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psnet.ahrq.gov/issue/team-based-approach-improving-medication-reconciliation-rates-family-medicine-residency
June 15, 2022 - Study
Team-based approach to improving medication reconciliation rates in family medicine residency clinics.
Citation Text:
Harper PG, Schafer KM, Van Riper K, et al. Team-based approach to improving medication reconciliation rates in family medicine residency clinics. J Am Pharm Assoc (…
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psnet.ahrq.gov/issue/prevalence-and-characterisation-diagnostic-error-among-7-day-all-cause-hospital-medicine
April 12, 2023 - Study
Prevalence and characterisation of diagnostic error among 7-day all-cause hospital medicine readmissions: a retrospective cohort study.
Citation Text:
Raffel KE, Kantor MA, Barish P, et al. Prevalence and characterisation of diagnostic error among 7-day all-cause hospital medicine …
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psnet.ahrq.gov/issue/board-bedside-how-application-financial-structures-safety-and-quality-can-drive
January 29, 2015 - Study
From board to bedside: how the application of financial structures to safety and quality can drive accountability in a large health care system.
Citation Text:
Austin M, Demski R, Callender T, et al. From Board to Bedside: How the Application of Financial Structures to Safety and Q…
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psnet.ahrq.gov/issue/near-misses-and-unsafe-conditions-reported-pediatric-emergency-research-network
June 07, 2017 - Study
Near misses and unsafe conditions reported in a Pediatric Emergency Research Network.
Citation Text:
Ruddy RM, Chamberlain JM, Mahajan P, et al. Near misses and unsafe conditions reported in a Pediatric Emergency Research Network. BMJ Open. 2015;5(9):e007541. doi:10.1136/bmjopen-20…
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psnet.ahrq.gov/issue/new-recommendations-duty-hours-acgme-task-force
July 14, 2021 - Commentary
Classic
The new recommendations on duty hours from the ACGME Task Force.
Citation Text:
Nasca TJ, Day SH, Amis S, et al. The new recommendations on duty hours from the ACGME Task Force. N Engl J Med. 2010;363(2):e3. doi:10.1056/NEJMsb1005800.
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psnet.ahrq.gov/issue/frequency-failure-inform-patients-clinically-significant-outpatient-test-results
April 24, 2018 - Study
Frequency of failure to inform patients of clinically significant outpatient test results.
Citation Text:
Casalino LP, Dunham D, Chin MH, et al. Frequency of failure to inform patients of clinically significant outpatient test results. Arch Intern Med. 2009;169(12):1123-9. doi:10…
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psnet.ahrq.gov/issue/factors-associated-intern-fatigue
October 28, 2009 - Study
Factors associated with intern fatigue.
Citation Text:
Friesen LD, Vidyarthi A, Baron RB, et al. Factors associated with intern fatigue. J Gen Intern Med. 2008;23(12):1981-6. doi:10.1007/s11606-008-0798-3.
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Format:
DOI Google Scholar PubMed BibTeX EndNo…
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psnet.ahrq.gov/issue/misdiagnosis-and-failure-diagnose-emergency-care-causes-and-empathy-solution
August 04, 2021 - Commentary
Misdiagnosis and failure to diagnose in emergency care: causes and empathy as a solution.
Citation Text:
Pelaccia T, Messman AM, Kline JA. Misdiagnosis and failure to diagnose in emergency care: causes and empathy as a solution. Patient Edu Couns. 2020;103(8):1650-1656. doi:10…
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psnet.ahrq.gov/issue/national-survey-patient-safety-experiences-hospital-medicine-during-covid-19-pandemic
November 30, 2022 - Study
National survey of patient safety experiences in hospital medicine during the COVID-19 pandemic.
Citation Text:
Carter D, Rosen A, Applebaum JR, et al. National survey of patient safety experiences in hospital medicine during the COVID-19 pandemic. Jt Comm J Qual Patient Saf. 2024;…
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psnet.ahrq.gov/issue/compendium-strategies-prevent-healthcare-associated-infections-acute-care-hospitals
September 01, 2014 - Special or Theme Issue
Classic
A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals.
Citation Text:
A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals. Yokoe DS, Mermel LA,…
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psnet.ahrq.gov/issue/simulation-based-teamwork-training-emergency-department-staff-does-it-improve-clinical-team
December 22, 2009 - Study
Classic
Simulation based teamwork training for emergency department staff: does it improve clinical team performance when added to an existing didactic teamwork curriculum?
Citation Text:
Shapiro MJ, Morey JC, Small SD, et al. Simulation based teamwork t…
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psnet.ahrq.gov/issue/creating-high-reliability-health-care-system-improving-performance-core-processes-care-johns
January 27, 2016 - Study
Creating a high-reliability health care system: improving performance on core processes of care at Johns Hopkins Medicine.
Citation Text:
Pronovost P, Armstrong M, Demski R, et al. Creating a high-reliability health care system: improving performance on core processes of care at Jo…
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psnet.ahrq.gov/issue/operational-failures-general-practice-consensus-building-study-priorities-improvement
February 07, 2024 - Study
Operational failures in general practice: a consensus-building study on the priorities for improvement.
Citation Text:
Sinnott C, Alboksmaty A, Moxey JM, et al. Operational failures in general practice: a consensus-building study on the priorities for improvement. Br J Gen Pract. 2…
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psnet.ahrq.gov/issue/management-test-results-primary-care-does-electronic-medical-record-make-difference
April 12, 2011 - Study
The management of test results in primary care: does an electronic medical record make a difference?
Citation Text:
Elder NC, McEwen TR, Flach J, et al. The management of test results in primary care: does an electronic medical record make a difference? Fam Med. 2010;42(5):327-33…
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psnet.ahrq.gov/issue/measuring-teamwork-performance-teams-crisis-situations-systematic-review-assessment-tools-and
November 04, 2020 - Review
Emerging Classic
Measuring the teamwork performance of teams in crisis situations: a systematic review of assessment tools and their measurement properties.
Citation Text:
Boet S, Etherington N, Larrigan S, et al. Measuring the teamwork performance of tea…
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psnet.ahrq.gov/issue/resident-duty-hours-surgery-ensuring-patient-safety-providing-optimum-resident-education-and
August 26, 2011 - Commentary
Resident duty hours in surgery for ensuring patient safety, providing optimum resident education and training, and promoting resident well-being: a response from the American College of Surgeons to the Report of the Institute of Medicine, "Resident Duty Hours: Enhancing Sleep, Supervision…
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psnet.ahrq.gov/issue/patient-safety-outcomes-under-flexible-and-standard-resident-duty-hour-rules
March 13, 2019 - Study
Emerging Classic
Patient safety outcomes under flexible and standard resident duty-hour rules.
Citation Text:
Patient safety outcomes under flexible and standard resident duty-hour rules. Silber JH, Bellini LM, Shea JA, et al; iCOMPARE Research Group. N En…
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psnet.ahrq.gov/issue/value-autopsies-era-high-tech-medicine-discrepant-findings-persist
October 18, 2023 - Study
The value of autopsies in the era of high-tech medicine: discrepant findings persist.
Citation Text:
Kuijpers CCHJ, Fronczek J, van de Goot FRW, et al. The value of autopsies in the era of high-tech medicine: discrepant findings persist. J Clin Pathol. 2014;67(6):512-9. doi:10.1136…
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psnet.ahrq.gov/node/72737/psn-pdf
February 09, 2021 - Geisinger’s Outpatient Addiction Medicine Specialty
Program Uses Data-Driven Decision Making and MAT to
Reduce Mortality Rates
February 9, 2021
https://psnet.ahrq.gov/innovation/geisingers-outpatient-addiction-medicine-specialty-program-uses-data-
driven-decision
Summary
The team at Geisinger sought to develop a…
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psnet.ahrq.gov/node/49842/psn-pdf
September 01, 2018 - The Wrong Blade: A Lack of Familiarity With Pediatric
Emergency Equipment
September 1, 2018
Katznelson J. The Wrong Blade: A Lack of Familiarity With Pediatric Emergency Equipment. PSNet
[internet]. 2018.
https://psnet.ahrq.gov/web-mm/wrong-blade-lack-familiarity-pediatric-emergency-equipment
The Case
As part of…