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psnet.ahrq.gov/issue/prevention-wrong-site-tooth-extraction-clinical-guidelines
August 04, 2021 - Commentary
Prevention of wrong-site tooth extraction: clinical guidelines.
Citation Text:
Lee JS, Curley AW, Smith RA, et al. Prevention of wrong-site tooth extraction: clinical guidelines. J Oral Maxillofac Surg. 2007;65(9):1793-9.
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psnet.ahrq.gov/issue/performance-web-based-clinical-diagnosis-support-system-internists
August 02, 2023 - Study
Performance of a web-based clinical diagnosis support system for internists.
Citation Text:
Graber ML, Mathew A. Performance of a web-based clinical diagnosis support system for internists. J Gen Intern Med. 2008;23 Suppl 1:37-40. doi:10.1007/s11606-007-0271-8.
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psnet.ahrq.gov/issue/simulation-operational-readiness-new-freestanding-emergency-department-strategy-and-tactics
August 20, 2018 - Study
Simulation for operational readiness in a new freestanding emergency department: strategy and tactics.
Citation Text:
Kerner RL, Gallo K, Cassara M, et al. Simulation for Operational Readiness in a New Freestanding Emergency Department. Simul Healthc. 2016;11(5). doi:10.1097/sih.00…
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psnet.ahrq.gov/issue/medical-harm-historical-conceptual-and-ethical-dimensions-iatrogenic-illness
May 13, 2020 - Book/Report
Classic
Medical Harm: Historical, Conceptual, and Ethical Dimensions of Iatrogenic Illness.
Citation Text:
Medical Harm: Historical, Conceptual, and Ethical Dimensions of Iatrogenic Illness. Sharpe VA, Faden AI. Cambridge NY; Cambridge University…
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psnet.ahrq.gov/issue/factors-associated-diagnostic-error-analysis-closed-medical-malpractice-claims
July 13, 2022 - Study
Factors associated with diagnostic error: an analysis of closed medical malpractice claims.
Citation Text:
Grenon V, Szymonifka J, Adler-Milstein J, et al. Factors associated with diagnostic error: an analysis of closed medical malpractice claims. J Patient Saf. 2023;19(3):211-215.…
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psnet.ahrq.gov/issue/vital-signs-core-metrics-health-and-health-care-progress
November 24, 2021 - Book/Report
Vital Signs: Core Metrics for Health and Health Care Progress.
Citation Text:
Vital Signs: Core Metrics for Health and Health Care Progress. Blumenthal D, Malphrus E, McGinnis JM, eds. Committee on Core Metrics for Better Health at Lower Cost, Institute of Medicine. Washingto…
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psnet.ahrq.gov/issue/dual-process-cognitive-interventions-enhance-diagnostic-reasoning-systematic-review
March 20, 2019 - Review
Dual-process cognitive interventions to enhance diagnostic reasoning: a systematic review.
Citation Text:
Lambe KA, O'Reilly G, Kelly BD, et al. Dual-process cognitive interventions to enhance diagnostic reasoning: a systematic review. BMJ Qual Saf. 2016;25(10):808-820. doi:10.113…
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psnet.ahrq.gov/issue/improving-patient-care-cognitive-psychology-missed-diagnoses
October 03, 2012 - Commentary
Improving patient care. The cognitive psychology of missed diagnoses.
Citation Text:
Redelmeier DA. Improving patient care. The cognitive psychology of missed diagnoses. Ann Intern Med. 2005;142(2):115-120.
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psnet.ahrq.gov/issue/burnout-among-health-care-professionals-call-explore-and-address-underrecognized-threat-safe
November 11, 2020 - Book/Report
Burnout Among Health Care Professionals. A Call to Explore and Address This Underrecognized Threat to Safe, High-Quality Care.
Citation Text:
Burnout Among Health Care Professionals. A Call to Explore and Address This Underrecognized Threat to Safe, High-Quality Care. Dyrbye …
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psnet.ahrq.gov/issue/effects-work-hour-reduction-residents-lives-systematic-review
March 02, 2011 - Review
Effects of work hour reduction on residents' lives: a systematic review.
Citation Text:
Fletcher KE, Underwood W, Davis SQ, et al. Effects of Work Hour Reduction on Residents’ Lives. JAMA. 2005;294(9):1088. doi:10.1001/jama.294.9.1088.
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psnet.ahrq.gov/issue/procuring-interoperability-achieving-high-quality-connected-and-person-centered-care
September 19, 2018 - Book/Report
Procuring Interoperability: Achieving High-Quality, Connected, and Person-Centered Care.
Citation Text:
Procuring Interoperability: Achieving High-Quality, Connected, and Person-Centered Care. Pronovost P, Johns MME, Palmer S, et al, eds. Washington, DC: National Academy of M…
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psnet.ahrq.gov/issue/development-and-implementation-checklists-obstetrics
July 13, 2010 - Commentary
The development and implementation of checklists in obstetrics.
Citation Text:
Medicine S for M-F, Bernstein PS, Combs A, et al. The development and implementation of checklists in obstetrics. Am J Obstet Gynecol. 2017;217(2):B2-B6. doi:10.1016/j.ajog.2017.05.032.
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psnet.ahrq.gov/issue/errors-medicine-punishment-versus-learning-medical-adverse-events-revisited-expanding-frame
August 24, 2022 - Review
Errors in medicine: punishment versus learning medical adverse events revisited - expanding the frame.
Citation Text:
Brattebø G, Flaatten HK. Errors in medicine: punishment versus learning medical adverse events revisited – expanding the frame. Curr Opin Anaesthesiol. 2023;36(2):…
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psnet.ahrq.gov/web-mm/one-toxic-drug-not-another
October 02, 2019 - SPOTLIGHT CASE
One Toxic Drug Is Not Like Another
Citation Text:
Holmboe ES. One Toxic Drug Is Not Like Another. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2011.
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psnet.ahrq.gov/node/33645/psn-pdf
February 01, 2007 - Diagnostic Errors in Medicine: What Do Doctors and
Umpires Have in Common?
February 1, 2007
Graber ML. Diagnostic Errors in Medicine: What Do Doctors and Umpires Have in Common? PSNet
[internet]. 2007.
https://psnet.ahrq.gov/perspective/diagnostic-errors-medicine-what-do-doctors-and-umpires-have-common
Perspectiv…
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psnet.ahrq.gov/node/49806/psn-pdf
September 01, 2017 - Failed Interpretation of Screening Tool: Delayed
Treatment
September 1, 2017
Cable CA, Murphy DJ, Martin GS. Failed Interpretation of Screening Tool: Delayed Treatment. PSNet
[internet]. 2017.
https://psnet.ahrq.gov/web-mm/failed-interpretation-screening-tool-delayed-treatment
The Case
An 88-year-old man present…
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psnet.ahrq.gov/node/39947/psn-pdf
July 03, 2014 - Association between implementation of a medical team
training program and surgical mortality.
July 3, 2014
Neily J, Mills PD, Young-Xu Y, et al. Association between implementation of a medical team training
program and surgical mortality. JAMA. 2010;304(15):1693-1700. doi:10.1001/jama.2010.1506.
https://psnet.ahrq…
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psnet.ahrq.gov/node/46843/psn-pdf
June 21, 2018 - Electronic health record reviews to measure diagnostic
uncertainty in primary care.
June 21, 2018
Bhise V, Rajan SS, Sittig DF, et al. Electronic health record reviews to measure diagnostic uncertainty in
primary care. J Eval Clin Pract. 2018;24(3):545-551. doi:10.1111/jep.12912.
https://psnet.ahrq.gov/issue/elect…
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psnet.ahrq.gov/node/43803/psn-pdf
January 29, 2015 - Creating a high-reliability health care system: improving
performance on core processes of care at Johns Hopkins
Medicine.
January 29, 2015
Pronovost P, Armstrong M, Demski R, et al. Creating a high-reliability health care system: improving
performance on core processes of care at Johns Hopkins Medicine. Acad Med.…
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psnet.ahrq.gov/node/84413/psn-pdf
February 23, 2022 - A Loss of Trust and a Missed Diagnosis
February 23, 2022
Landefeld J, Teasdale S, Jain S. A Loss of Trust and a Missed Diagnosis. PSNet [internet]. 2022.
https://psnet.ahrq.gov/web-mm/loss-trust-and-missed-diagnosis
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