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psnet.ahrq.gov/node/60856/psn-pdf
August 26, 2020 - Too Many Cooks in the Kitchen
August 26, 2020
Dutton RP. Too Many Cooks in the Kitchen. PSNet [internet]. 2020.
https://psnet.ahrq.gov/web-mm/too-many-cooks-kitchen
Disclosure of Relevant Financial Relationships: As a provider accredited by the Accreditation Council for
Continuing Medical Education (ACCME), the Un…
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psnet.ahrq.gov/node/74121/psn-pdf
November 30, 2021 - Hidden Danger! Insidious Postpartum Bleeding After
Emergency Cesarean Delivery.
November 30, 2021
Leiserowitz GS, Hedriana H. Hidden Danger! Insidious Postpartum Bleeding After Emergency Cesarean
Delivery. PSNet [internet]. 2021.
https://psnet.ahrq.gov/web-mm/hidden-danger-insidious-postpartum-bleeding-after-emerg…
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psnet.ahrq.gov/web-mm/isolated-clot-real-error
December 01, 2013 - SPOTLIGHT CASE
Isolated Clot, Real Error
Citation Text:
Parks A, Fang MC. Isolated Clot, Real Error. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2018.
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psnet.ahrq.gov/curated-library/value-and-patient-safety
October 30, 2019 - Breadcrumb
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Value and Patient Safety
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Created By: Lorri Zipperer, Cybrarian, AHRQ PSNet Tea…
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psnet.ahrq.gov/web-mm/cognitive-and-communication-blind-spot-contributes-permanent-paralysis
January 13, 2010 - SPOTLIGHT CASE
A Cognitive and Communication Blind Spot Contributes to Permanent Paralysis
Citation Text:
Utter GH. A Cognitive and Communication Blind Spot Contributes to Permanent Paralysis. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health an…
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psnet.ahrq.gov/web-mm/managing-complexity-diagnosis-life-threatening-complications-after-gastric-bypass-surgery
September 25, 2019 - SPOTLIGHT CASE
Managing Complexity in Diagnosis: Life-threatening Complications after Gastric Bypass Surgery.
Citation Text:
Olson APJ. Managing Complexity in Diagnosis: Life-threatening Complications after Gastric Bypass Surgery.. PSNet [internet]. Rockville (MD): Agency for Healthcare Research …
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psnet.ahrq.gov/node/865373/psn-pdf
March 27, 2024 - that
clinicians do for our patients on a minute-to-minute basis, that for many patients eclipses the limitations
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psnet.ahrq.gov/perspective/missed-nursing-care-key-measure-patient-safety
March 01, 2018 - Nurse staffing and patient outcomes: strengths and limitations of the evidence to inform policy and practice
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psnet.ahrq.gov/sites/default/files/2024-05/spotlight_case_hindsight_is_2020_slides_final_revised_05.03.2024.pdf
January 01, 2024 - treatment opportunities.
11
Background (2)
• This diagnostic uncertainty is compounded both by the limitations
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psnet.ahrq.gov/perspective/conversation-linda-aiken-phd-rn
March 01, 2018 - Nurse staffing and patient outcomes: strengths and limitations of the evidence to inform policy and practice
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psnet.ahrq.gov/web-mm/critical-echocardiogram-result-lost-follow
July 31, 2023 - Knowing our limitations and using the human and technical resources available to create additional layers
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psnet.ahrq.gov/perspective/virtual-nursing-improving-patient-care-and-meeting-workforce-challenges
August 30, 2023 - resulted in patient safety concerns , especially in telehealth versions of episodic care in which limitations
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psnet.ahrq.gov/perspective/conversation-kathleen-sanford-and-sue-schuelke-about-virtual-nursing
August 30, 2023 - resulted in patient safety concerns , especially in telehealth versions of episodic care in which limitations
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psnet.ahrq.gov/node/33796/psn-pdf
January 01, 2016 - whether that's a wild dream or not, but
there was nothing like an autopsy to sensitize you to the limitations
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psnet.ahrq.gov/perspective/conversation-edward-tenner-phd
June 01, 2011 - requires what Sterman ( 11 ) described as understanding how all models are wrong, a humility about the limitations
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psnet.ahrq.gov/perspective/patient-safety-and-health-information-technology-learning-our-mistakes
July 01, 2012 - Patient Safety and Health Information Technology: Learning from Our Mistakes
Ross Koppel, PhD | July 1, 2012
Also Read a Conversation
View more articles from the same authors.
Citation Text:
Koppel R. Patient Safety and Health Information Technology: Learning f…
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psnet.ahrq.gov/perspective/risk-management-and-patient-safety
December 01, 2010 - Risk Management and Patient Safety
Barry M. Manuel, MD; Jack L. McCarthy; William Berry, MD, MPH; Kathy Dwyer | December 1, 2010
Also Read a Conversation
View more articles from the same authors.
Citation Text:
Manuel BM, McCarthy JL, Berry WR, et al. Risk Mana…
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psnet.ahrq.gov/perspective/conversation-david-blumenthal-md-mpp
July 01, 2012 - In Conversation With… David Blumenthal, MD, MPP
July 1, 2012
Also Read an Essay
Citation Text:
In Conversation With… David Blumenthal, MD, MPP. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Service…
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psnet.ahrq.gov/perspective/conversation-withvineet-arora-md-ma
March 01, 2011 - In Conversation with…Vineet Arora, MD, MA
March 1, 2011
Also Read an Essay
Citation Text:
In Conversation with…Vineet Arora, MD, MA . PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2011. …
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psnet.ahrq.gov/perspective/conversation-james-augustine-md
July 28, 2021 - In Conversation With... James Augustine, MD
July 28, 2021
Also Read the Essay
Citation Text:
In Conversation With.. James Augustine, MD. PSNet [internet]. 2021.In Conversation With... James Augustine, MD. PSNet [internet]. Rockville (MD): Agency for Healthcare Re…