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3041. Elopement | PSNet
      psnet.ahrq.gov/web-mm/elopement
      July 14, 2010 - SPOTLIGHT CASE Elopement Citation Text: Gerardi D. Elopement. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2007. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMe…

3042. Transfusion Overload | PSNet
      psnet.ahrq.gov/web-mm/transfusion-overload
      September 23, 2020 - SPOTLIGHT CASE Transfusion Overload Citation Text: Patel MS, Carson JL. Transfusion Overload. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2012. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML En…

3043. Methicillin-Resistant Staphylococcus aureus | PSNet
      psnet.ahrq.gov/perspective/methicillin-resistant-staphylococcus-aureus
      June 24, 2010 - We must involve patients (and their families) in this process so doctors and nurses expect to be challenged

3044. Health Care Data Science for Quality Improvement and Patient Safety | PSNet
      psnet.ahrq.gov/perspective/health-care-data-science-quality-improvement-and-patient-safety
      October 01, 2016 - A data analyst who is not comfortable seeking out nurses, pharmacists, or laboratory technicians would

3045. In Conversation with...Patrick S. Romano, MD, MPH | PSNet
      psnet.ahrq.gov/perspective/conversation-withpatrick-s-romano-md-mph
      July 10, 2024 - outcomes data to improve the quality and effectiveness of health care; and the role of physicians, nurses … Clearly, all of us who work on the front lines as physicians, nurses, and hospital employees recognize

3046. COVID-19: Team and Human Factors to Improve Safety | PSNet
      psnet.ahrq.gov/primer/covid-19-team-and-human-factors-improve-safety
      September 15, 2024 - self-reported quality of patient care and adverse events during COVID-19: a cross-sectional online survey among nurses

3047. 5 pandemic mistakes we keep repeating. We can learn from our failures. | PSNet
      psnet.ahrq.gov/issue/5-pandemic-mistakes-we-keep-repeating-we-can-learn-our-failures
      March 10, 2021 - Newspaper/Magazine Article 5 pandemic mistakes we keep repeating. We can learn from our failures. Citation Text: 5 pandemic mistakes we keep repeating. We can learn from our failures. Zeynep Tufekci. The Atlantic. February 26, 2021 Copy Citation Save Save to you…

3048. Roadmap to Health Care Safety for Massachusetts. | PSNet
      psnet.ahrq.gov/issue/roadmap-health-care-safety-massachusetts
      June 15, 2016 - Book/Report Roadmap to Health Care Safety for Massachusetts. Citation Text: Roadmap to Health Care Safety for Massachusetts. Massachusetts Healthcare Safety and Quality Consortium. Boston, MA: Betsy Lehman Center for Patient Safety; April 2023. Copy Citation Save …

3049. Preventable Hospitalizations: A Window Into Primary and Preventive Care, 2000. | PSNet
      psnet.ahrq.gov/issue/preventable-hospitalizations-window-primary-and-preventive-care-2000
      October 06, 2016 - Government Resource Preventable Hospitalizations: A Window Into Primary and Preventive Care, 2000. Citation Text: Preventable Hospitalizations: A Window Into Primary and Preventive Care, 2000. Kruzikas DT, Jiang HJ, Remus D, et al for Agency for Healthcare Research and Quality; Rockv…

3050. Toolkit to Engage High-Risk Patients in Safe Transitions Across Ambulatory Settings. | PSNet
      psnet.ahrq.gov/issue/toolkit-engage-high-risk-patients-safe-transitions-across-ambulatory-settings
      March 11, 2017 - Toolkit Toolkit to Engage High-Risk Patients in Safe Transitions Across Ambulatory Settings. Citation Text: Toolkit to Engage High-Risk Patients in Safe Transitions Across Ambulatory Settings. Davis K, Collier S, Situ J, et al. Rockville, MD: Agency for Healthcare Research and Quality; D…

3051. Errors in a stat laboratory: changes in type and frequency since 1996. | PSNet
      psnet.ahrq.gov/issue/errors-stat-laboratory-changes-type-and-frequency-1996
      December 21, 2016 - Study Errors in a stat laboratory: changes in type and frequency since 1996. Citation Text: Carraro P, Plebani M. Errors in a stat laboratory: types and frequencies 10 years later. Clin Chem. 2007;53(7):1338-42. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X…

3052. Patient Options for Safe and Effective Disposal of Unused Opioids. | PSNet
      psnet.ahrq.gov/issue/patient-options-safe-and-effective-disposal-unused-opioids
      March 06, 2019 - Book/Report Patient Options for Safe and Effective Disposal of Unused Opioids. Citation Text: Patient Options for Safe and Effective Disposal of Unused Opioids. Washington, DC: United States Government Accountability Office; September 2019. Publication GAO-19-650. Copy Citation …

3053. Digital Clinical Safety Strategy | PSNet
      psnet.ahrq.gov/issue/digital-clinical-safety-strategy
      March 01, 2023 - Book/Report Digital Clinical Safety Strategy Citation Text: Digital Clinical Safety Strategy NHSX, NHS Digital, NHS England, et al. London, England: Crown Copyright; September 2021. Copy Citation Save Save to your library Print Download PDF Sha…

3054. High-risk, high-alert medication management practices in a regional state psychiatric facility. | PSNet
      psnet.ahrq.gov/issue/high-risk-high-alert-medication-management-practices-regional-state-psychiatric-facility
      January 06, 2017 - Study High-risk, high-alert medication management practices in a regional state psychiatric facility. Citation Text: McKee J, Cleary S. High-Risk, High-Alert Medication Management Practices in a Regional State Psychiatric Facility. Hosp Pharm. 2007;42(4):323-330. doi:10.1310/hpj4204-323.…

3055. Talking with Patients and Families about Medical Error: A Guide for Education and Practice. | PSNet
      psnet.ahrq.gov/issue/talking-patients-and-families-about-medical-error-guide-education-and-practice
      July 24, 2019 - Book/Report Talking with Patients and Families about Medical Error: A Guide for Education and Practice. Citation Text: Talking with Patients and Families about Medical Error: A Guide for Education and Practice. Truog RD, Browning DM, Johnson JA, Gallagher TH. Baltimore, MD: Johns Hopkins…

3056. Staff warned about the lack of psychiatric care at a VA clinic. They couldn’t prevent tragedy. | PSNet
      psnet.ahrq.gov/issue/staff-warned-about-lack-psychiatric-care-va-clinic-they-couldnt-prevent-tragedy
      December 12, 2018 - Newspaper/Magazine Article Staff warned about the lack of psychiatric care at a VA clinic. They couldn’t prevent tragedy. Citation Text: Staff warned about the lack of psychiatric care at a VA clinic. They couldn’t prevent tragedy. McGrory K, Bedi N. ProPublica, January 6, 2024. Copy…

3057. Communication factors in the follow-up of abnormal mammograms. | PSNet
      psnet.ahrq.gov/issue/communication-factors-follow-abnormal-mammograms
      March 02, 2011 - Study Communication factors in the follow-up of abnormal mammograms. Citation Text: Poon EG, Haas JS, Puopolo AL, et al. Communication factors in the follow-up of abnormal mammograms. J Gen Intern Care. 2004;19(4):316-323. doi:10.1111/j.1525-1497.2004.30357.x. Copy Citation Forma…

3058. Adverse Events in Hospitals: Public Disclosure of Information About Events. | PSNet
      psnet.ahrq.gov/issue/adverse-events-hospitals-public-disclosure-information-about-events
      August 01, 2012 - Book/Report Adverse Events in Hospitals: Public Disclosure of Information About Events. Citation Text: Adverse Events in Hospitals: Public Disclosure of Information About Events. Wright S. Washington, DC: US Department of Health and Human Services, Office of the Inspector General; Ja…

3059. Report of the Mid Staffordshire NHS Foundation Trust: Public Inquiry. | PSNet
      psnet.ahrq.gov/issue/report-mid-staffordshire-nhs-foundation-trust-public-inquiry
      November 06, 2015 - Book/Report Report of the Mid Staffordshire NHS Foundation Trust: Public Inquiry. Citation Text: Report of the Mid Staffordshire NHS Foundation Trust: Public Inquiry. Francis R. London, UK: The Stationary Office; 2013. ISBN: 9780102981469.   Copy Citation Sav…

3060. Human Factors In Healthcare. | PSNet
      psnet.ahrq.gov/issue/human-factors-healthcare
      May 01, 2013 - Special or Theme Issue Human Factors In Healthcare. Citation Text: Human Factors In Healthcare. Keebler JR, Salas E, Rosen MA, et al. eds. Hum Factors. 2022;64(1):5-258. Copy Citation Save Save to your library Print Download PDF Share Faceb…