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psnet.ahrq.gov/node/60351/psn-pdf
January 01, 2021 - Adverse events in the paediatric emergency department:
a prospective cohort study.
May 20, 2020
Plint AC, Stang A, Newton AS, et al. Adverse events in the paediatric emergency department: a
prospective cohort study. BMJ Qual Saf. 2021;30(3):216-227. doi:10.1136/bmjqs-2019-010055.
https://psnet.ahrq.gov/issue/adver…
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psnet.ahrq.gov/node/44424/psn-pdf
August 19, 2015 - Taking patients' narratives about clinicians from anecdote
to science.
August 19, 2015
Schlesinger M, Grob R, Shaller D, et al. Taking Patients' Narratives about Clinicians from Anecdote to
Science. New Engl J Med. 2015;373(7):675-679. doi:10.1056/NEJMsb1502361.
https://psnet.ahrq.gov/issue/taking-patients-narrati…
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psnet.ahrq.gov/node/73889/psn-pdf
September 29, 2021 - Australian hospital leaders on the provision of safe care:
implications for safety I and safety II.
September 29, 2021
Leggat SG, Balding C, Bish M. Perspectives of Australian hospital leaders on the provision of safe care:
implications for safety I and safety II. J Health Org Manag. 2021;35(5):550-560. doi:10.1108…
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psnet.ahrq.gov/node/39003/psn-pdf
January 28, 2010 - Reducing in-hospital cardiac arrests and hospital
mortality by introducing a medical emergency team.
January 28, 2010
Konrad D, Jäderling G, Bell M, et al. Reducing in-hospital cardiac arrests and hospital mortality by
introducing a medical emergency team. Intensive Care Med. 2010;36(1):100-6. doi:10.1007/s00134-00…
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psnet.ahrq.gov/node/38228/psn-pdf
July 14, 2010 - Timely follow-up of abnormal outpatient test results:
perceived barriers and impact on patient safety.
July 14, 2010
Moore C, Saigh O, Trikha A, et al. Timely Follow-Up of Abnormal Outpatient Test Results. J Patient Saf.
2008;4(4):241-244. doi:10.1097/pts.0b013e31818d1ca4.
https://psnet.ahrq.gov/issue/timely-follo…
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psnet.ahrq.gov/node/838029/psn-pdf
September 07, 2022 - Emergency preparedness: be ready for unanticipated
electronic health record (EHR) downtime.
September 7, 2022
ISMP Medication Safety Alert! Acute care edition! August 25, 2022:27(17)1-6.
https://psnet.ahrq.gov/issue/emergency-preparedness-be-ready-unanticipated-electronic-health-record-ehr-
downtime
Unanticipated…
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psnet.ahrq.gov/node/46582/psn-pdf
February 14, 2018 - Technological distractions—part 1 and part 2.
February 14, 2018
Kane-Gill SL, O'Connor MF, Rothschild JM, et al. Technologic Distractions (Part 1): Summary of
Approaches to Manage Alert Quantity With Intent to Reduce Alert Fatigue and Suggestions for Alert
Fatigue Metrics. Crit Care Med. 2017;45(9):1481-1488. doi:1…
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psnet.ahrq.gov/node/43143/psn-pdf
April 25, 2016 - Surgical programs in the Veterans Health Administration
maintain briefing and debriefing following medical team
training.
April 25, 2016
West P, Neily J, Warner L, et al. Surgical programs in the Veterans Health Administration maintain briefing
and debriefing following medical team training. Jt Comm J Qual Patient…
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psnet.ahrq.gov/node/46292/psn-pdf
August 02, 2017 - Clinical alerts to decrease high-risk medication use in
older adults.
August 2, 2017
Lord-Adem W, Brandt NJ. Clinical Alerts to Decrease High-Risk Medication Use in Older Adults. J Gerontol
Nurs. 2017;43(7):7-12. doi:10.3928/00989134-20170614-04.
https://psnet.ahrq.gov/issue/clinical-alerts-decrease-high-risk-medi…
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psnet.ahrq.gov/node/45588/psn-pdf
January 23, 2017 - Computer-assisted process modeling to enhance
intraoperative safety in cardiac surgery.
January 23, 2017
Tarola CL, Quin JA, Haime ME, et al. Computer-Assisted Process Modeling to Enhance Intraoperative
Safety in Cardiac Surgery. JAMA Surg. 2016;151(12):1183-1186. doi:10.1001/jamasurg.2016.2839.
https://psnet.ahrq…
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psnet.ahrq.gov/node/858175/psn-pdf
December 13, 2023 - Defining the landscape of patient harm after osteopathic
manipulative treatment: synthesis of an adverse event
model.
December 13, 2023
Unger MD, Barr JN, Brower JA, et al. Defining the landscape of patient harm after osteopathic manipulative
treatment: synthesis of an adverse event model. BMC Complementary Medici…
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psnet.ahrq.gov/node/47979/psn-pdf
May 01, 2019 - Inpatient notes: just what the doctor ordered—checklists
to improve diagnosis.
May 1, 2019
Gupta A, Graber ML. Web Exclusive. Annals for Hospitalists Inpatient Notes - Just What the Doctor
Ordered-Checklists to Improve Diagnosis. Ann Intern Med. 2019;170(8):HO2-HO3. doi:10.7326/M19-0829.
https://psnet.ahrq.gov/iss…
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psnet.ahrq.gov/node/46865/psn-pdf
March 07, 2018 - Chasing the 6-sigma: drawing lessons from the cockpit
culture.
March 7, 2018
Hickey EJ, Halvorsen F, Laussen PC, et al. Chasing the 6-sigma: Drawing lessons from the cockpit culture.
J Thorac Cardiovasc Surg. 2017;155(2). doi:10.1016/j.jtcvs.2017.09.097.
https://psnet.ahrq.gov/issue/chasing-6-sigma-drawing-lessons…
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psnet.ahrq.gov/node/843082/psn-pdf
January 25, 2023 - Determination of unnecessary blood transfusion by
comprehensive 15-hospital record review.
January 25, 2023
Jadwin DF, Fenderson PG, Friedman MT, et al. Determination of unnecessary blood transfusion by
comprehensive 15-hospital record review. Jt Comm J Qual Patient Saf. 2023;49(1):42-52.
doi:10.1016/j.jcjq.2022.1…
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psnet.ahrq.gov/node/43352/psn-pdf
July 16, 2014 - Are amended surgical pathology reports getting to the
correct responsible care provider?
July 16, 2014
Parkash V, Domfeh A, Cohen P, et al. Are amended surgical pathology reports getting to the correct
responsible care provider? Am J Clin Pathol. 2014;142(1):58-63. doi:10.1309/AJCPY55EVINJCLGX.
https://psnet.ahrq.…
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psnet.ahrq.gov/node/61049/psn-pdf
January 01, 2021 - The effects of hospital-physician financial integration on
adverse incident rate: an agency theory perspective.
October 21, 2020
Upadhyay S, Weech-Maldonado R, Opoku-Agyeman W. The effects of hospital-physician financial
integration on adverse incident rate: an agency theory perspective. Health Serv Manage Res.
20…
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psnet.ahrq.gov/node/40541/psn-pdf
July 22, 2011 - Effect of a pharmacist-led multicomponent intervention
focusing on the medication monitoring phase to prevent
potential adverse drug events in nursing homes.
July 22, 2011
Lapane KL, Hughes C, Daiello LA, et al. Effect of a pharmacist-led multicomponent intervention focusing on
the medication monitoring phase to p…
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psnet.ahrq.gov/node/73113/psn-pdf
April 07, 2021 - Analysis of results from event investigations in industrial
and patient safety contexts.
April 7, 2021
Harms-Ringdahl L. Analysis of results from event investigations in industrial and patient safety contexts.
Safety. 2021;7(1):19. doi:10.3390/safety7010019.
https://psnet.ahrq.gov/issue/analysis-results-event-inve…
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psnet.ahrq.gov/node/43606/psn-pdf
October 15, 2014 - Opioids for chronic noncancer pain: a position paper of
the American Academy of Neurology.
October 15, 2014
Franklin GM, Neurology AA of. Opioids for chronic noncancer pain: a position paper of the American
Academy of Neurology. Neurology. 2014;83(14):1277-84. doi:10.1212/WNL.0000000000000839.
https://psnet.ahrq.g…
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psnet.ahrq.gov/node/46947/psn-pdf
March 21, 2018 - Leaving patients to their own devices? Smart technology,
safety and therapeutic relationships.
March 21, 2018
Ho A, Quick O. Leaving patients to their own devices? Smart technology, safety and therapeutic
relationships. BMC Med Ethics. 2018;19(1):18. doi:10.1186/s12910-018-0255-8.
https://psnet.ahrq.gov/issue/leav…