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psnet.ahrq.gov/issue/really-stupid-mistake-it-does-feel-cop-out-blame-my-error-human-frailty-im-afraid-thats
August 16, 2023 - Commentary
A really stupid mistake: it does feel like a cop out to blame my error on human frailty, but I'm afraid that's exactly what it was.
Citation Text:
Maskell G. A really stupid mistake: it does feel like a cop out to blame my error on human frailty, but I'm afraid that's exactly …
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psnet.ahrq.gov/issue/enhanced-detection-blood-bank-sample-collection-errors-centralized-patient-database
March 20, 2019 - Study
Enhanced detection of blood bank sample collection errors with a centralized patient database.
Citation Text:
MacIvor D, Triulzi DJ, Yazer MH. Enhanced detection of blood bank sample collection errors with a centralized patient database. Transfusion (Paris). 2009;49(1):40-3. doi:…
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psnet.ahrq.gov/issue/critical-need-nursing-education-address-diagnostic-process
June 08, 2022 - Commentary
The critical need for nursing education to address the diagnostic process.
Citation Text:
Gleason KT, Harkless G, Stanley J, et al. The critical need for nursing education to address the diagnostic process. Nurs Outlook. 2021;69(3):362-369. doi:10.1016/j.outlook.2020.12.005.
…
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psnet.ahrq.gov/issue/decade-health-information-technology-usability-challenges-and-path-forward
January 16, 2019 - Commentary
Emerging Classic
A decade of health information technology usability challenges and the path forward.
Citation Text:
Ratwani RM, Reider J, Singh H. A Decade of Health Information Technology Usability Challenges and the Path Forward. JAMA. 2019;321(8):…
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psnet.ahrq.gov/issue/drone-delivery-medications-review-landscape-and-legal-considerations
May 18, 2022 - Commentary
Emerging Classic
Drone delivery of medications: review of the landscape and legal considerations.
Citation Text:
Lin CA, Shah K, Mauntel LCC, et al. Drone delivery of medications: Review of the landscape and legal considerations. Am J Health Syst Phar…
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psnet.ahrq.gov/issue/blueprint-leadership-during-covid-19
December 15, 2021 - Commentary
A blueprint for leadership during COVID-19.
Citation Text:
Rosa WE, Schlak AE, Rushton CH. A blueprint for leadership during COVID-19. Nurs Manage. 2020;51(8):28-34. doi:10.1097/01.numa.0000688940.29231.6f.
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psnet.ahrq.gov/issue/what-covid-19-teaches-us-about-implicit-bias-pediatric-health-care
March 25, 2020 - Commentary
What COVID-19 teaches us about implicit bias in pediatric health care.
Citation Text:
Mulchan SS, Wakefield EO, Santos M. What COVID-19 teaches us about implicit bias in pediatric health care. J Ped Psychol. 2021;46(2):138-143. doi:10.1093/jpepsy/jsaa131.
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psnet.ahrq.gov/Information/Privacy
May 23, 2025 - Privacy Policy
Thank you for visiting AHRQ PSNet.
The site is produced by an editorial team at the University of California, Davis under a contract from the Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services.
We collect no personal information about you when you visit …
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pso.ahrq.gov/become/establish-policies
August 01, 2021 - SHARE:
More topics in this section
Work With a PSO
How To Choose a PSO
Become a PSO
Assess Eligibility to Become a PSO
Assess Compatibility of Anticipated PSO Operations with Patient Safety Rule Requirements
Establish Po…
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digital.ahrq.gov/medical-condition/hyperlipidemia-hl
January 01, 2023 - Hyperlipidemia (HL)
Patient-Centered Outcomes Research Clinical Decision Support (CDS) Connect
Description
This research developed and maintained the CDS Connect platform, including its public repository of CDS resources and tools. Current work explores the potential of publi…
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psnet.ahrq.gov/issue/improving-standardization-paging-communication-using-quality-improvement-methodology
September 23, 2020 - Study
Improving standardization of paging communication using quality improvement methodology.
Citation Text:
Weigert RM, Schmitz AH, Soung PJ, et al. Improving Standardization of Paging Communication Using Quality Improvement Methodology. Pediatrics. 2019;143(4). doi:10.1542/peds.2018-1…
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digital.ahrq.gov/sites/default/files/docs/page/THQITStoriesHorn2010.pdf
June 16, 2021 - Nursing Home Health IT Reduces Pressure Ulcers and Increases Staff’s Job Satisfaction
…
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psnet.ahrq.gov/issue/survey-impact-disruptive-behaviors-and-communication-defects-patient-safety
February 03, 2010 - Study
Classic
A survey of the impact of disruptive behaviors and communication defects on patient safety.
Citation Text:
Rosenstein AH, O'Daniel M. A survey of the impact of disruptive behaviors and communication defects on patient safety. Jt Comm J Qual Patie…
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psnet.ahrq.gov/issue/understanding-risk-factors-complaints-against-pharmacists-content-analysis
February 07, 2024 - Study
Understanding risk factors for complaints against pharmacists: a content analysis.
Citation Text:
Wang Y, Ram S (S), Scahill S. Understanding risk factors for complaints against pharmacists: a content analysis. J Patient Saf. 2024;20(4):e18-e28. doi:10.1097/pts.0000000000001217.
…
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digital.ahrq.gov/track-9-emerging-approaches-drive-change-healthcare
January 01, 2023 - This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: https://digital.ahrq.gov/contact-us . Let us know th…
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digital.ahrq.gov/track-2-implementation-issues-patient-safety-and-health-it
January 01, 2023 - This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: https://digital.ahrq.gov/contact-us . Let us know th…
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www.ahrq.gov/sites/default/files/wysiwyg/cahps/news-and-events/events/20141022_cg/3_julie_susi.pdf
April 01, 2014 - Achieving Excellence Across All CG-CAHPS Core Measures: Lessons from Top-Performing Medical Practices
Mercy Hospital
Fore River Campus
Portland, Maine
23
Breast Care Specialists of Maine
A two-surgeon practice, we take pride in offering
timely, accurate consultation and treatment for
benign and malignant …
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psnet.ahrq.gov/issue/strategies-learning-failure
September 25, 2024 - Commentary
Classic
Strategies for learning from failure.
Citation Text:
Edmondson A. Strategies of learning from failure. Harv Bus Rev. 2011;89(4):48-55, 137.
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digital.ahrq.gov/ahrq-funded-projects/past-initiatives/privacy-and-security-project/florida
January 01, 2023 - Florida
Team Description
Dear Interested Party:
The Agency for Health Care Administration is pleased to participate in the national health information security and privacy collaborative to study the privacy and security issues related to the development and interoperability of a national…
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www.uspreventiveservicestaskforce.org/uspstf/sites/default/files/file/supporting_documents/high-bmi-children-adolescents-draft-rec-bulletin.pdf
January 16, 2024 - The Task Force Issues Draft Recommendations on Interventions for High Body Mass Index in Children and Adolescents
1
www.uspreventiveservicestaskforce.org
Task Force Issues Draft Recommendation Statement on
Interventions for High Body Mass Index in Children and Adolescents
Behavioral interventions can he…