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  1. Opioid-Related Inpatient Stays and Emergency Department Visits Among Patients Aged 65 Years and Older, 2010 and 2015. | PSNet

    psnet.ahrq.gov/issue/opioid-related-inpatient-stays-and-emergency-department-visits-among-patients-aged-65-years
    March 14, 2018 - Book/Report Opioid-Related Inpatient Stays and Emergency Department Visits Among Patients Aged 65 Years and Older, 2010 and 2015. Citation Text: Opioid-Related Inpatient Stays and Emergency Department Visits Among Patients Aged 65 Years and Older, 2010 and 2015. Weiss AJ, Heslin KC, Barr…

  2. Conversations on diagnostic uncertainty and its management among pediatric acute care physicians. | PSNet

    psnet.ahrq.gov/issue/conversations-diagnostic-uncertainty-and-its-management-among-pediatric-acute-care-physicians
    March 17, 2021 - Study Conversations on diagnostic uncertainty and its management among pediatric acute care physicians. Citation Text: Patel SJ, Ipsaro A, Brady PW. Conversations on diagnostic uncertainty and its management among pediatric acute care physicians. Hosp Pediatr. 2022;12(3):317-324. doi:10.…

  3. What happened to my patient? An educational intervention to facilitate postdischarge patient follow-up. | PSNet

    psnet.ahrq.gov/issue/what-happened-my-patient-educational-intervention-facilitate-postdischarge-patient-follow
    June 22, 2022 - Commentary What happened to my patient? An educational intervention to facilitate postdischarge patient follow-up. Citation Text: Narayana S, Rajkomar A, Harrison JD, et al. What Happened to My Patient? An Educational Intervention to Facilitate Postdischarge Patient Follow-Up. J Grad Med…

  4. Diagnostic errors, health disparities, and artificial intelligence: a combination for health or harm. | PSNet

    psnet.ahrq.gov/issue/diagnostic-errors-health-disparities-and-artificial-intelligence-combination-health-or-harm
    December 09, 2020 - Commentary Diagnostic errors, health disparities, and artificial intelligence: a combination for health or harm. Citation Text: Ibrahim SA, Pronovost PJ. Diagnostic errors, health disparities, and artificial intelligence: a combination for health or harm. JAMA Health Forum. 2021;2(9):e21…

  5. Measuring teamwork in health care settings: a review of survey instruments. | PSNet

    psnet.ahrq.gov/issue/measuring-teamwork-health-care-settings-review-survey-instruments
    December 14, 2016 - Review Measuring teamwork in health care settings: a review of survey instruments. Citation Text: Valentine MA, Nembhard IM, Edmondson A. Measuring teamwork in health care settings: a review of survey instruments. Med Care. 2015;53(4):e16-e30. doi:10.1097/MLR.0b013e31827feef6. Copy Cit…

  6. VHA's movement for change: implementing high-reliability principles and practices. | PSNet

    psnet.ahrq.gov/issue/vhas-movement-change-implementing-high-reliability-principles-and-practices
    August 21, 2024 - Commentary VHA's movement for change: implementing high-reliability principles and practices. Citation Text: Cox GR, Starr LM. VHA's movement for change: implementing high-reliability principles and practices. J Healthc Manag. 2023;68(3):151-157. doi:10.1097/jhm-d-23-00056. Copy Citati…

  7. Fullerton C et al. 2006 "Lessons learned from pilot site implementation of an ambulatory electronic health record." | Digital Healthcare Research

    digital.ahrq.gov/health-it-tools-and-resources/workflow-assessment-health-it-toolkit/experience/fullerton-c-et-al
    January 01, 2023 - Fullerton C et al. 2006 "Lessons learned from pilot site implementation of an ambulatory electronic health record." Reference Fullerton C, Aponte P, Hopkins R III, et al. Lessons learned from pilot site implementation of an ambulatory electronic health record. Baylor University Medical Center Proceedi…

  8. The wicked problem of patient misidentification: how could the technological revolution help address patient safety? | PSNet

    psnet.ahrq.gov/issue/wicked-problem-patient-misidentification-how-could-technological-revolution-help-address
    July 10, 2024 - Commentary The wicked problem of patient misidentification: how could the technological revolution help address patient safety? Citation Text: Ferguson C, Hickman L, Macbean C, et al. The wicked problem of patient misidentification: How could the technological revolution help address pat…

  9. Cognitive and implicit biases in nurses' judgment and decision-making: a scoping review. | PSNet

    psnet.ahrq.gov/issue/cognitive-and-implicit-biases-nurses-judgment-and-decision-making-scoping-review
    October 20, 2021 - Review Cognitive and implicit biases in nurses' judgment and decision-making: a scoping review. Citation Text: Thirsk LM, Panchuk JT, Stahlke S, et al. Cognitive and implicit biases in nurses' judgment and decision-making: a scoping review. Int J Nurs Stud. 2022;133:104284. doi:10.1016/j…

  10. Reducing inappropriate outpatient medication prescribing in older adults across electronic health record systems. | PSNet

    psnet.ahrq.gov/issue/reducing-inappropriate-outpatient-medication-prescribing-older-adults-across-electronic
    September 29, 2021 - Study Reducing inappropriate outpatient medication prescribing in older adults across electronic health record systems. Citation Text: Friebe MP, LeGrand JR, Shepherd BE, et al. Reducing inappropriate outpatient medication prescribing in older adults across electronic health record syste…

  11. Planning and implementing a systems-based patient safety curriculum in medical education. | PSNet

    psnet.ahrq.gov/issue/planning-and-implementing-systems-based-patient-safety-curriculum-medical-education
    June 29, 2009 - Commentary Planning and implementing a systems-based patient safety curriculum in medical education. Citation Text: Thompson DA, Cowan J, Holzmueller CG, et al. Planning and implementing a systems-based patient safety curriculum in medical education. Am J Med Qual. 2008;23(4):271-8. do…

  12. A qualitative survey of factors shaping the role of a safety professional. | PSNet

    psnet.ahrq.gov/issue/qualitative-survey-factors-shaping-role-safety-professional
    August 12, 2020 - Study A qualitative survey of factors shaping the role of a safety professional. Citation Text: Van Wassenhove W, Foussard C, Dekker SWA, et al. A qualitative survey of factors shaping the role of a safety professional. Safety Sci. 2022;154:105835. doi:10.1016/j.ssci.2022.105835. Copy …

  13. The Veterans Affairs shift change physician-to-physician handoff project. | PSNet

    psnet.ahrq.gov/issue/veterans-affairs-shift-change-physician-physician-handoff-project
    April 30, 2014 - Study The Veterans Affairs shift change physician-to-physician handoff project. Citation Text: Anderson J, Shroff D, Curtis A, et al. The Veterans Affairs shift change physician-to-physician handoff project. Jt Comm J Qual Patient Saf. 2010;36(2):62-71. Copy Citation Format: …

  14. A meta-review of methods of measuring and monitoring safety in primary care. | PSNet

    psnet.ahrq.gov/issue/meta-review-methods-measuring-and-monitoring-safety-primary-care
    November 03, 2021 - Review A meta-review of methods of measuring and monitoring safety in primary care. Citation Text: O’Connor P, Madden C, O’Dowd E, et al. A meta-review of methods of measuring and monitoring safety in primary care. Int J Qual Health Care. 2021;33(3):mzab117. doi:10.1093/intqhc/mzab117. …

  15. Patients' views of adverse events in primary and ambulatory care: a systematic review to assess methods and the content of what patients consider to be adverse events. | PSNet

    psnet.ahrq.gov/issue/patients-views-adverse-events-primary-and-ambulatory-care-systematic-review-assess-methods
    December 18, 2017 - Review Patients' views of adverse events in primary and ambulatory care: a systematic review to assess methods and the content of what patients consider to be adverse events. Citation Text: Lang S, Garrido MV, Heintze C. Patients' views of adverse events in primary and ambulatory care: a…

  16. Towards a framework for managing risk associated with technology-induced error. | PSNet

    psnet.ahrq.gov/issue/towards-framework-managing-risk-associated-technology-induced-error
    May 10, 2013 - Commentary Towards a framework for managing risk associated with technology-induced error. Citation Text: Borycki EM, Kushniruk AW. Towards a Framework for Managing Risk Associated with Technology-Induced Error. Stud Health Technol Inform. 2017;234:42-48. Copy Citation Format: …

  17. An observational study of postoperative handoff standardization failures. | PSNet

    psnet.ahrq.gov/issue/observational-study-postoperative-handoff-standardization-failures
    March 10, 2021 - Study An observational study of postoperative handoff standardization failures. Citation Text: Abraham J, Meng A, Sona C, et al. An observational study of postoperative handoff standardization failures. Int J Med Inform. 2021;151:104458. doi:10.1016/j.ijmedinf.2021.104458. Copy Citatio…

  18. How organisations contribute to improving the quality of healthcare. | PSNet

    psnet.ahrq.gov/issue/how-organisations-contribute-improving-quality-healthcare
    June 25, 2014 - Commentary How organisations contribute to improving the quality of healthcare. Citation Text: Fulop NJ, Ramsay AIG. How organisations contribute to improving the quality of healthcare. BMJ. 2019;365:l1773. doi:10.1136/bmj.l1773. Copy Citation Format: DOI Google Scholar Pub…

  19. CancelRx: a health IT tool to reduce medication discrepancies in the outpatient setting. | PSNet

    psnet.ahrq.gov/issue/cancelrx-health-it-tool-reduce-medication-discrepancies-outpatient-setting
    March 23, 2022 - Study CancelRx: a health IT tool to reduce medication discrepancies in the outpatient setting. Citation Text: Watterson TL, Stone JA, Brown RL, et al. CancelRx: a health IT tool to reduce medication discrepancies in the outpatient setting. J Am Med Inform Assoc. 2021;28(7):1526-1533. doi…

  20. Misdiagnosis in the emergency department: time for a system solution. | PSNet

    psnet.ahrq.gov/issue/misdiagnosis-emergency-department-time-system-solution
    March 25, 2020 - Commentary Misdiagnosis in the emergency department: time for a system solution. Citation Text: Edlow JA, Pronovost PJ. Misdiagnosis in the emergency department: time for a system solution. JAMA. 2023;329(8):631-632. doi:10.1001/jama.2023.0577. Copy Citation Format: DOI Goo…
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