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psnet.ahrq.gov/issue/interruptions-emergency-department-work-observational-and-interview-study
September 29, 2021 - Study
Interruptions in emergency department work: an observational and interview study.
Citation Text:
Berg LM, Källberg A-S, Göransson KE, et al. Interruptions in emergency department work: an observational and interview study. BMJ Qual Saf. 2013;22(8):656-63. doi:10.1136/bmjqs-2013-001…
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psnet.ahrq.gov/issue/discrepancies-between-prescribed-and-actual-pediatric-home-parenteral-nutrition-solutions
November 11, 2009 - Study
Discrepancies between prescribed and actual pediatric home parenteral nutrition solutions.
Citation Text:
Raphael BP, Murphy M, Gura KM, et al. Discrepancies Between Prescribed and Actual Pediatric Home Parenteral Nutrition Solutions. Nutr Clin Pract. 2016;31(5):654-658. doi:10.117…
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psnet.ahrq.gov/issue/henry-ford-health-system-no-harm-campaign-comprehensive-model-reduce-harm-and-save-lives
May 11, 2019 - Commentary
The Henry Ford Health System No Harm Campaign: a comprehensive model to reduce harm and save lives.
Citation Text:
Conway WA, Hawkins S, Jordan J, et al. 2011 John M. Eisenberg Patient Safety and Quality Awards. The Henry Ford Health System No Harm Campaign: a comprehensive mo…
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psnet.ahrq.gov/issue/participation-system-thinking-simulation-experience-changes-adverse-event-reporting
July 30, 2014 - Study
Participation in a system-thinking simulation experience changes adverse event reporting.
Citation Text:
Sanko JS, Mckay M. Participation in a system-thinking simulation experience changes adverse event reporting. Simul Healthc. 2020;15(3):167-171. doi:10.1097/sih.0000000000000473.…
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psnet.ahrq.gov/issue/relationship-between-early-emergency-team-calls-and-serious-adverse-events
June 02, 2010 - Study
The relationship between early emergency team calls and serious adverse events.
Citation Text:
Chen J, Bellomo R, Flabouris A, et al. The relationship between early emergency team calls and serious adverse events. Crit Care Med. 2009;37(1):148-53. doi:10.1097/CCM.0b013e3181928ce3…
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psnet.ahrq.gov/issue/clinical-and-financial-implications-second-opinion-surgical-pathology-review
August 04, 2021 - Study
Clinical and financial implications of second-opinion surgical pathology review.
Citation Text:
Johnson SM, Samulski TD, O’Connor SM, et al. Clinical and financial implications of second-opinion surgical pathology review. Am J Clin Pathol. 2021;156(4):559-568. doi:10.1093/ajcp/aqaa…
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psnet.ahrq.gov/issue/incoming-interns-recognize-inadequate-physical-examination-cause-patient-harm
July 20, 2022 - Study
Incoming interns recognize inadequate physical examination as a cause of patient harm.
Citation Text:
Russo S, Berg K, Davis JJ, et al. Incoming interns recognize inadequate physical examination as a cause of patient harm. J Med Educ Curric Dev. 2020;7:238212052092899. doi:10.1177/…
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psnet.ahrq.gov/issue/sustaining-teamwork-behaviors-through-reinforcement-teamstepps-principles
September 02, 2015 - Study
Sustaining teamwork behaviors through reinforcement of TeamSTEPPS principles.
Citation Text:
Lee S-H, Khanuja HS, Blanding RJ, et al. Sustaining Teamwork Behaviors Through Reinforcement of TeamSTEPPS Principles. J Patient Saf. 2021;17(7):e582-e586. doi:10.1097/pts.0000000000000414.…
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psnet.ahrq.gov/issue/beam-me-scotty-impact-personal-wireless-communication-devices-emergency-department
July 17, 2013 - Study
Beam me up Scotty! Impact of personal wireless communication devices in the emergency department.
Citation Text:
Richards JD, Harris T. Beam me up Scotty! Impact of personal wireless communication devices in the emergency department. Emerg Med J. 2011;28(1):29-32. doi:10.1136/emj…
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psnet.ahrq.gov/issue/radonda-vaught-medication-safety-and-profession-pharmacy-steps-improve-safety-and-ensure
May 25, 2022 - Commentary
RaDonda Vaught, medication safety, and the profession of pharmacy: steps to improve safety and ensure justice.
Citation Text:
Lambert BL, Schiff GD. RaDonda Vaught, medication safety, and the profession of pharmacy: steps to improve safety and ensure justice. J Am Coll Clin Ph…
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psnet.ahrq.gov/issue/sepsis-quality-safety-net-hospitals-analysis-medicares-sep-1-performance-measure
May 05, 2021 - Study
Sepsis quality in safety-net hospitals: an analysis of Medicare's SEP-1 performance measure.
Citation Text:
Barbash IJ, Kahn JM. Sepsis quality in safety-net hospitals: An analysis of Medicare's SEP-1 performance measure. J Crit Care. 2019;54:88-93. doi:10.1016/j.jcrc.2019.08.009. …
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psnet.ahrq.gov/issue/root-cause-analysis-swatting-mosquitoes-versus-draining-swamp
January 31, 2024 - Commentary
Root-cause analysis: swatting at mosquitoes versus draining the swamp.
Citation Text:
Trbovich PL, Shojania KG. Root-cause analysis: swatting at mosquitoes versus draining the swamp. BMJ Qual Saf. 2017;26(5):350-353. doi:10.1136/bmjqs-2016-006229.
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psnet.ahrq.gov/issue/evaluating-implementation-rapid-response-team-considering-alternative-outcome-measures
October 19, 2022 - Study
Evaluating implementation of a rapid response team: considering alternative outcome measures.
Citation Text:
Moriarty JP, Schiebel NE, Johnson MG, et al. Evaluating implementation of a rapid response team: considering alternative outcome measures. Int J Qual Health Care. 2014;26(1)…
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psnet.ahrq.gov/issue/was-close-call-endorsing-broad-definition-near-misses-health-care
August 31, 2016 - Commentary
"That was a close call": endorsing a broad definition of near misses in health care.
Citation Text:
Marks CM, Kasda E, Paine LA, et al. "That was a close call": endorsing a broad definition of near misses in health care. Jt Comm J Qual Patient Saf. 2013;39(10):475-479.
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psnet.ahrq.gov/issue/health-care-huddles-managing-complexity-achieve-high-reliability
November 17, 2015 - Study
Health care huddles: managing complexity to achieve high reliability.
Citation Text:
Provost SM, Lanham H, Leykum LK, et al. Health care huddles: managing complexity to achieve high reliability. Health Care Manage Rev. 2015;40(1):2-12. doi:10.1097/HMR.0000000000000009.
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psnet.ahrq.gov/issue/sensemaking-safety-and-cooperative-work-intensive-care-unit
September 29, 2010 - Study
Sensemaking, safety, and cooperative work in the intensive care unit.
Citation Text:
Albolino S, Cook RI, O’Connor M. Sensemaking, safety, and cooperative work in the intensive care unit. Cog Tech Work. 2006;9(3):131-137. doi:10.1007/s10111-006-0057-5.
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psnet.ahrq.gov/issue/investigating-teamwork-operating-room-engaging-stakeholders-and-setting-agenda
January 31, 2018 - Study
Investigating teamwork in the operating room: engaging stakeholders and setting the agenda.
Citation Text:
Frasier LL, Quamme SRP, Becker A, et al. Investigating Teamwork in the Operating Room: Engaging Stakeholders and Setting the Agenda. JAMA Surg. 2017;152(1):109-111. doi:10.100…
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psnet.ahrq.gov/issue/call-action-addressing-pediatric-fall-safety-ambulatory-environments
June 30, 2021 - Study
Call to action: addressing pediatric fall safety in ambulatory environments.
Citation Text:
Benning S, Wolfe R, Banes M, et al. Call to action: addressing pediatric fall safety in ambulatory environments. J Pediatr Nurs. 2021;61:372-377. doi:10.1016/j.pedn.2021.09.012.
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psnet.ahrq.gov/issue/interprofessional-care-intensive-care-settings-and-factors-impact-it-results-scoping-review
August 15, 2018 - Review
Interprofessional care in intensive care settings and the factors that impact it: results from a scoping review of ethnographic studies.
Citation Text:
Paradis E, Leslie M, Gropper MA, et al. Interprofessional care in intensive care settings and the factors that impact it: resul…
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psnet.ahrq.gov/issue/room-horrors-simulation-healthcare-education-systematic-review
September 09, 2020 - Review
Room of horrors simulation in healthcare education: a systematic review.
Citation Text:
Lee SE, Repsha C, Seo WJ, et al. Room of horrors simulation in healthcare education: a systematic review. Nurse Educ Today. 2023;126:105824. doi:10.1016/j.nedt.2023.105824.
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