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psnet.ahrq.gov/issue/guilty-afraid-and-alone-struggling-medical-error
July 01, 2020 - Commentary
Classic
Guilty, afraid, and alone — struggling with medical error.
Citation Text:
Delbanco T, Bell SK. Guilty, afraid, and alone--struggling with medical error. N Engl J Med. 2007;357(17):1682-3.
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psnet.ahrq.gov/issue/low-literacy-impairs-comprehension-prescription-drug-warning-labels
January 21, 2009 - Study
Low literacy impairs comprehension of prescription drug warning labels.
Citation Text:
Davis TC, Wolf MS, Bass PF, et al. Low literacy impairs comprehension of prescription drug warning labels. J Gen Intern Med. 2006;21(8):847-51.
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psnet.ahrq.gov/issue/surgical-team-behaviors-and-patient-outcomes
April 08, 2011 - Study
Classic
Surgical team behaviors and patient outcomes.
Citation Text:
Mazzocco K, Petitti DB, Fong KT, et al. Surgical team behaviors and patient outcomes. Am J Surg. 2009;197(5):678-85. doi:10.1016/j.amjsurg.2008.03.002.
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psnet.ahrq.gov/issue/deficiencies-care-care-coordination-and-facility-response-patient-who-died-suicide-memphis-va
December 16, 2020 - Book/Report
Deficiencies in Care, Care Coordination, and Facility Response to a Patient Who Died by Suicide, Memphis VA Medical Center in Tennessee.
Citation Text:
Deficiencies in Care, Care Coordination, and Facility Response to a Patient Who Died by Suicide, Memphis VA Medical Center i…
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psnet.ahrq.gov/issue/interventions-improve-timely-cancer-diagnosis-integrative-review
May 25, 2022 - Study
Interventions to improve timely cancer diagnosis: an integrative review.
Citation Text:
Graber ML, Winters BD, Matin R, et al. Interventions to improve timely cancer diagnosis: an integrative review. Diagnosis (Berl). 2024;Epub Oct 18. doi:10.1515/dx-2024-0113.
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psnet.ahrq.gov/issue/ai-promise-or-peril-patient-safety
July 20, 2022 - Commentary
AI: promise or peril for patient safety.
Citation Text:
Ullem BD, Hatlie MJ, Lounsbury O. AI: promise or peril for patient safety. J Patient Saf. 2025;21(1):34-37. doi:10.1097/pts.0000000000001301.
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digital.ahrq.gov/technology/pharmacy-information-system
January 01, 2023 - Pharmacy Information System
CancelRx case study: Implications for clinic and community pharmacy work systems.
Citation
Watterson TL, Stone JA, Kleinschmidt PC, Chui MA. CancelRx case study: Implications for clinic and community pharmacy work systems. BMC Health Serv Res. 2023 …
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digital.ahrq.gov/health-care-theme/transitions-care
January 01, 2023 - Transitions in Care
Scalable Digital Communication Intervention to Support Older Adults and Care Partners Transitioning Home After Major Surgery
Description
This research will develop and evaluate the Perioperative Optimization of Senior Health (myPOSH) mobile application that…
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psnet.ahrq.gov/issue/addressing-opioid-epidemic-united-states-lessons-department-veterans-affairs
September 07, 2022 - Commentary
Classic
Addressing the opioid epidemic in the United States: lessons from the Department of Veterans Affairs.
Citation Text:
Gellad WF, Good CB, Shulkin DJ. Addressing the Opioid Epidemic in the United States: Lessons From the Department of Veterans A…
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psnet.ahrq.gov/issue/self-reported-violations-during-medication-administration-two-paediatric-hospitals
December 01, 2010 - Study
Self-reported violations during medication administration in two paediatric hospitals.
Citation Text:
Alper SJ, Holden RJ, Scanlon MC, et al. Self-reported violations during medication administration in two paediatric hospitals. BMJ Qual Saf. 2012;21(5):408-15. doi:10.1136/bmjqs-…
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psnet.ahrq.gov/issue/anesthetic-mishaps-breaking-chain-accident-evolution
April 08, 2011 - Commentary
Classic
Anesthetic mishaps: breaking the chain of accident evolution.
Citation Text:
Gaba DM, Maxwell M, DeAnda A. Anesthetic mishaps: breaking the chain of accident evolution. Anesthesiology. 1987;66(5):670-6.
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psnet.ahrq.gov/issue/nurse-staffing-levels-and-quality-care-hospitals
June 25, 2010 - Study
Classic
Nurse-staffing levels and the quality of care in hospitals.
Citation Text:
Needleman J, Buerhaus P, Mattke S, et al. Nurse-staffing levels and the quality of care in hospitals. N Engl J Med. 2002;346(22):1715-22.
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psnet.ahrq.gov/issue/effectiveness-radiofrequency-detection-system-adjunct-manual-counting-protocols-tracking
October 19, 2022 - Study
Effectiveness of a radiofrequency detection system as an adjunct to manual counting protocols for tracking surgical sponges: a prospective trial of 2,285 patients.
Citation Text:
Rupp CC, Kagarise MJ, Nelson SM, et al. Effectiveness of a radiofrequency detection system as an adju…
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psnet.ahrq.gov/issue/effects-cpoe-based-medication-ordering-outcomes-overview-systematic-reviews
March 10, 2021 - Review
Effects of CPOE-based medication ordering on outcomes: an overview of systematic reviews.
Citation Text:
Abraham J, Kitsiou S, Meng A, et al. Effects of CPOE-based medication ordering on outcomes: an overview of systematic reviews. BMJ Qual Saf. 2020;29(10):854–863. doi:10.1136/bm…
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psnet.ahrq.gov/issue/medication-reconciliation-academic-medical-center-implementation-comprehensive-program
April 24, 2018 - Commentary
Medication reconciliation at an academic medical center: implementation of a comprehensive program from admission to discharge.
Citation Text:
Murphy EM, Oxencis CJ, Klauck JA, et al. Medication reconciliation at an academic medical center: implementation of a comprehensive …
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psnet.ahrq.gov/issue/joint-commissions-new-and-revised-workplace-violence-prevention-standards-hospitals-major
April 27, 2022 - Commentary
The Joint Commission's new and revised workplace violence prevention standards for hospitals: a major step forward toward improved quality and safety.
Citation Text:
Arnetz JE. The Joint Commission's new and revised workplace violence prevention standards for hospitals: a majo…
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psnet.ahrq.gov/issue/therapeutic-duplication-general-surgical-wards
December 22, 2021 - Study
Therapeutic duplication on the general surgical wards.
Citation Text:
Huynh I, Rajendran T. Therapeutic duplication on the general surgical wards. BMJ Open Qual. 2021;10(3):e001363. doi:10.1136/bmjoq-2021-001363.
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psnet.ahrq.gov/issue/what-computer-needs-physician-humanism-and-artificial-intelligence
June 21, 2016 - Commentary
What this computer needs is a physician: humanism and artificial intelligence.
Citation Text:
Verghese A, Shah NH, Harrington RA. What This Computer Needs Is a Physician: Humanism and Artificial Intelligence. JAMA. 2018;319(1):19-20. doi:10.1001/jama.2017.19198.
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psnet.ahrq.gov/issue/medication-safety-systems-and-important-role-pharmacists
July 19, 2023 - Review
Medication safety systems and the important role of pharmacists.
Citation Text:
Mansur JM. Medication Safety Systems and the Important Role of Pharmacists. Drugs Aging. 2016;33(3):213-21. doi:10.1007/s40266-016-0358-1.
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psnet.ahrq.gov/issue/racism-and-electronic-health-records-ehrs-perspectives-research-and-practice
March 27, 2024 - Commentary
Racism and electronic health records (EHRs): perspectives for research and practice.
Citation Text:
Emani S, Rodriguez JA, Bates DW. Racism and electronic health records (EHRs): perspectives for research and practice. J Am Med Inform Assoc. 2023;30(5):995-999. doi:10.1093/jami…