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Improved incident reporting following the implementation of a standardized emergency department peer review process. | PSNet

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September 10, 2014 - Study Improved incident reporting following the implementation of a standardized emergency department peer review process. Citation Text: Reznek MA, Barton BA. Improved incident reporting following the implementation of a standardized emergency department peer review process. Int J Qual …

Ten challenges in improving quality in healthcare: lessons from the Health Foundation's programme evaluations and relevant literature. | PSNet

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February 19, 2020 - Commentary Ten challenges in improving quality in healthcare: lessons from the Health Foundation's programme evaluations and relevant literature. Citation Text: Dixon-Woods M, McNicol S, Martin G. Ten challenges in improving quality in healthcare: lessons from the Health Foundation's p…

Understanding the heterogeneity of labor and delivery units: using design thinking methodology to assess environmental factors that contribute to safety in childbirth. | PSNet

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August 15, 2018 - Study Understanding the heterogeneity of labor and delivery units: using design thinking methodology to assess environmental factors that contribute to safety in childbirth. Citation Text: Sherman J, Hedli LC, Kristensen-Cabrera AI, et al. Understanding the Heterogeneity of Labor and Del…

Exploring the association between organizational safety climate, failure to rescue, and mortality in inpatient surgical units. | PSNet

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January 26, 2022 - Study Exploring the association between organizational safety climate, failure to rescue, and mortality in inpatient surgical units. Citation Text: Bacon CT, McCoy TP, Henshaw DS. Exploring the Association Between Organizational Safety Climate, Failure to Rescue, and Mortality in Inpatie…

Adverse drug events in the outpatient setting: an 11-year national analysis. | PSNet

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April 08, 2011 - Study Adverse drug events in the outpatient setting: an 11-year national analysis. Citation Text: Bourgeois FT, Shannon MW, Valim C, et al. Adverse drug events in the outpatient setting: an 11-year national analysis. Pharmacoepidemiol Drug Saf. 2010;19(9):901-10. doi:10.1002/pds.1984. …

Differentiating between detrimental and beneficial interruptions: a mixed-methods study. | PSNet

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May 03, 2017 - Study Differentiating between detrimental and beneficial interruptions: a mixed-methods study. Citation Text: Myers RA, McCarthy MC, Whitlatch A, et al. Differentiating between detrimental and beneficial interruptions: a mixed-methods study. BMJ Qual Saf. 2016;25(11):881-888. doi:10.1136…

What to expect when you're evaluating healthcare improvement: a concordat approach to managing collaboration and uncomfortable realities. | PSNet

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February 17, 2011 - Commentary What to expect when you're evaluating healthcare improvement: a concordat approach to managing collaboration and uncomfortable realities. Citation Text: Brewster L, Aveling E-L, Martin G, et al. What to expect when you're evaluating healthcare improvement: a concordat approach…

FDA requiring color changes to Duragesic (fentanyl) pain patches to aid safety―emphasizing that accidental exposure to used patches can cause death. | PSNet

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August 05, 2020 - Press Release/Announcement FDA requiring color changes to Duragesic (fentanyl) pain patches to aid safety―emphasizing that accidental exposure to used patches can cause death. Citation Text: FDA requiring color changes to Duragesic (fentanyl) pain patches to aid safety―emphasizing that…

Need to systematically identify and mitigate risks upon hospitalisation for patients with chronic health conditions. | PSNet

psnet.ahrq.gov/issue/need-systematically-identify-and-mitigate-risks-upon-hospitalisation-patients-chronic-health

August 04, 2021 - Commentary Need to systematically identify and mitigate risks upon hospitalisation for patients with chronic health conditions. Citation Text: Pronovost PJ, Carrington EM. Need to systematically identify and mitigate risks upon hospitalisation for patients with chronic health conditions.…

Hospital finances and patient safety outcomes. | PSNet

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April 27, 2010 - Study Hospital finances and patient safety outcomes. Citation Text: Encinosa W, Bernard DM. Hospital finances and patient safety outcomes. Inquiry. 2005;42(1):60-72. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId RIS …

Disclosure of medical injury to patients: an improbable risk management strategy. | PSNet

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February 17, 2011 - Commentary Classic Disclosure of medical injury to patients: an improbable risk management strategy. Citation Text: Studdert DM, Mello MM, Gawande AA, et al. Disclosure of medical injury to patients: an improbable risk management strategy. Health Aff (Millwood).…

Causes of errors in the electrocardiographic diagnosis of atrial fibrillation by physicians. | PSNet

psnet.ahrq.gov/issue/causes-errors-electrocardiographic-diagnosis-atrial-fibrillation-physicians

April 16, 2018 - Study Causes of errors in the electrocardiographic diagnosis of atrial fibrillation by physicians. Citation Text: Davidenko JM, Snyder LS. Causes of errors in the electrocardiographic diagnosis of atrial fibrillation by physicians. J Electrocardiol. 2007;40(5):450-6. Copy Citation …

SAFER Care: improving caregiver comprehension of discharge instructions. | PSNet

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October 26, 2022 - Study SAFER Care: improving caregiver comprehension of discharge instructions. Citation Text: Uong A, Philips K, Hametz P, et al. SAFER care: improving caregiver comprehension of discharge instructions. Pediatrics. 2021;147(4):e20200031. doi:10.1542/peds.2020-0031. Copy Citation Fo…

Missed ischemic stroke diagnosis in the emergency department by emergency medicine and neurology services. | PSNet

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August 03, 2017 - Study Missed ischemic stroke diagnosis in the emergency department by emergency medicine and neurology services. Citation Text: Arch AE, Weisman DC, Coca S, et al. Missed Ischemic Stroke Diagnosis in the Emergency Department by Emergency Medicine and Neurology Services. Stroke. 2016;47(3…

Rethinking diagnostic delay in cancer: how difficult is the diagnosis? | PSNet

psnet.ahrq.gov/issue/rethinking-diagnostic-delay-cancer-how-difficult-diagnosis

August 19, 2020 - Commentary Rethinking diagnostic delay in cancer: how difficult is the diagnosis? Citation Text: Lyratzopoulos G, Wardle J, Rubin G. Rethinking diagnostic delay in cancer: how difficult is the diagnosis? BMJ. 2014;349:g7400. doi:10.1136/bmj.g7400. Copy Citation Format: DOI …

Unconscious bias among health professionals: a scoping review. | PSNet

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December 10, 2008 - Review Unconscious bias among health professionals: a scoping review. Citation Text: Meidert U, Dönnges G, Bucher T, et al. Unconscious bias among health professionals: a scoping review. Int J Environ Res Public Health. 2023;20(16):6569. doi:10.3390/ijerph20166569. Copy Citation Fo…

Intravenous fluid prescribing errors in children: mixed methods analysis of critical incidents. | PSNet

psnet.ahrq.gov/issue/intravenous-fluid-prescribing-errors-children-mixed-methods-analysis-critical-incidents

June 14, 2023 - Study Intravenous fluid prescribing errors in children: mixed methods analysis of critical incidents. Citation Text: Conn RL, McVea S, Carrington A, et al. Intravenous fluid prescribing errors in children: Mixed methods analysis of critical incidents. PLoS One. 2017;12(10):e0186210. doi:…

Leader safety storytelling: a qualitative analysis of the attributes of effective safety storytelling and its outcomes. | PSNet

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November 16, 2022 - Study Leader safety storytelling: a qualitative analysis of the attributes of effective safety storytelling and its outcomes. Citation Text: Benetti PJ, Kanse L, Fruhen LS, et al. Leader safety storytelling: a qualitative analysis of the attributes of effective safety storytelling and it…

The "Quality Minute"—a new, brief, and structured technique for quality improvement education during the morbidity and mortality conference. | PSNet

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January 09, 2019 - Commentary The "Quality Minute"—a new, brief, and structured technique for quality improvement education during the morbidity and mortality conference. Citation Text: Hoffman RL, Morris JB, Kelz RR. The “Quality Minute”—A New, Brief, and Structured Technique for Quality Improvement Educa…

Operating room organization and surgical performance: a systematic review. | PSNet

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March 05, 2025 - Review Operating room organization and surgical performance: a systematic review. Citation Text: Pasquer A, Ducarroz S, Lifante JC, et al. Operating room organization and surgical performance: a systematic review. Patient Saf Surg. 2024;18(1):5. doi:10.1186/s13037-023-00388-3. Copy Cit…

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