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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/60234/psn-pdf
    April 15, 2020 - Mistakes, Errors and Failures across Cultures. April 15, 2020 Vanderheiden E, Mayer C, eds. Springer Nature. Cham, Switzerland: 2020. ISBN 9783030355739 https://psnet.ahrq.gov/issue/mistakes-errors-and-failures-across-cultures-navigating-potentials Human error, mistakes and failure have cultural aspects that are im…
  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/37722/psn-pdf
    February 18, 2011 - Leveraging computerized sign-out to increase error reporting and addressing patient safety in graduate medical education. February 18, 2011 Foster PN, Sidhu R, Gadhia DA, et al. Leveraging computerized sign-out to increase error reporting and addressing patient safety in graduate medical education. J Gen Intern Me…
  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44893/psn-pdf
    March 09, 2016 - Improving the governance of patient safety in emergency care: a systematic review of interventions. March 9, 2016 Hesselink G, Berben S, Beune T, et al. Improving the governance of patient safety in emergency care: a systematic review of interventions. BMJ Open. 2016;6(1):e009837. doi:10.1136/bmjopen-2015-009837. …
  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/44785/psn-pdf
    January 27, 2016 - Reducing Adverse Drug Events Related to Opioids Implementation Guide. January 27, 2016 Frederickson TW. Gordon DB, De Pinto M, et al. Philadelphia, PA: Society of Hospital Medicine; 2015. https://psnet.ahrq.gov/issue/reducing-adverse-drug-events-related-opioids-implementation-guide Opioids are high-risk medication…
  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/845276/psn-pdf
    March 01, 2023 - Cognitive biases in surgery: systematic review. March 1, 2023 Armstrong BA, Dutescu IA, Tung A, et al. Cognitive biases in surgery: systematic review. Br J Surg. 2023;110(6):645-654. doi:10.1093/bjs/znad004. https://psnet.ahrq.gov/issue/cognitive-biases-surgery-systematic-review Cognitive biases are a known source…
  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41434/psn-pdf
    June 06, 2012 - ASHP national survey of pharmacy practice in hospital settings: prescribing and transcribing—2010. June 6, 2012 Pedersen CA, Schneider PJ, Scheckelhoff DJ. ASHP national survey of pharmacy practice in hospital settings: prescribing and transcribing--2010. Am J Health Syst Pharm. 2011;68(8):669-88. doi:10.2146/ajhp…
  8. 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…
  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45369/psn-pdf
    October 29, 2017 - The aging physician and the medical profession: a review. October 29, 2017 Dellinger P, Pellegrini CA, Gallagher TH. The Aging Physician and the Medical Profession: A Review. JAMA Surg. 2017;152(10):967-971. doi:10.1001/jamasurg.2017.2342. https://psnet.ahrq.gov/issue/aging-physician-and-medical-profession-review …
  10. 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…
  11. 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…
  12. 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…
  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/38735/psn-pdf
    June 24, 2009 - Reflection and analysis of how pharmacy students learn to communicate about medication errors. June 24, 2009 Noland CM, Rickles NM. Reflection and analysis of how pharmacy students learn to communicate about medication errors. Health Commun. 2009;24(4):351-60. doi:10.1080/10410230902889399. https://psnet.ahrq.gov/…
  14. 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…
  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/38830/psn-pdf
    February 18, 2011 - Are opioid dependence and methadone maintenance treatment (MMT) documented in the medical record? A patient safety issue. February 18, 2011 Walley AY, Farrar D, Cheng DM, et al. Are opioid dependence and methadone maintenance treatment (MMT) documented in the medical record? A patient safety issue. J Gen Intern Me…
  16. 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…
  17. 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…
  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/73100/psn-pdf
    March 31, 2021 - Public comment period extended for strategies to improve patient safety: Draft Report to Congress for Public Comment and Review by the National Academy of Medicine. March 31, 2021 Fed Register. 2021;86(51):14752-14753. https://psnet.ahrq.gov/issue/public-comment-period-extended-strategies-improve-patient-safety-d…
  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44065/psn-pdf
    July 16, 2015 - Nurses' use of computerized clinical guidelines to improve patient safety in hospitals. July 16, 2015 Hovde B, Jensen KH, Alexander GL, et al. Nurses' Use of Computerized Clinical Guidelines to Improve Patient Safety in Hospitals. West J Nurs Res. 2015;37(7):877-98. doi:10.1177/0193945915577430. https://psnet.ahrq…
  20. 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…