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psnet.ahrq.gov/node/45750/psn-pdf
February 01, 2017 - Cognitive biases associated with medical decisions: a
systematic review.
February 1, 2017
Saposnik G, Redelmeier DA, Ruff CC, et al. Cognitive biases associated with medical decisions: a
systematic review. BMC Med Inform Decis Mak. 2016;16(1):138.
https://psnet.ahrq.gov/issue/cognitive-biases-associated-medical-de…
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psnet.ahrq.gov/node/34722/psn-pdf
April 07, 2011 - A preliminary taxonomy of medical errors in family
practice.
April 7, 2011
Dovey S, Meyers DS, Phillips RL, et al. A preliminary taxonomy of medical errors in family practice. Qual
Saf Health Care. 2002;11(3):233-8.
https://psnet.ahrq.gov/issue/preliminary-taxonomy-medical-errors-family-practice
Efforts to improv…
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psnet.ahrq.gov/node/36076/psn-pdf
September 28, 2010 - Variation in caregiver perceptions of teamwork climate in
labor and delivery units.
September 28, 2010
Sexton JB, Holzmueller CG, Pronovost PJ, et al. Variation in caregiver perceptions of teamwork climate in
labor and delivery units. J Perinatol. 2006;26(8):463-70.
https://psnet.ahrq.gov/issue/variation-caregiver…
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psnet.ahrq.gov/node/42369/psn-pdf
September 19, 2013 - Patient safety in healthcare preregistration educational
curricula: multiple case study-based investigations of
eight medicine, nursing, pharmacy and physiotherapy
university courses.
September 19, 2013
Cresswell K, Howe A, Steven A, et al. Patient safety in healthcare preregistration educational curricula:
multi…
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psnet.ahrq.gov/node/43826/psn-pdf
June 01, 2015 - Radiation Oncology Incident Learning System.
June 1, 2015
American Society for Radiation Oncology and American Association of Physicists in Medicine.
https://psnet.ahrq.gov/issue/radiation-oncology-incident-learning-system
Reporting of near misses and adverse events can provide a foundation for learning from error.…
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psnet.ahrq.gov/node/46333/psn-pdf
June 25, 2018 - High reliability leadership: a conceptual framework.
June 25, 2018
Martínez-Córcoles M. High reliability leadership: A conceptual framework. J Contingencies Crisis Manage.
2017;26(2):237-246. doi:10.1111/1468-5973.12187.
https://psnet.ahrq.gov/issue/high-reliability-leadership-conceptual-framework
Leadership engag…
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psnet.ahrq.gov/node/38573/psn-pdf
April 22, 2009 - Causes, consequences, detection, and prevention of
identification errors in laboratory diagnostics.
April 22, 2009
Lippi G, Blanckaert N, Bonini P, et al. Causes, consequences, detection, and prevention of identification
errors in laboratory diagnostics. Clin Chem Lab Med. 2009;47(2):143-53. doi:10.1515/CCLM.2009.0…
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psnet.ahrq.gov/perspective/conversation-withtroyen-brennan-md-jd-mph
December 21, 2022 - In Conversation with…Troyen A. Brennan, MD, JD, MPH
December 1, 2005
Citation Text:
In Conversation with…Troyen A. Brennan, MD, JD, MPH. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2005.
…
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psnet.ahrq.gov/node/60952/psn-pdf
September 30, 2020 - When the Lytes Go Out: A Case of Inpatient Cardiac
Arrest
September 30, 2020
Stripe B, Zuidema D. When the Lytes Go Out: A Case of Inpatient Cardiac Arrest . PSNet [internet]. 2020.
https://psnet.ahrq.gov/web-mm/when-lytes-go-out-case-inpatient-cardiac-arrest
Disclosure of Relevant Financial Relationships: As a pr…
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psnet.ahrq.gov/node/49787/psn-pdf
March 01, 2017 - Diagnosing a Missed Diagnosis
March 1, 2017
Reilly JB, Webster C. Diagnosing a Missed Diagnosis. PSNet [internet]. 2017.
https://psnet.ahrq.gov/web-mm/diagnosing-missed-diagnosis
The Case
A 57-year old woman was admitted to the hospital with cough, slurred speech, confusion, and
disorientation. She was taking mod…
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psnet.ahrq.gov/node/33768/psn-pdf
June 01, 2014 - In Conversation With… Dave deBronkart
June 1, 2014
In Conversation With… Dave deBronkart. PSNet [internet]. 2014.
https://psnet.ahrq.gov/perspective/conversation-dave-debronkart
Editor's note: A co-founder and co-chair of the Society for Participatory Medicine, Dave deBronkart, also
known as e-Patient Dave, is a …
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psnet.ahrq.gov/node/837607/psn-pdf
June 29, 2022 - Common Formats for Event Reporting - Diagnostic Safety
Version 1.0
June 29, 2022
Agency for Healthcare Research and Quality.
https://psnet.ahrq.gov/issue/common-formats-event-reporting-diagnostic-safety-version-10
Effective measurement of diagnostic error is essential for understanding the problem and genera…
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psnet.ahrq.gov/node/60972/psn-pdf
January 30, 2003 - Unequal Treatment: Confronting Racial and Ethnic
Disparities in Health Care.
January 30, 2003
Smedley BD, Stith AY, Nelson AR, eds and Institute of Medicine. Washington, DC; The National
Academies Press: 2003. ISBN 9780309082655.
https://psnet.ahrq.gov/issue/unequal-treatment-confronting-racial-and-ethnic-dis…
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psnet.ahrq.gov/node/60604/psn-pdf
June 17, 2020 - The limits of current A.I. in health care: patient safety
policing in hospitals.
June 17, 2020
Furrow BR. NE Univ Law Rev. 2020;12(1):1-55.
https://psnet.ahrq.gov/issue/limits-current-ai-health-care-patient-safety-policing-hospitals
Artificial intelligence (AI) has the potential to improve the use of big data to e…
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psnet.ahrq.gov/node/34765/psn-pdf
January 04, 2017 - The Fifth Discipline: The Art & Practice of The Learning
Organization. Revised & Updated Edition.
January 4, 2017
Senge PM. New York, NY: Currency Doubleday; 2009. ISBN: 9780385517256.
https://psnet.ahrq.gov/issue/fifth-discipline-art-practice-learning-organization-revised-updated-edition
Senge’s seminal and oft-r…
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psnet.ahrq.gov/node/41306/psn-pdf
May 04, 2012 - Identifying nontechnical skills associated with safety in
the emergency department: a scoping review of the
literature.
May 4, 2012
Flowerdew L, Brown R, Vincent CA, et al. Identifying nontechnical skills associated with safety in the
emergency department: a scoping review of the literature. Ann Emerg Med. 2012;59…
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psnet.ahrq.gov/node/40105/psn-pdf
December 22, 2010 - Enhancing patient safety in the pediatric emergency
department: teams, communication, and lessons from
crew resource management.
December 22, 2010
Pruitt CM, Liebelt EL. Enhancing patient safety in the pediatric emergency department: teams,
communication, and lessons from crew resource management. Pediatr Emerg Ca…
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psnet.ahrq.gov/node/34646/psn-pdf
July 01, 2015 - The attributes of medical event reporting systems.
July 1, 2015
Battles JB, Kaplan HS, van der Schaaf TW, et al. The attributes of medical event-reporting systems:
experience with a prototype medical event-reporting system for transfusion medicine. Arch Pathol Lab Med.
1998;122(3):231-8.
https://psnet.ahrq.gov/iss…
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psnet.ahrq.gov/node/46427/psn-pdf
April 04, 2018 - Improving Diagnosis in Radiology—Progress and
Proposals.
April 4, 2018
Bruno MA, Johnson K, Argy N, Graber ML, eds. Diagnosis. 2017;4(3):111-191.
https://psnet.ahrq.gov/issue/improving-diagnosis-radiology-progress-and-proposals
Radiology plays a unique role in the determination of a diagnosis. Cognitive and system…
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psnet.ahrq.gov/node/42199/psn-pdf
June 12, 2013 - Contextual information influences diagnosis accuracy
and decision making in simulated emergency medicine
emergencies.
June 12, 2013
McRobert AP, Causer J, Vassiliadis J, et al. Contextual information influences diagnosis accuracy and
decision making in simulated emergency medicine emergencies. BMJ Qual Saf. 2013;2…