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psnet.ahrq.gov/node/49632/psn-pdf
July 01, 2011 - After discussion, the provider sent off a prostate-specific antigen (PSA) test to screen the patient … Future research is needed to test the impact of such interventions on key clinical outcomes, including … Handoffs causing patient harm: a survey of medical and surgical
house staff. … Committee on Optimizing Graduate Medical Trainee (Resident) Hours and Work Schedule to
Improve Patient … Chicago, IL: Accreditation Council of Graduate Medical Education; 2011. [Available
at]
9.
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psnet.ahrq.gov/issue/factors-associated-mental-health-outcomes-among-health-care-workers-exposed-coronavirus
March 24, 2019 - May 12, 2021
Toward safer health care: a review strategy of FDA medical device adverse … WebM&M Cases
A Postpartum Woman with an Erroneous SARS-CoV-2 Test … April 28, 2021
Telemedicine as a medical examination tool during the Covid … April 22, 2020
Psychological impact and coping strategies of frontline medical staff
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psnet.ahrq.gov/issue/health-care-consumers-inclination-engage-selected-patient-safety-practices-survey-adults
March 03, 2011 - Both AHRQ's " 20 Tips to Help Prevent Medical Errors " and the Joint Commission's " Speak Up " program … as checking for handwashing compliance) than less confrontational practices (such as following up on test
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psnet.ahrq.gov/issue/patient-and-caregiver-perspectives-causes-and-prevention-ambulatory-adverse-events
November 24, 2021 - November 29, 2023
Preferences and perceptions of medical error disclosure among marginalized … October 5, 2016
Patient, physician, medical assistant, and office visit factors associated … March 9, 2016
Test result communication in primary care: a survey of current practice
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psnet.ahrq.gov/web-mm/pregnant-danger
January 12, 2011 - In the present case, the patient would fall into Category V (medical complaint not related to pregnancy … Case Examples
These cases are included to test how an institution’s ED triage policy would handle … outcomes of the triage are similar.
21-year-old G2P1 presents to ED with a positive pregnancy test … deformity in right lower extremity and vaginal bleeding.
17-year-old G1P0 with a positive home pregnancy test … December 22, 2010
Medical liability and patient safety: setting the proper course.
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psnet.ahrq.gov/node/33872/psn-pdf
January 01, 2018 - population-based study in Iowa, 20% of participants shared that they or someone
close to them had experienced a medical … offered patients unprecedented access to their health information,
including the ability to review test … In a 2018 study, most patients
who viewed their online test results did not receive explanations of … patient-feedback-reporting-tool-opennotes-implications-patient-clinician-safety-and-quality
https://psnet.ahrq.gov/issue/patient-perceptions-receiving-test-results-online-portals-mixed-methods-study
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psnet.ahrq.gov/web-mm/diagnostic-overshadowing-dangers
February 12, 2020 - The initial electrocardiogram revealed sinus tachycardia at 156 bpm and initial laboratory test results … The medical team attributed her pain to the fracture. … However, because of a delay in reporting, by the time the medical team saw the laboratory test results … Raven, MD, MPH, MSc This case illustrates the challenges inherent in providing acute medical care for … Often, ED patients have no one to advocate for them or corroborate details of their medical, behavioral
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psnet.ahrq.gov/perspective/conversation-david-w-bates-about-are-we-safer-today
February 26, 2025 - I am currently the Medical Director for Clinical and Quality Analysis for MGB Healthcare. … Another example is a positive Clostridium difficile test. … C. difficile is usually a complication, so having a positive test strongly suggests that the person … In the outpatient setting, one of the biggest causes of harm is that somebody has a diagnostic test that … In the Harvard Medical Practice Study , nurses and medical records analysts screened 31,429 records
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psnet.ahrq.gov/issue/creating-oversight-infrastructure-electronic-health-record-related-patient-safety-hazards
May 22, 2015 - 2023
Application of human factors methods to understand missed follow-up of abnormal test … Electronic error-reporting systems: a case study into the impact on nurse reporting of medical … April 24, 2013
A comprehensive overview of medical error in hospitals using incident-reporting
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psnet.ahrq.gov/issue/more-words-interpersonal-communication-cognitive-bias-and-diagnostic-errors
March 11, 2013 - March 11, 2013
Variation in electronic test results management and its implications for … November 11, 2020
Cognitive bias impact on management of postoperative complications, medical … Patient and Family Centered I-PASS (Family-Centered Communication Program to Reduce Medical
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psnet.ahrq.gov/issue/methods-assessing-preventability-adverse-drug-events-systematic-review
July 24, 2013 - January 7, 2015
Risk factors for patient-reported medical errors in eleven countries. … May 19, 2014
Clinical errors and medical negligence. … July 1, 2013
The safety implications of missed test results for hospitalised patients
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psnet.ahrq.gov/issue/what-words-convey-potential-patient-narratives-inform-quality-improvement
August 19, 2015 - Seroprevalence of SARS-CoV-2 among frontline health care personnel in a multistate hospital network--13 academic medical … September 23, 2020
When mistakes multiply: how inadequate responses to medical mishaps … September 18, 2019
Understanding test results follow-up in the ambulatory setting: analysis
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psnet.ahrq.gov/issue/electronic-health-records-ambulatory-care-national-survey-physicians
February 17, 2011 - August 27, 2012
Medical large language models are vulnerable to data-poisoning attacks … June 21, 2018
Electronic detection of delayed test result follow-up in patients with … Patient safety perceptions of primary care providers after implementation of an electronic medical
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psnet.ahrq.gov/issue/validation-mobile-app-reducing-errors-administration-medications-emergency
September 23, 2020 - Seroprevalence of SARS-CoV-2 among frontline health care personnel in a multistate hospital network--13 academic medical … Settings Help Improve Management of Sepsis
May 31, 2023
Variation in electronic test
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psnet.ahrq.gov/perspective/approach-improving-patient-safety-communication
August 31, 2020 - Open communication between the medical team and patients and families can broaden perspectives, provide … to their electronic health record (EHR) can give them the ability to review and report errors in the medical … teams and lessen the risk of medical errors. … diagnostic information, technical problems, data entry problems, and system failures with tracking test … research is needed to better understand communication approaches applied during the COVID-19 pandemic and test
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psnet.ahrq.gov/issue/development-electronic-pediatric-all-cause-harm-measurement-tool-using-modified-delphi-method
July 03, 2016 - discussion and evidence review, investigators produced a list of 51 triggers , which they plan to pilot test … October 30, 2010
The impact of electronic medical records data sources on an adverse
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psnet.ahrq.gov/issue/preliminary-study-patient-safety-and-quality-use-cases-icd-11-mms
July 22, 2020 - In addition to the medical entities such as disease and injury, it contains a second component, the … April 29, 2018
Variation in electronic test results management and its implications for
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psnet.ahrq.gov/issue/exploring-costs-unsafe-care-nhs-report-prepared-department-health
July 10, 2019 - 2014
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psnet.ahrq.gov/issue/improving-diagnosis
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psnet.ahrq.gov/issue/problems-after-discharge-and-understanding-communication-their-primary-care-physicians-pcps
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