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psnet.ahrq.gov/node/43441/psn-pdf
July 12, 2018 - Fixing Healthcare Delivery.
July 12, 2018
University of Florida, Institute for Healthcare Improvement, Coursera.
https://psnet.ahrq.gov/issue/fixing-healthcare-delivery
This online course presents teamwork, systems design, leadership, and change management as strategies
to improve health care safety. The course in…
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psnet.ahrq.gov/node/37656/psn-pdf
May 08, 2019 - Canadian Disclosure Guidelines: Being Open and Honest
with Patients and Families.
May 8, 2019
Disclosure Working Group. Edmonton, AB, Canada; Canadian Patient Safety Institute; 2011. ISBN
9781926541389.
https://psnet.ahrq.gov/issue/canadian-disclosure-guidelines-being-open-and-honest-patients-and-families
These n…
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psnet.ahrq.gov/node/41091/psn-pdf
October 01, 2021 - ISMP List of High-Alert Medications in
Community/Ambulatory Healthcare.
October 1, 2021
Horsham, PA: Institute for Safe Medication Practices; 2021.
https://psnet.ahrq.gov/issue/ismp-list-high-alert-medications-communityambulatory-healthcare
This fact sheet provides a list of high-alert medications commonly used in…
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psnet.ahrq.gov/node/34119/psn-pdf
June 11, 2019 - 2017 ISMP Medication Safety Self Assessment for
Community/Ambulatory Pharmacy.
June 11, 2019
Horsham, PA: Institute for Safe Medication Practices; 2017.
https://psnet.ahrq.gov/issue/2017-ismp-medication-safety-self-assessment-communityambulatory-
pharmacy
This community pharmacy measurement tool can be used to re…
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psnet.ahrq.gov/node/34598/psn-pdf
November 15, 2011 - Complexity and the Adoption of Innovation in Health
Care.
November 15, 2011
Plsek P. Washington DC: National Institute for Health Care Management Foundation and National
Committee for Quality Health Care; 2003.
https://psnet.ahrq.gov/issue/complexity-and-adoption-innovation-health-care
In discussing the complexit…
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psnet.ahrq.gov/node/40317/psn-pdf
November 21, 2016 - Achieving an Exceptional Patient and Family Experience
of Inpatient Hospital Care.
November 21, 2016
Balik B, Conway J, Zipperer L, Watson J. Cambridge, MA: Institute for Healthcare Improvement; 2011.
https://psnet.ahrq.gov/issue/achieving-exceptional-patient-and-family-experience-inpatient-hospital-care
This whit…
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psnet.ahrq.gov/node/39427/psn-pdf
July 30, 2012 - Responding to patient safety incidents: the "seven
pillars."
July 30, 2012
McDonald TB, Helmchen LA, Smith KM, et al. Responding to patient safety incidents: the "seven pillars".
Qual Saf Health Care. 2010;19(6):e11. doi:10.1136/qshc.2008.031633.
https://psnet.ahrq.gov/issue/responding-patient-safety-incidents-sev…
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psnet.ahrq.gov/node/37358/psn-pdf
January 02, 2017 - Reducing surgical complications.
January 2, 2017
Griffin F. Reducing surgical complications. Jt Comm J Qual Patient Saf. 2007;33(11):660-5.
https://psnet.ahrq.gov/issue/reducing-surgical-complications
The author supports the Institute for Healthcare Improvement’s 5 Million Lives Campaign by
recommending several ch…
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psnet.ahrq.gov/node/38223/psn-pdf
October 14, 2015 - Patient-Centered Care Improvement Guide.
October 14, 2015
Frampton S, Guastello S, Brady C, et al. Derby, CT: Planetree; Camden, ME: Picker Institute; 2008.
https://psnet.ahrq.gov/issue/patient-centered-care-improvement-guide
This guide contains comprehensive information about best practices and implementation tool…
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psnet.ahrq.gov/node/36121/psn-pdf
April 29, 2018 - Practitioners agree on medication reconciliation value,
but frustration and difficulties abound.
April 29, 2018
ISMP Medication Safety Alert! Acute care edition. July 13, 2006.
https://psnet.ahrq.gov/issue/practitioners-agree-medication-reconciliation-value-frustration-and-difficulties-
abound
This article summar…
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psnet.ahrq.gov/node/38375/psn-pdf
December 01, 2019 - ISMP QuarterWatch Reports.
April 17, 2019
Horsham, PA: Institute for Safe Medication Practices.
https://psnet.ahrq.gov/issue/ismp-quarterwatch-reports
This website provides quarterly reports that identify and analyze new risks related to medications and
adverse drug events submitted to the Food and Drug Administra…
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psnet.ahrq.gov/node/50902/psn-pdf
February 12, 2020 - Improving care by using patient feedback.
February 12, 2020
National Institute for Health Research. Southampton, UK: NIHR Dissemination Centre; December 2019.
https://psnet.ahrq.gov/issue/improving-care-using-patient-feedback
Patient feedback is a problematic source of patient safety improvement information. This r…
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psnet.ahrq.gov/node/38335/psn-pdf
March 23, 2009 - For patients, a list of hospital hazards.
March 23, 2009
Landro L. Wall Street Journal (Eastern edition). December 23, 2008;D2.
https://psnet.ahrq.gov/issue/patients-list-hospital-hazards
Emphasizing the importance of safe device use to prevent patient harm, this article reports on the top 10
technology hazards in…
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psnet.ahrq.gov/node/41563/psn-pdf
December 04, 2016 - Harm to Healing - Partnering with Patients Who Have
Been Harmed.
December 4, 2016
Trew M, Nettleton S, Flemons W. Edmonton, AB, Canada: Canadian Patient Safety Institute; June 2012.
https://psnet.ahrq.gov/issue/harm-healing-partnering-patients-who-have-been-harmed
This publication describes an investigation into e…
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psnet.ahrq.gov/node/39172/psn-pdf
December 09, 2009 - Advancing Patient Safety: A Decade of Evidence, Design,
and Implementation.
December 9, 2009
Rockville, MD; Agency for Healthcare Research and Quality; November 2009. AHRQ Publication No.
09(10)-0084.
https://psnet.ahrq.gov/issue/advancing-patient-safety-decade-evidence-design-and-implementation
This publication …
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psnet.ahrq.gov/training-catalog/ismp-education-solutions
August 09, 2025 - ISMP Education Solutions
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Organization:
Organization
ECRI Institute
Event Description: As a global leader in medication s…
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psnet.ahrq.gov/node/40111/psn-pdf
December 14, 2012 - Disruptive behavior affects hospital financial health.
December 14, 2012
Rosenstein AH. Measuring and managing the economic impact of disruptive behaviors in the hospital.
Journal of healthcare risk management : the journal of the American Society for Healthcare Risk
Management. 2010;30(2):20-6. doi:10.1002/jhrm.20…
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psnet.ahrq.gov/node/39494/psn-pdf
May 13, 2019 - Chasing Zero: Winning the War on Healthcare Harm.
May 13, 2019
Austin, TX: Texas Medical Institute for Technology and the Quaid Foundation; 2010.
https://psnet.ahrq.gov/issue/chasing-zero-winning-war-healthcare-harm
This documentary reports on families affected by medical errors; it includes the story of a high-pro…
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psnet.ahrq.gov/node/36077/psn-pdf
July 05, 2006 - Perinatal patient safety from the perspective of nurse
executives: a round table discussion.
July 5, 2006
Thorman KE; Capitulo KL; Dubow J; Hanold K; Noonan M; Wehmeyer J.
https://psnet.ahrq.gov/issue/perinatal-patient-safety-perspective-nurse-executives-round-table-discussion
The authors summarize a discussion be…
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psnet.ahrq.gov/node/35036/psn-pdf
March 29, 2007 - Escape Fire: Designs for the Future of Health Care.
March 29, 2007
Berwick DM. San Francisco, CA: John Wiley & Sons; 2004.
https://psnet.ahrq.gov/issue/escape-fire-designs-future-health-care
This book presents a decade's worth of keynote speeches made by the Institute for Healthcare
Improvement's cofounder and pre…