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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46824/psn-pdf
    June 26, 2018 - Management reasoning: beyond the diagnosis. June 26, 2018 Cook DA, Sherbino J, Durning SJ. Management Reasoning: Beyond the Diagnosis. JAMA. 2018;319(22):2267-2268. doi:10.1001/jama.2018.4385. https://psnet.ahrq.gov/issue/management-reasoning-beyond-diagnosis This commentary reviews five differences between diagno…
  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44678/psn-pdf
    July 05, 2017 - Patient Safety Risk Management Playbook. July 5, 2017 Chicago, IL: American Society for Healthcare Risk Management; 2015. https://psnet.ahrq.gov/issue/patient-safety-risk-management-playbook Proactive risk management is an important component to improving the safety of care. Exploring principles of high reliabilit…
  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47380/psn-pdf
    September 05, 2018 - Operating management system for high reliability: leadership, accountability, learning and innovation in healthcare. September 5, 2018 Day RM, Demski RJ, Pronovost PJ, et al. Operating management system for high reliability: Leadership, accountability, learning and innovation in healthcare. J Patient Saf Risk Mana…
  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45574/psn-pdf
    November 23, 2016 - Patient safety events in out-of-hospital paediatric airway management: a medical record review by the CSI-EMS. November 23, 2016 Hansen M, Meckler G, Lambert W, et al. Patient safety events in out-of-hospital paediatric airway management: a medical record review by the CSI-EMS. BMJ Open. 2016;6(11):e012259. doi:10…
  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/36294/psn-pdf
    July 14, 2010 - Care management implementation and patient safety. July 14, 2010 Alexander JA; Weiner BJ; Baker LC; et al. J Patient Saf. 2006;2(2):83-96. https://psnet.ahrq.gov/issue/care-management-implementation-and-patient-safety The Institute of Medicine's Crossing the Quality Chasm report endorsed care management, defined as…
  6. psnet.ahrq.gov/issue/serious-safety-events-getting-zero-second-edition
    February 19, 2014 - Book/Report Serious Safety Events: Getting to Zero. Second Edition. Citation Text: Serious Safety Events: Getting to Zero. Second Edition. Hoppes M, Mitchell JL. Chicago, IL: American Society for Healthcare Risk Management; October 2014. Copy Citation Save Save to…
  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49701/psn-pdf
    February 01, 2014 - An Easily Forgotten Tube February 1, 2014 Ousey K. An Easily Forgotten Tube. PSNet [internet]. 2014. https://psnet.ahrq.gov/web-mm/easily-forgotten-tube The Case A 45-year-old man was admitted to the intensive care unit (ICU) for acute liver failure secondary to alcohol abuse. His illness was complicated by acute…
  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43013/psn-pdf
    March 12, 2014 - Laboratory test ordering and results management systems: a qualitative study of safety risks identified by administrators in general practice. March 12, 2014 Bowie P, Halley L, McKay J. Laboratory test ordering and results management systems: a qualitative study of safety risks identified by administrators in gene…
  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42109/psn-pdf
    March 13, 2013 - Nursing crew resource management: a follow-up report from the Veterans Health Administration. March 13, 2013 Sculli GL, Fore AM, West P, et al. Nursing crew resource management: a follow-up report from the Veterans Health Administration. J Nurs Adm. 2013;43(3):122-6. doi:10.1097/NNA.0b013e318283dafa. https://psnet…
  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41303/psn-pdf
    March 11, 2013 - Clinical risk management in hospitals: strategy, central coordination and dialogue as key enablers. March 11, 2013 Briner M, Manser T, Kessler O. Clinical risk management in hospitals: strategy, central coordination and dialogue as key enablers. J Eval Clin Pract. 2013;19(2):363-369. doi:10.1111/j.1365-2753.2012.01…
  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43218/psn-pdf
    July 28, 2014 - Risk management—learning from the mistakes of others. July 28, 2014 Meydan C. Risk management--learning from the mistakes of others. J Eval Clin Pract. 2014;20(4):505-7. doi:10.1111/jep.12165. https://psnet.ahrq.gov/issue/risk-management-learning-mistakes-others This commentary introduces a structured process for …
  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/36705/psn-pdf
    July 25, 2011 - Managed care penetration and other factors affecting computerized physician order entry in the ambulatory setting. July 25, 2011 Menachemi N, Ford E, Chukmaitov A, et al. Managed care penetration and other factors affecting computerized physician order entry in the ambulatory setting. Am J Manag Care. 2006;12(12):…
  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/38217/psn-pdf
    April 26, 2017 - Patient safety climate in US hospitals: variation by management level. April 26, 2017 Singer SJ, Falwell A, Gaba DM, et al. Patient safety climate in US hospitals: variation by management level. Med Care. 2008;46(11):1149-56. doi:10.1097/MLR.0b013e31817925c1. https://psnet.ahrq.gov/issue/patient-safety-climate-us-…
  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47281/psn-pdf
    August 22, 2018 - The dilemma of patient safety work: perceptions of hospital middle managers. August 22, 2018 Sanner M, Halford C, Vengberg S, et al. The dilemma of patient safety work: Perceptions of hospital middle managers. J Healthc Risk Manag. 2018;38(2):47-55. doi:10.1002/jhrm.21325. https://psnet.ahrq.gov/issue/dilemma-pati…
  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/37687/psn-pdf
    February 22, 2011 - Use of an interactive, telephone-based self-management support program to identify adverse events among ambulatory diabetes patients. February 22, 2011 Sarkar U, Handley MA, Gupta R, et al. Use of an interactive, telephone-based self-management support program to identify adverse events among ambulatory diabetes p…
  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/40557/psn-pdf
    June 29, 2011 - A systemic methodology for risk management in healthcare sector. June 29, 2011 Cagliano AC, Grimaldi S, Rafele C. A systemic methodology for risk management in healthcare sector. Saf Sci. 2011;49(5). doi:10.1016/j.ssci.2011.01.006. https://psnet.ahrq.gov/issue/systemic-methodology-risk-management-healthcare-sector…
  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43528/psn-pdf
    October 01, 2014 - Critical incident stress management (CISM) in complex systems: cultural adaptation and safety impacts in healthcare. October 1, 2014 Müller-Leonhardt A, Mitchell SG, Vogt J, et al. Critical Incident Stress Management (CISM) in complex systems: cultural adaptation and safety impacts in healthcare. Accid Anal Prev. …
  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45092/psn-pdf
    May 11, 2016 - The experiences of risk managers in providing emotional support for health care workers after adverse events. May 11, 2016 Edrees HH, Brock DM, Wu AW, et al. The experiences of risk managers in providing emotional support for health care workers after adverse events. J Healthc Risk Manag. 2016;35(4):14-21. doi:10.…
  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44267/psn-pdf
    October 13, 2015 - Crew resource management in the intensive care unit: a prospective 3-year cohort study. October 13, 2015 Haerkens MHTM, Kox M, Lemson J, et al. Crew Resource Management in the Intensive Care Unit: a prospective 3-year cohort study. Acta Anaesthesiol Scand. 2015;59(10):1319-29. doi:10.1111/aas.12573. https://psnet.…
  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41582/psn-pdf
    August 08, 2012 - Safety management in different high-risk domains--all the same? August 8, 2012 Grote G. Safety management in different high-risk domains – All the same? Safety Sci. 2011;50(10):1983- 1992. doi:10.1016/j.ssci.2011.07.017. https://psnet.ahrq.gov/issue/safety-management-different-high-risk-domains-all-same This comm…

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