 2011
de Vries EN, Ramrattan MA, Smorenburg SM, et al. The incidence and nature of in-hospital adverse
events: a systematic review. Qual Saf Health Care. 2008;17(3):216-223. doi:10.1136/qshc.2007.023622.
https://psnet.ahrq.gov/is…
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psnet.ahrq.gov/node/37091/psn-pdf
March 02, 2016 - The tension between needing to improve care and
knowing how to do it.
March 2, 2016
Auerbach AD, Landefeld S, Shojania KG. The tension between needing to improve care and knowing how
to do it. N Engl J Med. 2007;357(6):608-13.
https://psnet.ahrq.gov/issue/tension-between-needing-improve-care-and-knowing-how-do-it
…
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psnet.ahrq.gov/node/34087/psn-pdf
June 16, 2011 - Evaluation of the culture of safety: survey of clinicians
and managers in an academic medical center.
June 16, 2011
Pronovost PJ, Weast B, Holzmueller CG, et al. Evaluation of the culture of safety: survey of clinicians and
managers in an academic medical center. Qual Saf Health Care. 2003;12(6):405-10.
https://ps…
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psnet.ahrq.gov/node/36455/psn-pdf
December 22, 2010 - Changing the work environment in ICUs to achieve
patient-focused care: the time has come.
December 22, 2010
McCauley K, Irwin RS. Changing the work environment in ICUs to achieve patient-focused care: the time
has come. Chest. 2006;130(5):1571-8.
https://psnet.ahrq.gov/issue/changing-work-environment-icus-achieve-…
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psnet.ahrq.gov/node/60017/psn-pdf
March 04, 2020 - Changes in cancer detection and false-positive recall in
mammography using artificial intelligence: a
retrospective, multireader study.
March 4, 2020
Kim H-E, Kim HH, Han B-K, et al. Changes in cancer detection and false-positive recall in mammography
using artificial intelligence: a retrospective, multireader stu…
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psnet.ahrq.gov/node/836824/psn-pdf
March 30, 2022 - Collaborative case review: a systems-based approach to
patient safety event investigation and analysis.
March 30, 2022
Lacson R, Khorasani R, Fiumara K, et al. Collaborative case review: a systems-based approach to patient
safety event investigation and analysis. J Patient Saf. 2022;18(2):e522-e527.
doi:10.1097/pt…
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psnet.ahrq.gov/node/42980/psn-pdf
February 17, 2017 - Disclosing adverse events to patients: international
norms and trends.
February 17, 2017
Wu AW, McCay L, Levinson W, et al. Disclosing Adverse Events to Patients: International Norms and
Trends. J Patient Saf. 2017;13(1):43-49. doi:10.1097/PTS.0000000000000107.
https://psnet.ahrq.gov/issue/disclosing-adverse-event…
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psnet.ahrq.gov/node/45651/psn-pdf
November 16, 2016 - Improving patient safety through the involvement of
patients: development and evaluation of novel
interventions to engage patients in preventing patient
safety incidents and protecting them against unintended
harm.
November 16, 2016
Wright J, Lawton R, O’Hara J, et al. Improving Patient Safety Through The Involve…
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psnet.ahrq.gov/node/35032/psn-pdf
February 03, 2011 - Five years after 'To Err is Human': what have we learned?
February 3, 2011
Leape L, Berwick DM. Five years after To Err Is Human: what have we learned? JAMA.
2005;293(19):2384-90.
https://psnet.ahrq.gov/issue/five-years-after-err-human-what-have-we-learned
Two of the leaders in the patient safety movement, Lucian …
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psnet.ahrq.gov/node/44321/psn-pdf
July 08, 2015 - Move toward full use of metric dosing: eliminate dosage
cups that measure liquids in fluid drams. Use cups that
measure mL.
July 8, 2015
National Alert Network. Horsham, PA: Institute for Safe Medication Practices; Bethesda, MD: American
Society of Health-System Pharmacists. June 30, 2015.
https://psnet.ahrq.gov/…
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psnet.ahrq.gov/node/35969/psn-pdf
August 10, 2010 - Systematic review: impact of health information
technology on quality, efficiency, and costs of medical
care.
August 10, 2010
Chaudhry B, Wang J, Wu S, et al. Systematic review: impact of health information technology on quality,
efficiency, and costs of medical care. Ann Intern Med. 2006;144(10):742-52.
https://…