Results

Total Results: over 10,000 records

Showing results for "learned".

3861. Practising open disclosure: clinical incident communication and systems improvement. | PSNet
      psnet.ahrq.gov/issue/practising-open-disclosure-clinical-incident-communication-and-systems-improvement
      November 23, 2016 - Commentary Practising open disclosure: clinical incident communication and systems improvement. Citation Text: Iedema R, Jorm C, Wakefield J, et al. Practising Open Disclosure: clinical incident communication and systems improvement. Sociol Health Illn. 2009;31(2):262-77. doi:10.1111…

3862. An engineered solution to the maladministration of spinal injections. | PSNet
      psnet.ahrq.gov/issue/engineered-solution-maladministration-spinal-injections
      March 14, 2022 - Study An engineered solution to the maladministration of spinal injections. Citation Text: Lawton R, Gardner P, Green B, et al. An engineered solution to the maladministration of spinal injections. Qual Saf Health Care. 2009;18(6):492-5. doi:10.1136/qshc.2007.025767. Copy Citation …

3863. Has the pendulum swung too far?; The impact of missed abdominal injuries in the era of nonoperative management. | PSNet
      psnet.ahrq.gov/issue/has-pendulum-swung-too-far-impact-missed-abdominal-injuries-era-nonoperative-management
      August 04, 2021 - Study Has the pendulum swung too far?; The impact of missed abdominal injuries in the era of nonoperative management. Citation Text: Fairfax LM, Christmas B, Deaugustinis M, et al. Has the pendulum swung too far? The impact of missed abdominal injuries in the era of nonoperative manage…

3864. Managing safety in perioperative settings: strategies of meso-level nurse leaders. | PSNet
      psnet.ahrq.gov/issue/managing-safety-perioperative-settings-strategies-meso-level-nurse-leaders
      April 06, 2011 - Study Managing safety in perioperative settings: strategies of meso-level nurse leaders. Citation Text: Brooks JV, Nelson-Brantley H. Managing safety in perioperative settings: strategies of meso-level nurse leaders. Health Care Manage Rev. 2023;48(2):175-184. doi:10.1097/hmr.00000000000…

3865. Extraneous tissue a potential source for diagnostic error in surgical pathology. | PSNet
      psnet.ahrq.gov/issue/extraneous-tissue-potential-source-diagnostic-error-surgical-pathology
      October 27, 2010 - Study Extraneous tissue a potential source for diagnostic error in surgical pathology. Citation Text: Layfield LJ, Witt BL, Metzger KG, et al. Extraneous tissue: a potential source for diagnostic error in surgical pathology. Am J Clin Pathol. 2011;136(5):767-72. doi:10.1309/AJCP4FFSBPHA…

3866. Surveillance Monitoring to Improve Patient Safety in Acute Hospital Care Units | PSNet
      psnet.ahrq.gov/perspective/surveillance-monitoring-improve-patient-safety-acute-hospital-care-units
      April 26, 2023 - Researchers who have implemented surveillance monitoring systems have noted several challenges and lessons learned … By using these lessons learned, surveillance monitoring programs will be much more likely to succeed … These programs could benefit from the lessons learned in this surveillance monitoring approach.

3867. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/73398/psn-pdf
      June 30, 2021 - KH: Along those lines, Anjali, what have we learned over the course of this pandemic?

3868. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/37543/psn-pdf
      March 03, 2011 - Rates of medication errors among depressed and burnt out residents: prospective cohort study. March 3, 2011 Fahrenkopf AM, Sectish TC, Barger LK, et al. Rates of medication errors among depressed and burnt out residents: prospective cohort study. BMJ. 2008;336(7642):488-91. doi:10.1136/bmj.39469.763218.BE. https:/…

3869. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/43604/psn-pdf
      October 15, 2014 - The challenges in monitoring and preventing patient safety incidents for people with intellectual disabilities in NHS acute hospitals: evidence from a mixed-methods study. October 15, 2014 Tuffrey-Wijne I, Goulding L, Gordon V, et al. The challenges in monitoring and preventing patient safety incidents for people…

3870. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/39583/psn-pdf
      October 30, 2010 - The harm susceptibility model: a method to prioritise risks identified in patient safety reporting systems. October 30, 2010 Pham JC, Colantuoni E, Dominici F, et al. The harm susceptibility model: a method to prioritise risks identified in patient safety reporting systems. Qual Saf Health Care. 2010;19(5):440-5. …

3871. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/43263/psn-pdf
      July 16, 2014 - Patient complaints in healthcare systems: a systematic review and coding taxonomy. July 16, 2014 Reader TW, Gillespie A, Roberts J. Patient complaints in healthcare systems: a systematic review and coding taxonomy. BMJ Qual Saf. 2014;23(8):678-689. doi:10.1136/bmjqs-2013-002437. https://psnet.ahrq.gov/issue/patien…

3872. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/39213/psn-pdf
      October 03, 2017 - Using patient safety morbidity and mortality conferences to promote transparency and a culture of safety. October 3, 2017 Szekendi MK, Barnard C, Creamer J, et al. Using patient safety morbidity and mortality conferences to promote transparency and a culture of safety. Jt Comm J Qual Patient Saf. 2010;36(1):3-9. h…

3873. Using a learning system approach to improve safety for prone-position ventilation patients. | PSNet
      psnet.ahrq.gov/issue/using-learning-system-approach-improve-safety-prone-position-ventilation-patients
      January 10, 2024 - Study Using a learning system approach to improve safety for prone-position ventilation patients. Citation Text: Thomas AL, Graham KL, Davila S, et al. Using a learning system approach to improve safety for prone-position ventilation patients. J Patient Saf. 2023;19(3):180-184. doi:10.10…

3874. Cardiac surgery errors: results from the UK National Reporting and Learning System. | PSNet
      psnet.ahrq.gov/issue/cardiac-surgery-errors-results-uk-national-reporting-and-learning-system
      May 24, 2012 - Study Cardiac surgery errors: results from the UK National Reporting and Learning System. Citation Text: Martinez EA, Shore AD, Colantuoni E, et al. Cardiac surgery errors: results from the UK National Reporting and Learning System. Int J Qual Health Care. 2011;23(2):151-8. doi:10.1093/i…

3875. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/34735/psn-pdf
      June 16, 2014 - goals to create unified reporting mechanisms, support an open learning culture, ensure that lessons learned

3876. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/37478/psn-pdf
      February 22, 2011 - adversedrugevent https://psnet.ahrq.gov/issue/intravenous-medication-safety-and-smart-infusion-systems-lessons-learned-and-future

3877. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/45490/psn-pdf
      September 01, 2018 - collaboration-regulators-support-quality-and-accountability-following-medical-errors https://psnet.ahrq.gov/issue/communication-and-resolution-programs-challenges-and-lessons-learned-six-early-adopters

3878. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/34849/psn-pdf
      May 14, 2012 - improving-patient-safety-five-years-after-iom-report https://psnet.ahrq.gov/issue/five-years-after-err-human-what-have-we-learned

3879. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/45350/psn-pdf
      October 21, 2016 - This report discusses the need to ensure that lessons learned in military trauma care are acted on and

3880. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/47505/psn-pdf
      March 19, 2019 - A past PSNet perspective explored insights learned from experience with the AHRQ-supported teamwork