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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43191/psn-pdf
    December 12, 2018 - harnessing-implementation-science-improve-care-quality-and-patient-safety-systematic-review https://psnet.ahrq.gov/issue/science-improvement https://psnet.ahrq.gov/issue/leading-change-why-transformation-efforts-fail
  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/48083/psn-pdf
    August 07, 2019 - Similar to a prior study, investigators found that missed cancer diagnosis is the leading type of diagnostic
  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49729/psn-pdf
    April 01, 2015 - List three factors leading to a missed diagnosis of aortic dissection. … The dissection was probably present on admission and the tear in the aorta had impaired blood flow leading … A second factor leading to misdiagnosis was clinical symptoms and laboratory findings that suggested … Extension of the aortic dissection downwards to involve the mesenteric artery leading to mesenteric … Factors leading to failure to diagnose acute aortic dissection in the emergency room.
  4. psnet.ahrq.gov/Information/Panel
    January 01, 2012 - She has worked on interdisciplinary teams across numerous practice settings and is currently leading … clinical leadership throughout his career, including developing new medical school courses and clerkships, leading … disparities, health equity, and patient safety to the initiative to uncover the contributing factors leading … Watson has been recognized as one of the 50 Experts Leading the Field of Patient Safety by Becker’s Hospital … Review, a leading healthcare publication.
  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45679/psn-pdf
    January 03, 2018 - The World Health Organization has taken a leading role in eliminating health care–associated harms and
  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/39446/psn-pdf
    May 25, 2010 - This Swedish study used critical incident debriefing techniques to explore factors leading to potential
  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/34935/psn-pdf
    June 23, 2009 - While reviewing the details of the case, the author explores the pitfalls leading to missed diagnoses
  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46129/psn-pdf
    September 28, 2017 - insights-malpractice This analysis of closed malpractice claims sought to characterize the types of errors leading
  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43420/psn-pdf
    September 17, 2014 - how-useful-are-medication-patient-information-leaflets-older-adults-content-readability-and https://psnet.ahrq.gov/issue/medication-use-leading-emergency-department-visits-adverse-drug-events-older-adults
  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/40049/psn-pdf
    April 12, 2011 - The system was relatively easy to use, but some participants raised concerns about error reporting leading
  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41155/psn-pdf
    March 06, 2012 - functional-decline-associated-polypharmacy-and-potentially-inappropriate-medications https://psnet.ahrq.gov/issue/medication-use-leading-emergency-department-visits-adverse-drug-events-older-adults
  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/40256/psn-pdf
    March 02, 2011 - development-core-drug-list-towards-improving-prescribing-education-and-reducing-errors-uk https://psnet.ahrq.gov/issue/medication-use-leading-emergency-department-visits-adverse-drug-events-older-adults
  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46734/psn-pdf
    February 07, 2018 - This review explores simulation in anesthesiology and the role of anesthetists in leading further innovation
  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45687/psn-pdf
    October 31, 2017 - medication-errors-and-adverse-drug-events https://psnet.ahrq.gov/issue/national-estimates-insulin-related-hypoglycemia-and-errors-leading-emergency-department
  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42996/psn-pdf
    March 19, 2014 - physician-led-chart-audit-engaging-providers-fortifying-culture-safety This quality improvement intervention engaged physician leaders and frontline clinicians in leading
  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/39348/psn-pdf
    March 10, 2010 - how-will-it-work-qualitative-study-strategic-stakeholders-accounts-patient-safety-initiative https://psnet.ahrq.gov/issue/leading-change-why-transformation-efforts-fail
  17. psnet.ahrq.gov/perspective/what-weve-learned-about-leveraging-leadership-and-culture-affect-change-and-improve
    March 01, 2017 - Creating a culture of safety requires leading differently. … Evidence suggests this process is effective for leading organizational change.( 6 ) It also models a … Leading through partnership means understanding that no amount of time, interest, information, and skill … Leading change: why transformation efforts fail. Harv Bus Rev. 1995;73:59-67. [Available at] 8.
  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/38118/psn-pdf
    October 01, 2019 - issue/adverse-drug-events-hospitalized-cardiac-patients https://psnet.ahrq.gov/issue/medication-use-leading-emergency-department-visits-adverse-drug-events-older-adults
  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/60178/psn-pdf
    April 01, 2020 - rate-preventable-mortality-hospitalized-patients-systematic-review-and-meta-analysis https://psnet.ahrq.gov/issue/medical-error-third-leading-cause-death-us
  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42879/psn-pdf
    January 22, 2014 - prevalence-patterns-and-predictors-nursing-care-left-undone-european- hospitals-results Nurses are frequently forced to prioritize tasks during busy shifts, leading

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