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Bridging the feedback gap: a sociotechnical approach to informing clinicians of patients' subsequent clinical course and outcomes. | PSNet

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January 21, 2019 - Commentary Bridging the feedback gap: a sociotechnical approach to informing clinicians of patients' subsequent clinical course and outcomes. Citation Text: Cifra CL, Sittig DF, Singh H. Bridging the feedback gap: a sociotechnical approach to informing clinicians of patients’ subsequent …

Adverse events in intensive care and continuing care units during bed-bath procedures: the prospective observational NURSIng during critical carE (NURSIE) study. | PSNet

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March 05, 2025 - Study Adverse events in intensive care and continuing care units during bed-bath procedures: the prospective observational NURSIng during critical carE (NURSIE) study. Citation Text: Decormeille G, Maurer-Maouchi V, Mercier G, et al. Adverse events in intensive care and continuing care u…

Crisis management for surgical teams and their leaders, lessons from the COVID-19 pandemic; a structured approach to developing resilience or natural organisational responses. | PSNet

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February 12, 2020 - Review Crisis management for surgical teams and their leaders, lessons from the COVID-19 pandemic; a structured approach to developing resilience or natural organisational responses. Citation Text: Pring ET, Malietzis G, Kendall SWH, et al. Crisis management for surgical teams and their …

Patient safety in remote primary care encounters: multimethod qualitative study combining Safety I and Safety II analysis. | PSNet

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March 23, 2022 - Study Patient safety in remote primary care encounters: multimethod qualitative study combining Safety I and Safety II analysis. Citation Text: Payne R, Clarke A, Swann N, et al. Patient safety in remote primary care encounters: multimethod qualitative study combining Safety I and Safety…

Exploring new avenues to assess the sharp end of patient safety: an analysis of nationally aggregated peer review data. | PSNet

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December 21, 2014 - Study Exploring new avenues to assess the sharp end of patient safety: an analysis of nationally aggregated peer review data. Citation Text: Meeks DW, Meyer AND, Rose B, et al. Exploring new avenues to assess the sharp end of patient safety: an analysis of nationally aggregated peer revi…

Safety at the time of the COVID-19 pandemic: how to keep our oncology patients and healthcare workers safe. | PSNet

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September 03, 2011 - Commentary Safety at the time of the COVID-19 pandemic: how to keep our oncology patients and healthcare workers safe. Citation Text: Cinar P, Kubal T, Freifeld A, et al. Safety at the time of the COVID-19 pandemic: how to keep our oncology patients and healthcare workers safe. J Natl Co…

Beating the weekend trend: increased mortality in older adult traumatic brain injury (TBI) patients admitted on weekends. | PSNet

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December 21, 2014 - Slideset Beating the weekend trend: increased mortality in older adult traumatic brain injury (TBI) patients admitted on weekends. Citation Text: Schneider EB, Hirani SA, Hambridge HL, et al. Beating the weekend trend: increased mortality in older adult traumatic brain injury (TBI) pat…

Improving clinical handover between intensive care unit and general ward professionals at intensive care unit discharge. | PSNet

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January 30, 2019 - Review Improving clinical handover between intensive care unit and general ward professionals at intensive care unit discharge. Citation Text: van Sluisveld N, Hesselink G, van der Hoeven JG, et al. Improving clinical handover between intensive care unit and general ward professionals at…

A look into the nature and causes of human errors in the intensive care unit. | PSNet

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June 29, 2009 - Study Classic A look into the nature and causes of human errors in the intensive care unit. Citation Text: Donchin Y, Gopher D, Olin M, et al. A look into the nature and causes of human errors in the intensive care unit. Crit Care Med. 1995;23(2):294-300. Co…

Postdischarge adverse events among neonates admitted to the neonatal intensive care unit. | PSNet

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October 05, 2022 - Study Postdischarge adverse events among neonates admitted to the neonatal intensive care unit. Citation Text: Tsilimingras D, Natarajan G, Bajaj M, et al. Postdischarge adverse events among neonates admitted to the neonatal intensive care unit. J Patient Saf. 2022;18(5):462-469. doi:10.…

Teamwork before and during COVID-19: the good, the same, and the ugly…. | PSNet

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September 14, 2022 - Study Teamwork before and during COVID-19: the good, the same, and the ugly…. Citation Text: Rehder KJ, Adair KC, Eckert E, et al. Teamwork before and during COVID-19: the good, the same, and the ugly…. J Patient Saf. 2023;19(1):36-41. doi:10.1097/pts.0000000000001070. Copy Citation …

Registered nurses' and medical doctors' experiences of patient safety in health information exchange during interorganizational care transitions: a qualitative review. | PSNet

psnet.ahrq.gov/issue/registered-nurses-and-medical-doctors-experiences-patient-safety-health-information-exchange

July 22, 2020 - Review Registered nurses' and medical doctors' experiences of patient safety in health information exchange during interorganizational care transitions: a qualitative review. Citation Text: Hyvämäki P, Kääriäinen M, Tuomikoski A-M, et al. Registered nurses' and medical doctors' experienc…

Analysis of errors in dictated clinical documents assisted by speech recognition software and professional transcriptionists. | PSNet

psnet.ahrq.gov/issue/analysis-errors-dictated-clinical-documents-assisted-speech-recognition-software-and

July 06, 2022 - Study Emerging Classic Analysis of errors in dictated clinical documents assisted by speech recognition software and professional transcriptionists. Citation Text: Zhou L, Blackley SV, Kowalski L, et al. Analysis of Errors in Dictated Clinical Documents Assisted…

A mixed methods evaluation of medication reconciliation in the primary care setting. | PSNet

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November 16, 2022 - Study A mixed methods evaluation of medication reconciliation in the primary care setting. Citation Text: Gionfriddo MR, Duboski V, Middernacht A, et al. A mixed methods evaluation of medication reconciliation in the primary care setting. PLoS ONE. 2021;16(12):e0260882. doi:10.1371/journ…

The impact of automated notification on follow-up of actionable tests pending at discharge: a cluster-randomized controlled trial. | PSNet

psnet.ahrq.gov/issue/impact-automated-notification-follow-actionable-tests-pending-discharge-cluster-randomized

March 04, 2015 - Study Classic The impact of automated notification on follow-up of actionable tests pending at discharge: a cluster-randomized controlled trial. Citation Text: Dalal A, Schaffer A, Gershanik EF, et al. The Impact of Automated Notification on Follow-up of Actiona…

Did duty hour reform lead to better outcomes among the highest risk patients? | PSNet

psnet.ahrq.gov/issue/did-duty-hour-reform-lead-better-outcomes-among-highest-risk-patients

January 13, 2010 - Study Did duty hour reform lead to better outcomes among the highest risk patients? Citation Text: Volpp KG, Rosen AK, Rosenbaum PR, et al. Did duty hour reform lead to better outcomes among the highest risk patients? J Gen Intern Med. 2009;24(10):1149-55. doi:10.1007/s11606-009-1011-z…

Development, testing, and findings of a pediatric-focused trigger tool to identify medication-related harm in US children's hospitals. | PSNet

psnet.ahrq.gov/issue/development-testing-and-findings-pediatric-focused-trigger-tool-identify-medication-related

April 11, 2011 - Study Development, testing, and findings of a pediatric-focused trigger tool to identify medication-related harm in US children's hospitals. Citation Text: Takata GS, Mason W, Taketomo C, et al. Development, testing, and findings of a pediatric-focused trigger tool to identify medicati…

Factors that affect opioid quality improvement initiatives in primary care: insights from ten health systems. | PSNet

psnet.ahrq.gov/issue/factors-affect-opioid-quality-improvement-initiatives-primary-care-insights-ten-health

November 03, 2021 - Study Factors that affect opioid quality improvement initiatives in primary care: insights from ten health systems. Citation Text: Childs E, Tano CA, Mikosz CA, et al. Factors that affect opioid quality improvement initiatives in primary care: insights from ten health systems. Jt Comm J …

Using the Generic Analysis Method to analyze sentinel event reports across hospitals: a retrospective cross-sectional study. | PSNet

psnet.ahrq.gov/issue/using-generic-analysis-method-analyze-sentinel-event-reports-across-hospitals-retrospective

May 18, 2022 - Study Using the Generic Analysis Method to analyze sentinel event reports across hospitals: a retrospective cross-sectional study. Citation Text: Baartmans MC, van Schoten SM, Smit BJ, et al. Using the Generic Analysis Method to analyze sentinel event reports across hospitals: a retrospe…

Lessons learned from a national hospital antibiotic stewardship implementation project. | PSNet

psnet.ahrq.gov/issue/lessons-learned-national-hospital-antibiotic-stewardship-implementation-project

July 20, 2022 - Study Lessons learned from a national hospital antibiotic stewardship implementation project. Citation Text: Cosgrove SE, Ahn R, Dullabh P, et al. Lessons learned from a national hospital antibiotic stewardship implementation project. Jt Comm J Qual Patient Saf. 2024;50(6):435-441. doi:1…

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