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psnet.ahrq.gov/issue/organizational-learning-hospitals-realist-review
June 19, 2019 - Review
Organizational learning in hospitals: a realist review.
Citation Text:
Lyman B, Jacobs JD, Hammond EL, et al. Organizational learning in hospitals: A realist review. J Adv Nurs. 2019;75(11):2352-2377. doi:10.1111/jan.14091.
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psnet.ahrq.gov/issue/health-it-enabled-quality-measurement-perspectives-pathways-and-practical-guidance
September 16, 2015 - Book/Report
Health IT-Enabled Quality Measurement: Perspectives, Pathways, and Practical Guidance.
Citation Text:
Health IT-Enabled Quality Measurement: Perspectives, Pathways, and Practical Guidance. Roper RA, Anderson KM, Marsh CA, Flemming AC. Rockville, MD: Agency for Healthcare Re…
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psnet.ahrq.gov/issue/physician-liability-age-data-reliance-and-errors
March 18, 2020 - Commentary
Physician liability in the age of data reliance and errors.
Citation Text:
Physician liability in the age of data reliance and errors. Montesantos L. Ann Health Law Life Sci. 2022;31(Spring):179-215.
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psnet.ahrq.gov/issue/leadership-survey-immunization-against-burnout-insights-report
November 15, 2016 - Book/Report
Leadership Survey: Immunization Against Burnout: Insights Report.
Citation Text:
Leadership Survey: Immunization Against Burnout: Insights Report. Swensen S, Strongwater S, Mohta NS. NEJM Catalyst: Insights Report. April 12, 2018.
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psnet.ahrq.gov/issue/critical-care-delivery-united-states-distribution-services-and-compliance-leapfrog
November 18, 2020 - Study
Critical care delivery in the United States: distribution of services and compliance with Leapfrog recommendations.
Citation Text:
Critical care delivery in the United States: distribution of services and compliance with Leapfrog recommendations. Angus DC; Shorr AF; White A; Dr…
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psnet.ahrq.gov/issue/medical-error-what-do-we-know-what-do-we-do
May 06, 2016 - Book/Report
Classic
Medical Error: What Do We Know? What Do We Do?
Citation Text:
Medical Error: What Do We Know? What Do We Do? Rosenthal MM; Sutcliffe KM, eds. San Francisco, CA: Jossey-Bass; 2002.
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psnet.ahrq.gov/issue/interruptions-and-miscommunications-surgery-observational-study
August 11, 2021 - Study
Interruptions and miscommunications in surgery: an observational study.
Citation Text:
Gillespie BM, Chaboyer W, Fairweather N. Interruptions and miscommunications in surgery: an observational study. AORN J. 2012;95(5):576-90. doi:10.1016/j.aorn.2012.02.012.
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psnet.ahrq.gov/issue/detection-patient-risk-nurses-theoretical-framework
September 24, 2010 - Commentary
Detection of patient risk by nurses: a theoretical framework.
Citation Text:
Despins LA, Scott-Cawiezell J, Rouder JN. Detection of patient risk by nurses: a theoretical framework. J Adv Nurs. 2010;66(2). doi:10.1111/j.1365-2648.2009.05215.x.
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psnet.ahrq.gov/issue/enhancing-healthcare-process-design-human-factors-engineering-and-reliability-science-part-1
October 17, 2018 - Commentary
Enhancing healthcare process design with human factors engineering and reliability science, part 1: setting the context.
Citation Text:
Boston-Fleischhauer C. Enhancing healthcare process design with human factors engineering and reliability science, part 1: setting the cont…
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psnet.ahrq.gov/issue/patient-self-medication-change-hospital-practice
March 09, 2022 - Study
Patient self-medication--a change in hospital practice.
Citation Text:
Grantham G, McMillan V, Dunn S, et al. Patient self-medication--a change in hospital practice. J Clin Nurs. 2006;15(8):962-70.
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psnet.ahrq.gov/issue/work-arounds-health-care-settings-literature-review-and-research-agenda
October 02, 2013 - Review
Work-arounds in health care settings: literature review and research agenda.
Citation Text:
Halbesleben JRB, Wakefield DS, Wakefield BJ. Work-arounds in health care settings: literature review and research agenda. Health Care Manage Rev. 2008;33(1):2-12. doi:10.1097/01.hmr.0000304…
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psnet.ahrq.gov/issue/failure-mode-and-effect-analysis-technique-prevent-chemotherapy-errors
May 30, 2008 - Commentary
Failure mode and effect analysis: a technique to prevent chemotherapy errors.
Citation Text:
Sheridan-Leos N, Schulmeister L, Hartranft S. Failure mode and effect analysis: a technique to prevent chemotherapy errors. Clin J Oncol Nurs. 2006;10(3):393-8.
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psnet.ahrq.gov/issue/building-memory-preventing-harm-reducing-risks-and-improving-patient-safety
December 24, 2007 - Government Resource
Building a Memory: Preventing Harm, Reducing Risks and Improving Patient Safety.
Citation Text:
Building a Memory: Preventing Harm, Reducing Risks and Improving Patient Safety. Scobie S, Thomson R. London, UK : National Patient Safety Agency; 2005.
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psnet.ahrq.gov/issue/how-identify-and-address-unsafe-conditions-associated-health-it
June 29, 2016 - Book/Report
How to Identify and Address Unsafe Conditions Associated With Health IT.
Citation Text:
How to Identify and Address Unsafe Conditions Associated With Health IT. Wallace C, Zimmer KP, Possanza L, Giannini R, Solomon R. Washington, DC: Office of the National Coordinator for…
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psnet.ahrq.gov/issue/airway-carts-systems-based-approach-airway-safety
July 21, 2010 - Study
Airway carts: a systems-based approach to airway safety.
Citation Text:
Kane BG, Bond WF, Worrilow CC, et al. Airway Carts. J Patient Saf. 2008;2(3). doi:10.1097/01.jps.0000242995.09037.07.
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digital.ahrq.gov/ahrq-funded-projects/facilitators-and-barriers-adoption-successful-urban-telemedicine-model/annual-summary/2010
January 01, 2010 - Facilitators and Barriers to Adoption of a Successful Urban Telemedicine Model - 2010
Project Name
Facilitators and Barriers to Adoption of a Successful Urban Telemedicine Model
Principal Investigator
McConnochie, Kenneth
Organization
University of Rochester
Funding M…
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psnet.ahrq.gov/issue/patient-safety-patients-role
May 26, 2011 - Commentary
Patient safety: the patient's role.
Citation Text:
Ford D. Patient safety: the patient's role. . World Hosp Health Serv. 2006;42(3):45-48.
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psnet.ahrq.gov/issue/nurses-experience-barriers-safe-practice-neonatal-intensive-care-unit-thailand
August 16, 2023 - Study
The nurses' experience of barriers to safe practice in the neonatal intensive care unit in Thailand.
Citation Text:
Jirapaet V, Jirapaet K, Sopajaree C. The nurses' experience of barriers to safe practice in the neonatal intensive care unit in Thailand. J Obstet Gynecol Neonatal …
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www.ahrq.gov/news/newsroom/case-studies/201605.html
May 01, 2016 - Blue Shield of California Foundation Uses AHRQ Guide to Reduce Hospital Readmissions
Search All Impact Case Studies
May 2016
AHRQ's Hospital Guide to Reducing Medicaid Readmissions was used by Blue Shield of California Foundation to apply evidence-based strategies that significantly cut hospital readmissi…
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psnet.ahrq.gov/issue/communication-failure-basic-components-contributing-factors-and-call-structure
March 04, 2011 - Commentary
Communication failure: basic components, contributing factors, and the call for structure.
Citation Text:
Dayton E, Henriksen K. Communication failure: basic components, contributing factors, and the call for structure. Jt Comm J Qual Patient Saf. 2007;33(1):34-47.
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