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Showing results for "learned".

  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/36837/psn-pdf
    December 03, 2018 - Hospitals as cultures of entrapment: a re-analysis of the Bristol Royal Infirmary. December 3, 2018 Weick KE, Sutcliffe KM. Hospitals as Cultures of Entrapment: A Re-Analysis of the Bristol Royal Infirmary. Calif Manage Rev. 2012;45(2):73-84. doi:10.2307/41166166. https://psnet.ahrq.gov/issue/hospitals-cultures-en…

  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/867396/psn-pdf
    December 18, 2024 - Mental Health Inpatient Settings: Creating Conditions for the Delivery of Safe and Therapeutic Care to Adults. December 18, 2024 Mental Health Inpatient Settings: Creating Conditions For The Delivery Of Safe And Therapeutic Care To Adults. Health Services Safety Investigations Body; October 2024. https://psnet.ahr…

  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/38071/psn-pdf
    February 15, 2011 - A multifaceted approach to safety: the synergistic detection of adverse drug events in adult inpatients. February 15, 2011 Ferranti JM, Horvath MM, Cozart H, et al. A Multifaceted Approach to Safety. J Patient Saf. 2008;4(3):184- 190. doi:10.1097/pts.0b013e318184a9d5. https://psnet.ahrq.gov/issue/multifaceted-appr…

  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/48071/psn-pdf
    June 12, 2019 - Doctors were alarmed: would I have my children have surgery here? June 12, 2019 Gabler E. New York Times. May 31, 2019. https://psnet.ahrq.gov/issue/doctors-were-alarmed-would-i-have-my-children-have-surgery-here Pediatric cardiac surgery is highly technical and risky. This newspaper article reports on a poorly p…

  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/60225/psn-pdf
    April 15, 2020 - Beyond 'find and fix': improving quality and safety through resilient healthcare systems. April 15, 2020 Anderson JE, Ross AJ, Back J, et al. Beyond ‘find and fix’: improving quality and safety through resilient healthcare systems. Int J Qual Health Care. 2020;32(3):204-211. doi:10.1093/intqhc/mzaa007. https://psn…

  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45480/psn-pdf
    November 16, 2016 - Improving patient safety reporting with the common formats: common data representation for Patient Safety Organizations. November 16, 2016 Elkin PL, Johnson HC, Callahan MR, et al. Improving patient safety reporting with the common formats: Common data representation for Patient Safety Organizations. J Biomed Info…

  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46072/psn-pdf
    November 08, 2017 - Repeat prescribing of medications: a system-centred risk management model for primary care organisations. November 8, 2017 Price J, Man SL, Bartlett S, et al. Repeat prescribing of medications: A system-centred risk management model for primary care organisations. J Eval Clin Pract. 2017;23(4):779-796. doi:10.1111/…

  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45448/psn-pdf
    January 23, 2017 - Accuracy of laboratory data communication on ICU daily rounds using an electronic health record. January 23, 2017 Artis KA, Dyer E, Mohan V, et al. Accuracy of Laboratory Data Communication on ICU Daily Rounds Using an Electronic Health Record. Crit Care Med. 2017;45(2):179-186. doi:10.1097/CCM.0000000000002060. h…

  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/72683/psn-pdf
    January 27, 2021 - Analysis of patient safety risk management call data during the COVID?19 pandemic. January 27, 2021 Wessels R, McCorkle LM. Analysis of patient safety risk management call data during the COVID?19 pandemic. J Healthc Risk Manag. 2021;40(4):30-37. doi:10.1002/jhrm.21457. https://psnet.ahrq.gov/issue/analysis-patien…

  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46273/psn-pdf
    August 30, 2017 - Increasing patient safety with neonates via handoff communication during delivery: a call for interprofessional health care team training across GME and CME. August 30, 2017 Vanderbilt AA, Pappada SM, Stein H, et al. Increasing patient safety with neonates via handoff communication during delivery: a call for int…

  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/845073/psn-pdf
    February 22, 2023 - Nursing student errors and near misses: three years of data. February 22, 2023 Silvestre JH, Spector ND. Nursing student errors and near misses: three years of data. J Nurs Educ. 2023;62(1):12-19. doi:10.3928/01484834-20221109-05. https://psnet.ahrq.gov/issue/nursing-student-errors-and-near-misses-three-years-data…

  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46939/psn-pdf
    July 23, 2018 - Underdiagnosis of dementia: an observational study of patterns in diagnosis and awareness in US older adults. July 23, 2018 Amjad H, Roth DL, Sheehan OC, et al. Underdiagnosis of Dementia: an Observational Study of Patterns in Diagnosis and Awareness in US Older Adults. J Gen Intern Med. 2018;33(7):1131-1138. doi:…

  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44742/psn-pdf
    January 06, 2016 - A piece of my mind. From shame to guilt to love. January 6, 2016 Pronovost P, Bienvenu J. A piece of my mind. From shame to guilt to love. JAMA. 2015;314(23):2507- 2508. doi:10.1001/jama.2015.11521. https://psnet.ahrq.gov/issue/piece-my-mind-shame-guilt-love While numerous studies have examined the psychological i…

  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47263/psn-pdf
    January 01, 2021 - Dissecting communication barriers in healthcare: a path to enhancing communication resiliency, reliability, and patient safety. November 28, 2018 Guttman OT, Lazzara EH, Keebler JR, et al. Dissecting Communication Barriers in Healthcare: A Path to Enhancing Communication Resiliency, Reliability, and Patient Safety…

  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45098/psn-pdf
    May 04, 2016 - Reducing Risk and Promoting Patient Safety for NIH Intramural Clinical Research—Final Report. May 4, 2016 The Clinical Center Working Group Report to the Advisory Committee to the Director, National Institutes of Health. Bethesda, MD; National Institutes of Health; April 2016. https://psnet.ahrq.gov/issue/reducing…

  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/837335/psn-pdf
    June 08, 2022 - Root cause analysis using the prevention and recovery information system for monitoring and analysis method in healthcare facilities: a systematic literature review. June 8, 2022 Driesen BEJM, Baartmans M, Merten H, et al. Root cause analysis using the prevention and recovery information system for monitoring and …

  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/60334/psn-pdf
    May 13, 2020 - Crisis Standards of Care: Ten Years of Successes and Challenges–Proceedings of a Workshop. May 13, 2020 National Academies of Sciences, Engineering, and Medicine. Washington, DC; The National Academies Press: 2020. ISBN 9780309676250. https://psnet.ahrq.gov/issue/crisis-standards-care-ten-years-successes-and-…

  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/866694/psn-pdf
    September 11, 2024 - What's the harm? Results of an active surveillance adverse event reporting system for chiropractors and physiotherapists. September 11, 2024 Pohlman KA, Funabashi M, O’Beirne M, et al. What’s the harm? Results of an active surveillance adverse event reporting system for chiropractors and physiotherapists. PLoS ONE…

  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47841/psn-pdf
    April 24, 2019 - Criminalisation of unintentional error in healthcare in the UK: a perspective from New Zealand. April 24, 2019 Ameratunga R, Klonin H, Vaughan J, et al. Criminalisation of unintentional error in healthcare in the UK: a perspective from New Zealand. BMJ. 2019;364:l706. doi:10.1136/bmj.l706. https://psnet.ahrq.gov/i…

  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/850173/psn-pdf
    June 07, 2023 - A national safety board made transportation safer and could do the same for health care, advocates say. June 7, 2023 Jaklevic MC. CNN. May 30, 2023. https://psnet.ahrq.gov/issue/national-safety-board-made-transportation-safer-and-could-do-same-health- care-advocates-say Patient safety has long drawn from aviation…
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