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  1. www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-current-state-apb.html
    January 01, 2024 - Current State of Diagnostic Safety: Implications for Research, Practice, and Policy Appendix B. External Experts for Qualitative Interviews Previous Page Next Page Table of Contents Current State of Diagnostic Safety: Implications for Research, Practice, and Policy 1. Introduction 2. Methods 3…
  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46263/psn-pdf
    July 12, 2017 - The texting debate: beneficial means of communication or safety and security risk? July 12, 2017 ISMP Medication Safety Alert! Acute Care Edition. June 29, 2017;16:1-5. https://psnet.ahrq.gov/issue/texting-debate-beneficial-means-communication-or-safety-and-security-risk Adopting new technologies in health care ca…
  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/855099/psn-pdf
    November 08, 2023 - Doctors wrestle with A.I. in patient care, citing lax oversight. November 8, 2023 Jewett C. New York Times. October 30, 2023 https://psnet.ahrq.gov/issue/doctors-wrestle-ai-patient-care-citing-lax-oversight US Food and Drug Administration regulation and review is noted as having gaps in process that can affect pa…
  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46440/psn-pdf
    September 20, 2017 - Why do people stop taking their meds? Cost is just one reason. September 20, 2017 Hobson K. Health Shots. National Public Radio. September 8, 2017. https://psnet.ahrq.gov/issue/why-do-people-stop-taking-their-meds-cost-just-one-reason Medication regimen nonadherence can result in patient harm. This news article re…
  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43485/psn-pdf
    December 15, 2014 - Implementation of an emergency department sign-out checklist improves transfer of information at shift change. December 15, 2014 Dubosh NM, Carney D, Fisher J, et al. Implementation of an emergency department sign-out checklist improves transfer of information at shift change. J Emerg Med. 2014;47(5):580-5. doi:10…
  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44123/psn-pdf
    July 11, 2018 - The 2014 John M. Eisenberg Patient Safety and Quality Awards. July 11, 2018 Jt Comm J Qual Patient Saf. 2015;41(5):195-211. https://psnet.ahrq.gov/issue/2014-john-m-eisenberg-patient-safety-and-quality-awards Articles in this special issue highlight the achievements of the 2014 John M. Eisenberg Patient Safety and…
  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42117/psn-pdf
    March 20, 2013 - Nurse–patient ratios as a patient safety strategy: a systematic review. March 20, 2013 Shekelle PG. Nurse-patient ratios as a patient safety strategy: a systematic review. Ann Intern Med. 2013;158(5 Pt 2):404-409. doi:10.7326/0003-4819-158-5-201303051-00007. https://psnet.ahrq.gov/issue/nurse-patient-ratios-patien…
  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/38143/psn-pdf
    February 18, 2011 - A multidisciplinary teamwork training program: The Triad for Optimal Patient Safety (TOPS) experience. February 18, 2011 Sehgal NL, Fox M, Vidyarthi A, et al. A multidisciplinary teamwork training program: the Triad for Optimal Patient Safety (TOPS) experience. J Gen Intern Med. 2008;23(12):2053-7. doi:10.1007/s116…
  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42308/psn-pdf
    June 10, 2013 - Little shop of errors: an innovative simulation patient safety workshop for community health care professionals. June 10, 2013 Tupper JB, Pearson KB, Meinersmann KM, et al. Little shop of errors: an innovative simulation patient safety workshop for community health care professionals. J Contin Educ Nurs. 2013;44(6…
  10. www.ahrq.gov/es/patient-safety/settings/hospital/red/toolkit/ahcp-components.html
    March 01, 2013 - Re-Engineered Discharge (RED) Toolkit Tool 3 Continued Previous Page Next Page Table of Contents Re-Engineered Discharge (RED) Toolkit Tool 1: Overview Tool 2: How To Begin the Re-engineered Discharge Implementation at Your Hospital How CMS Measures the "30-Day All Cause Rehospitalization Rate…
  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/60034/psn-pdf
    March 11, 2020 - Responding to unprofessional behavior by trainees - a "just culture" framework. March 11, 2020 Wasserman JA, Redinger M, Gibb T. Responding to Unprofessional Behavior by Trainees — A “Just Culture” Framework. New England Journal of Medicine. 2020;382(8). doi:10.1056/nejmms1912591. https://psnet.ahrq.gov/issue/resp…
  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44667/psn-pdf
    March 15, 2016 - Incorporating metacognition into morbidity and mortality rounds: the next frontier in quality improvement. March 15, 2016 Katz D, Detsky AS. Incorporating metacognition into morbidity and mortality rounds: The next frontier in quality improvement. J Hosp Med. 2016;11(2):120-2. doi:10.1002/jhm.2505. https://psnet.a…
  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/837075/psn-pdf
    May 11, 2022 - Lessons Learned from the COVID-19 Pandemic to Improve Diagnosis. Proceedings of a Workshop–in Brief. May 11, 2022 National Academies of Sciences, Engineering, and Medicine. Washington, DC: The National Academies Press; 2022. https://psnet.ahrq.gov/issue/lessons-learned-covid-19-pandemic-improve-diagnosis-proceedin…
  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46611/psn-pdf
    January 01, 2021 - Sustaining teamwork behaviors through reinforcement of TeamSTEPPS principles. November 15, 2017 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. https://psnet.ahrq.gov/issue/…
  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/60265/psn-pdf
    January 01, 2019 - Quality Improvement and Patient Safety Competencies Across the Learning Continuum. January 1, 2019 AAMC New and Emerging Areas in Medicine Series. Washington, DC: Association of American Medical Colleges; 2019. ISBN: 9781577541882. https://psnet.ahrq.gov/issue/quality-improvement-and-patient-safety-competencies-ac…
  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/73407/psn-pdf
    June 16, 2021 - Common Formats for Patient Safety Data Collection: Diagnostic Safety 0.1. June 16, 2021 The Agency for Healthcare Research and Quality. Fed Register. 2021;86(103): 29263-29264. https://psnet.ahrq.gov/issue/common-formats-patient-safety-data-collection-diagnostic-safety-01 Measurement of diagnostic errors is an imp…
  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41533/psn-pdf
    July 18, 2012 - "Out of sight, out of mind": housestaff perceptions of quality-limiting factors in discharge care at teaching hospitals. July 18, 2012 Greysen R, Schiliro D, Horwitz LI, et al. "Out of sight, out of mind": housestaff perceptions of quality-limiting factors in discharge care at teaching hospitals. J Hosp Med. 2012;…
  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45982/psn-pdf
    August 03, 2017 - Workplace factors associated with burnout of family physicians. August 3, 2017 Rassolian M, Peterson LE, Fang B, et al. Workplace Factors Associated With Burnout of Family Physicians. JAMA Intern Med. 2017;177(7):1036-1038. doi:10.1001/jamainternmed.2017.1391. https://psnet.ahrq.gov/issue/workplace-factors-associa…
  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/61123/psn-pdf
    November 11, 2020 - Organizational Evidence-Based and Promising Practices for Improving Clinician Well-Being. November 11, 2020 Sinsky CA, Biddison LD, Mallick A, et al. NAM Perspectives. Washington DC: National Academy of Medicine; 2020. https://psnet.ahrq.gov/issue/organizational-evidence-based-and-promising-practices-improvin…
  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42610/psn-pdf
    November 18, 2013 - Teaching about how doctors think: a longitudinal curriculum in cognitive bias and diagnostic error for residents. November 18, 2013 Reilly JB, Ogdie AR, Von Feldt JM, et al. Teaching about how doctors think: a longitudinal curriculum in cognitive bias and diagnostic error for residents. BMJ Qual Saf. 2013;22(12):1…