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psnet.ahrq.gov/perspective/patient-safety-office-based-care-settings
January 31, 2024 - They found that such deviations were common, occurring in 70% of reviewed cases.
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psnet.ahrq.gov/web-mm/antibiotics-urisinusitis-simple-decision-gone-bad
January 01, 2014 - are among the most common presenting complaints to primary care physicians, with 83.1 million visits occurring
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psnet.ahrq.gov/node/74713/psn-pdf
January 26, 2022 - or used on patients” and relevant financial
relationships as “financial relationships in any amount occurring
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psnet.ahrq.gov/node/49852/psn-pdf
February 01, 2019 - Medicare patients admitted to the hospital undergo interhospital transfer (1), with
greater frequency occurring
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psnet.ahrq.gov/web-mm/elopement
July 14, 2010 - Wandering —defined as occurring when patients aimlessly move about within the building or grounds without
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psnet.ahrq.gov/perspective/conversation-enrico-coiera-mb-bs-phd
February 01, 2014 - people to interrupt because the last thing anybody wants to do is to prevent crucial communication from occurring … when administering medications, one can wear a bright color vest that says, "Medicine Administration Occurring
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psnet.ahrq.gov/perspective/patient-safety-and-health-information-technology-learning-our-mistakes
July 01, 2012 - RW : Do you see a transformation in vendor-built systems occurring on the horizon? … read the literature 5 years ago, you would have found that there was more good than harm but it was occurring
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psnet.ahrq.gov/perspective/conversation-david-blumenthal-md-mpp
July 01, 2012 - RW : Do you see a transformation in vendor-built systems occurring on the horizon? … read the literature 5 years ago, you would have found that there was more good than harm but it was occurring
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psnet.ahrq.gov/node/39389/psn-pdf
January 03, 2017 - Shaping systems for better behavioral choices: lessons
learned from a fatal medication error.
January 3, 2017
Smetzer JL, Baker C, Byrne FD, et al. Shaping systems for better behavioral choices: lessons learned from
a fatal medication error. Jt Comm J Qual Patient Saf. 2010;36(4):152-163.
https://psnet.ahrq.gov/is…
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psnet.ahrq.gov/issue/press-play-safety-conversations
August 24, 2022 - Multi-use Website
Press Play on Safety Conversations.
Citation Text:
Press Play on Safety Conversations. Healthcare Excellence Canada. 2022.
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psnet.ahrq.gov/issue/collaborative-accountability-and-improvement
August 14, 2018 - Multi-use Website
Collaborative for Accountability and Improvement.
Citation Text:
Collaborative for Accountability and Improvement. University of Washington.
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psnet.ahrq.gov/issue/patient-safety-18
June 26, 2013 - Special or Theme Issue
Patient Safety.
Citation Text:
Patient Safety. Halamek LP, ed. Semin Perinatol. 2019;43(8):151172-151182.
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psnet.ahrq.gov/issue/fires-during-surgeries-bigger-risk-thought
August 24, 2016 - Newspaper/Magazine Article
Fires during surgeries a bigger risk than thought.
Citation Text:
Fires during surgeries a bigger risk than thought. Kowalczyk L. Boston Globe. November 7, 2007
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psnet.ahrq.gov/issue/contributions-ergonomics-and-human-factors
January 28, 2015 - Special or Theme Issue
Contributions from Ergonomics and Human Factors.
Citation Text:
Contributions from Ergonomics and Human Factors. Qual Saf Health Care. 2010;19(suppl 3):i1-i79.
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psnet.ahrq.gov/issue/misdiagnosis-more-common-drug-errors-or-wrong-site-surgery
March 13, 2013 - Newspaper/Magazine Article
Misdiagnosis is more common than drug errors or wrong-site surgery.
Citation Text:
Misdiagnosis is more common than drug errors or wrong-site surgery. Boodman SG. Washington Post. May 6, 2013.
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psnet.ahrq.gov/issue/when-surgeon-should-just-say-im-sorry
February 05, 2014 - Newspaper/Magazine Article
When a surgeon should just say 'I'm sorry'.
Citation Text:
When a surgeon should just say 'I'm sorry'. Cohen E. CNN. March 24, 2016.
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psnet.ahrq.gov/node/49650/psn-pdf
March 01, 2012 - The most recent analysis described 46
deaths and 263 procedure-related complications occurring from … references
https://psnet.ahrq.gov//#references
Quality improvement strategies to prevent these events from occurring
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psnet.ahrq.gov/node/49830/psn-pdf
May 01, 2018 - In a recent study of adverse events occurring on
mental health units in the Veterans Health Administration … Adverse events occurring on VHA mental health units. Gen
Hosp Psychiatry. 2018;50:63-68.
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psnet.ahrq.gov/node/33687/psn-pdf
August 01, 2009 - downside of first-order problem solving is lack of
communication, which hinders real improvement from occurring … Even this meager form of second-order problem solving was rare,
occurring in only 7% of the situations
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psnet.ahrq.gov/web-mm/right-patient-wrong-sample
June 01, 2004 - The Commentary
Background Errors in laboratory services encompass a number of problems occurring outside … often attribute to errors inside the laboratory, are actually the result of preanalytic problems occurring … Specific Errors in This Case The particular error in this case is a mislabeling error occurring outside