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psnet.ahrq.gov/issue/sleep-deprivation-elective-surgical-procedures-and-informed-consent
December 21, 2017 - Commentary
Sleep deprivation, elective surgical procedures, and informed consent.
Citation Text:
Nurok M, Czeisler CA, Lehmann LS. Sleep deprivation, elective surgical procedures, and informed consent. N Engl J Med. 2010;363(27):2577-9. doi:10.1056/NEJMp1007901.
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psnet.ahrq.gov/issue/do-micropauses-prevent-surgeons-fatigue-and-loss-accuracy-associated-prolonged-surgery
November 29, 2023 - Study
Do micropauses prevent surgeon's fatigue and loss of accuracy associated with prolonged surgery? An experimental prospective study.
Citation Text:
Dorion D, Darveau S. Do micropauses prevent surgeon's fatigue and loss of accuracy associated with prolonged surgery? An experimental…
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psnet.ahrq.gov/issue/impact-patient-safety-mandates-medical-education-united-states
June 01, 2011 - Review
Impact of patient safety mandates on medical education in the United States.
Citation Text:
Kane JM, Brannen ML, Kern E. Impact of Patient Safety Mandates on Medical Education in the United States. J Patient Saf. 2008;4(2):93-97. doi:10.1097/pts.0b013e318173f7b5.
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psnet.ahrq.gov/issue/ashp-guidelines-remote-medication-order-processing
April 19, 2013 - Commentary
ASHP guidelines on remote medication order processing.
Citation Text:
Processing ASHPEP on RMO, Thompson B, Conrad G, et al. ASHP guidelines on remote medication order processing. Am J Health Syst Pharm. 2010;67(8):672-7. doi:10.2146/sp100003.
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psnet.ahrq.gov/issue/scandal-sentinel-event-recognizing-hidden-cost-quality-trade-offs
November 04, 2020 - Commentary
Scandal as a sentinel event—recognizing hidden cost–quality trade-offs.
Citation Text:
Bloche G. Scandal as a Sentinel Event--Recognizing Hidden Cost-Quality Trade-offs. N Engl J Med. 2016;374(11):1001-3. doi:10.1056/NEJMp1502629.
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psnet.ahrq.gov/issue/patient-safety-climate-92-us-hospitals-differences-work-area-and-discipline
September 02, 2009 - Study
Patient safety climate in 92 US hospitals: differences by work area and discipline.
Citation Text:
Singer SJ, Gaba DM, Falwell A, et al. Patient safety climate in 92 US hospitals: differences by work area and discipline. Med Care. 2009;47(1):23-31. doi:10.1097/MLR.0b013e31817e189…
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psnet.ahrq.gov/issue/continuous-improvement-ideal-health-care
August 04, 2021 - Commentary
Classic
Continuous improvement as an ideal in health care.
Citation Text:
Berwick D. Continuous improvement as an ideal in health care. New Engl J Med. 1989;320(1):53-56.
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psnet.ahrq.gov/issue/keeping-patients-safe-transforming-work-environment-nurses
July 05, 2016 - Book/Report
Classic
Keeping Patients Safe: Transforming the Work Environment of Nurses.
Citation Text:
Keeping Patients Safe: Transforming the Work Environment of Nurses. Page A; Committee on the Work Environment for Nurses and Patient Safety, Board on Healt…
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psnet.ahrq.gov/issue/ongoing-quality-improvement-journey-next-stop-high-reliability
January 23, 2012 - Commentary
The ongoing quality improvement journey: next stop, high reliability.
Citation Text:
Chassin MR, Loeb JM. The ongoing quality improvement journey: next stop, high reliability. Health Aff (Millwood). 2011;30(4):559-68. doi:10.1377/hlthaff.2011.0076.
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psnet.ahrq.gov/issue/medical-harm-historical-conceptual-and-ethical-dimensions-iatrogenic-illness
May 13, 2020 - Book/Report
Classic
Medical Harm: Historical, Conceptual, and Ethical Dimensions of Iatrogenic Illness.
Citation Text:
Medical Harm: Historical, Conceptual, and Ethical Dimensions of Iatrogenic Illness. Sharpe VA, Faden AI. Cambridge NY; Cambridge University…
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psnet.ahrq.gov/issue/rca2-improving-root-cause-analyses-and-actions-prevent-harm
June 21, 2016 - Book/Report
RCA2: Improving Root Cause Analyses and Actions to Prevent Harm.
Citation Text:
RCA2: Improving Root Cause Analyses and Actions to Prevent Harm. Boston, MA: National Patient Safety Foundation; 2015.
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psnet.ahrq.gov/issue/ahrq-communication-and-optimal-resolution-candor-toolkit
May 25, 2016 - Toolkit
AHRQ Communication and Optimal Resolution (CANDOR) Toolkit.
Citation Text:
AHRQ Communication and Optimal Resolution (CANDOR) Toolkit. Rockville, MD: Agency for Healthcare Research and Quality; May 2016.
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psnet.ahrq.gov/issue/100000-lives-campaign-setting-goal-and-deadline-improving-health-care-quality
February 29, 2012 - Commentary
The 100,000 Lives Campaign: setting a goal and a deadline for improving health care quality.
Citation Text:
Berwick DM, Calkins DR, McCannon CJ, et al. The 100 000 Lives Campaign. JAMA. 2006;295(3). doi:10.1001/jama.295.3.324.
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psnet.ahrq.gov/issue/problem-never-events
July 12, 2023 - Commentary
The problem with 'never events'.
Citation Text:
Zaslow J, Fortier J, Garber G. The problem with ‘never events’. BMJ Qual Saf. 2024;33(9):613-616. doi:10.1136/bmjqs-2023-016981.
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psnet.ahrq.gov/issue/science-human-factors-separating-fact-fiction
January 07, 2015 - Commentary
The science of human factors: separating fact from fiction.
Citation Text:
Russ AL, Fairbanks RJ, Karsh B-T, et al. The science of human factors: separating fact from fiction. BMJ Qual Saf. 2013;22(10):802-8. doi:10.1136/bmjqs-2012-001450.
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psnet.ahrq.gov/perspective/conversation-rebecca-smith-bindman-md
October 01, 2013 - In Conversation With… Rebecca Smith-Bindman, MD
October 1, 2013
Also Read an Essay
Citation Text:
In Conversation With… Rebecca Smith-Bindman, MD. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Serv…
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psnet.ahrq.gov/perspective/safety-radiology
October 01, 2013 - Safety in Radiology
Antonio Pinto, MD, PhD | October 1, 2013
Also Read a Conversation
View more articles from the same authors.
Citation Text:
Pinto A. Safety in Radiology. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Departm…
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psnet.ahrq.gov/web-mm/double-dose-transfer
November 01, 2012 - Double Dose at Transfer
Citation Text:
Hackman JL. Double Dose at Transfer. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2012.
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psnet.ahrq.gov/web-mm/patient-allergies-and-electronic-health-records
August 21, 2005 - Patient Allergies and Electronic Health Records
Citation Text:
Doyle MJ. Patient Allergies and Electronic Health Records. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2017.
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psnet.ahrq.gov/node/49868/psn-pdf
July 02, 2019 - Delayed Clozapine Prescription in an Elderly Man With
Dementia
July 2, 2019
Tsourounis C, Ghomeshi KK. Delayed Clozapine Prescription in an Elderly Man With Dementia. PSNet
[internet]. 2019.
https://psnet.ahrq.gov/web-mm/delayed-clozapine-prescription-elderly-man-dementia
The Case
An 86-year-old man with neurode…