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Psn-Pdf (pdf file)
psnet.ahrq.gov/node/34998/psn-pdfJune 22, 2009 - Cause and effect analysis of closed claims in obstetrics and gynecology. June 22, 2009 White AA, Pichert JW, Bledsoe SH, et al. Cause and effect analysis of closed claims in obstetrics and gynecology. Obstet Gynecol. 2005;105(5 Pt 1):1031-1038. https://psnet.ahrq.gov/issue/cause-and-effect-analysis-closed-claims-o… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/866324/psn-pdfJuly 17, 2024 - Total systems safety supports practitioners in partnering with families to protect patients. July 17, 2024 ISMP Medication Safety Alert! Acute Care. 2024;29(13):1-4. https://psnet.ahrq.gov/issue/total-systems-safety-supports-practitioners-partnering-families-protect-patients Patient and family concerns can provide… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/46563/psn-pdfFebruary 07, 2018 - Near-miss medication errors provide a wake-up call. February 7, 2018 Claffey C. Near-miss medication errors provide a wake-up call. Nursing (Brux). 2018;48(1):53-55. doi:10.1097/01.NURSE.0000527615.45031.9e. https://psnet.ahrq.gov/issue/near-miss-medication-errors-provide-wake-call Case studies of adverse events a… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/852448/psn-pdfJanuary 01, 2024 - A realist synthesis of interprofessional patient safety activities and healthcare student attitudes towards patient safety. August 16, 2023 Cleary E, Bloomfield J, Frotjold A, et al. A realist synthesis of interprofessional patient safety activities and healthcare student attitudes towards patient safety. J Interp… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/44797/psn-pdfMarch 15, 2016 - Incident and error reporting systems in intensive care: a systematic review of the literature. March 15, 2016 Brunsveld-Reinders AH, Arbous S, De Vos R, et al. Incident and error reporting systems in intensive care: a systematic review of the literature. Int J Qual Health Care. 2016;28(1):2-13. doi:10.1093/intqhc/m… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/866243/psn-pdfJuly 10, 2024 - Building a resilient patient safety culture: a large healthcare organization's approach to systematically reviewing serious harm events. July 10, 2024 Harvey B, Dhalla IA, O'Neill C, et al. Building a resilient patient safety culture: a large healthcare organization's approach to systematically reviewing serious h… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/73468/psn-pdfJuly 07, 2021 - The implementation of communication didactics for OB/GYN residents on the disclosure of adverse perioperative events. July 7, 2021 Chung EH, Truong T, Jooste KR, et al. The implementation of communication didactics for OB/GYN residents on the disclosure of adverse perioperative events. J Surg Educ. 2021;78(3):942-… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/866281/psn-pdfJuly 10, 2024 - Updating Eindhoven: clarifying the features of a patient safety near miss. July 10, 2024 Woodier N, Burnett C, Sampson P, et al. Updating Eindhoven: clarifying the features of a patient safety near miss. J Patient Saf Risk Manag. 2024;29(4):195-201. doi:10.1177/25160435241247096. https://psnet.ahrq.gov/issue/updat… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/47931/psn-pdfJanuary 01, 2020 - Managing risk in hazardous conditions: improvisation is not enough. July 24, 2019 Amalberti R, Vincent CA. Managing risk in hazardous conditions: improvisation is not enough. BMJ Qual Saf. 2020;29(1):60-63. doi:10.1136/bmjqs-2019-009443. https://psnet.ahrq.gov/issue/managing-risk-hazardous-conditions-improvisation… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/38046/psn-pdfSeptember 10, 2008 - Clinical and pathological disagreement upon the cause of death in a teaching hospital: analysis of 100 autopsy cases in a prospective study. September 10, 2008 Pinto Carvalho FL, Cordeiro JA, Cury PM. Clinical and pathological disagreement upon the cause of death in a teaching hospital: Analysis of 100 autopsy cas… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/46651/psn-pdfJanuary 17, 2018 - Piloting a patient safety and quality improvement co- curriculum. January 17, 2018 Kroker-Bode C, Whicker SA, Pline ER, et al. Piloting a patient safety and quality improvement co- curriculum. J Community Hosp Intern Med Perspect. 2017;7(6):351-357. doi:10.1080/20009666.2017.1403830. https://psnet.ahrq.gov/issue/… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/46389/psn-pdfNovember 15, 2017 - Creating a highly reliable neonatal intensive care unit through safer systems of care. November 15, 2017 Panagos PG, Pearlman SA. Creating a Highly Reliable Neonatal Intensive Care Unit Through Safer Systems of Care. Clin Perinatol. 2017;44(3):645-662. doi:10.1016/j.clp.2017.05.006. https://psnet.ahrq.gov/issue/cr… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/844554/psn-pdfFebruary 15, 2023 - Medication mix-up: what happened at Vanderbilt and how it impacts health care providers. February 15, 2023 Michel C, Talley C. J Health Life Sci Law. 2022;17(1):71 https://psnet.ahrq.gov/issue/medication-mix-what-happened-vanderbilt-and-how-it-impacts-health-care- providers High-profile medication errors like tha… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/861294/psn-pdfJanuary 24, 2024 - Shining a glaring light on surgery: technology that records every move aims to improve safety. January 24, 2024 Freyer FJ. Boston Globe. January 13, 2024. https://psnet.ahrq.gov/issue/shining-glaring-light-surgery-technology-records-every-move-aims-improve- safety The surgical black box uses cameras and microphon… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/60575/psn-pdfJune 10, 2020 - Applying principles from aviation safety investigations to root cause analysis of a critical incident during a simulated emergency. June 10, 2020 Imach S, Eppich W, Zech A, et al. Applying principles from aviation safety investigations to root cause analysis of a critical incident during a simulated emergency. Sim… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/45249/psn-pdfJune 22, 2016 - PHSO Review: Quality of NHS Complaints Investigations. June 22, 2016 First Report of Session 2016–17 Report. House of Commons Public Administration and Constitutional Affairs Committee. London, England: The Stationery Office; May 24, 2016. Publication HC 94. https://psnet.ahrq.gov/issue/phso-review-quality-nhs-comp… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/60628/psn-pdfJuly 14, 2020 - The Power to Predict: Leveraging Medical Malpractice Data to Reduce Patient Harm and Financial Loss. June 24, 2020 Cambridge, MA; CRICO Strategies: July 14, 2020. https://psnet.ahrq.gov/issue/power-predict-leveraging-medical-malpractice-data-reduce-patient-harm-and- financial-loss Malpractice claims can generate … -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/840483/psn-pdfNovember 30, 2022 - Crisis preparedness: a systems-based framework for avoiding harm in surgery. November 30, 2022 Gogalniceanu P, Karydis N, Costan V-V, et al. Crisis preparedness: a systems-based framework for avoiding harm in surgery. J Am Coll Surg. 2022;235(4):612-623. doi:10.1097/xcs.0000000000000300. https://psnet.ahrq.gov/iss… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/46016/psn-pdfMay 09, 2017 - Resident duty hours and medical education policy—raising the evidence bar. May 9, 2017 Asch DA, Bilimoria KY, Desai S. Resident Duty Hours and Medical Education Policy - Raising the Evidence Bar. N Engl J Med. 2017;376(18):1704-1706. doi:10.1056/NEJMp1703690. https://psnet.ahrq.gov/issue/resident-duty-hours-and-me… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/865528/psn-pdfApril 10, 2024 - Should dignity preservation be a precondition for safety and a design priority for healing in inpatient psychiatry spaces? April 10, 2024 Should dignity preservation be a precondition for safety and a design priority for healing in inpatient psychiatry spaces? AMA J Ethics. 2024;26(3):e205-e211. doi:10.1001/amajet…
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