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Preventable morbidity and mortality among non-trauma emergency surgery patients: the role of personal performance and system flaws in adverse events. | PSNet

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January 26, 2022 - Study Preventable morbidity and mortality among non-trauma emergency surgery patients: the role of personal performance and system flaws in adverse events. Citation Text: Velmahos CS, Kokoroskos N, Tarabanis C, et al. Preventable morbidity and mortality among non-trauma emergency surgery…

Medical malpractice lawsuits involving surgical residents. | PSNet

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August 20, 2018 - Study Medical malpractice lawsuits involving surgical residents. Citation Text: Thiels CA, Choudhry AJ, Ray-Zack MD, et al. Medical Malpractice Lawsuits Involving Surgical Residents. JAMA Surg. 2017;153(1). doi:10.1001/jamasurg.2017.2979. Copy Citation Format: DOI Google Sc…

Am I safe? An interpretative phenomenological analysis of vulnerability as experienced by patients with complications following surgery. | PSNet

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July 10, 2024 - Study Am I safe? An interpretative phenomenological analysis of vulnerability as experienced by patients with complications following surgery. Citation Text: Sutton E, Booth L, Ibrahim M, et al. Am I safe? An interpretative phenomenological analysis of vulnerability as experienced by pat…

Surgical safety does not happen by accident: learning from perioperative near miss case studies. | PSNet

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August 04, 2021 - Commentary Surgical safety does not happen by accident: learning from perioperative near miss case studies. Citation Text: Stucky CH, Michael Hartmann J, Yauger YJ, et al. Surgical safety does not happen by accident: learning from perioperative near miss case studies. J Perianesth Nurs. …

Patient handoffs: standardized and reliable measurement tools remain elusive. | PSNet

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July 13, 2010 - Review Patient handoffs: standardized and reliable measurement tools remain elusive. Citation Text: Patterson ES, Wears RL. Patient handoffs: standardized and reliable measurement tools remain elusive. Jt Comm J Qual Patient Saf. 2010;36(2):52-61. Copy Citation Format: Goog…

Animated stories of medical error as a means of teaching undergraduates patient safety: an evaluation study. | PSNet

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June 10, 2020 - Study Animated stories of medical error as a means of teaching undergraduates patient safety: an evaluation study. Citation Text: Cooper K, Hatfield E, Yeomans J. Animated stories of medical error as a means of teaching undergraduates patient safety: an evaluation study. Perspect Med Edu…

Using proactive risk assessment (HFMEA) to improve patient safety and quality associated with intraocular lens selection and implantation in cataract surgery. | PSNet

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September 19, 2016 - Study Using proactive risk assessment (HFMEA) to improve patient safety and quality associated with intraocular lens selection and implantation in cataract surgery. Citation Text: DeRosier JM, Hansemann BK, Smith-Wheelock MW, et al. Using Proactive Risk Assessment (HFMEA) to Improve Pati…

Organizational learning starting points and presuppositions: a case study from a hospital’s surgical department. | PSNet

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September 25, 2024 - Study Organizational learning starting points and presuppositions: a case study from a hospital’s surgical department. Citation Text: Jaakkola M, Lemmetty S, Collin K, et al. Organizational learning starting points and presuppositions: a case study from a hospital’s surgical department. …

Association between physician depressive symptoms and medical errors: A systematic review and meta-analysis | PSNet

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January 12, 2022 - Review Emerging Classic Association between physician depressive symptoms and medical errors: A systematic review and meta-analysis Citation Text: Pereira-Lima K, Mata DA, Loureiro SR, et al. Association Between Physician Depressive Symptoms and Medical Errors: …

A report card system using error profile analysis and concurrent morbidity and mortality review: surgical outcome analysis, part II. | PSNet

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June 18, 2008 - Study A report card system using error profile analysis and concurrent morbidity and mortality review: surgical outcome analysis, part II. Citation Text: Antonacci AC, Lam S, Lavarias V, et al. A report card system using error profile analysis and concurrent morbidity and mortality rev…

Persisting high rates of omissions during anesthesia induction are decreased by utilization of a pre- & post-induction checklist. | PSNet

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July 20, 2022 - Study Persisting high rates of omissions during anesthesia induction are decreased by utilization of a pre- & post-induction checklist. Citation Text: Krombach JW, Zürcher C, Simon SG, et al. Persisting high rates of omissions during anesthesia induction are decreased by utilization of a…

Verifying patient identity and site of surgery: improving compliance with protocol by audit and feedback. | PSNet

psnet.ahrq.gov/issue/verifying-patient-identity-and-site-surgery-improving-compliance-protocol-audit-and-feedback

October 26, 2010 - Study Verifying patient identity and site of surgery: improving compliance with protocol by audit and feedback. Citation Text: Garnerin P, Arès M, Huchet A, et al. Verifying patient identity and site of surgery: improving compliance with protocol by audit and feedback. Qual Saf Health …

Learning through simulated independent practice leads to better future performance in a simulated crisis than learning through simulated supervised practice. | PSNet

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June 14, 2019 - Study Learning through simulated independent practice leads to better future performance in a simulated crisis than learning through simulated supervised practice. Citation Text: Goldberg A, Silverman E, Samuelson S, et al. Learning through simulated independent practice leads to better …

Finding and fixing mistakes: do checklists work for clinicians with different levels of experience? | PSNet

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February 06, 2014 - Study Finding and fixing mistakes: do checklists work for clinicians with different levels of experience? Citation Text: Sibbald M, de Bruin A, van Merrienboer JJG. Finding and fixing mistakes: do checklists work for clinicians with different levels of experience? Adv Health Sci Educ T…

Communication of vital signs at emergency department handoff: opportunities for improvement. | PSNet

psnet.ahrq.gov/issue/communication-vital-signs-emergency-department-handoff-opportunities-improvement

May 16, 2012 - Study Communication of vital signs at emergency department handoff: opportunities for improvement. Citation Text: Venkatesh AK, Curley D, Chang Y, et al. Communication of Vital Signs at Emergency Department Handoff: Opportunities for Improvement. Ann Emerg Med. 2015;66(2):125-30. doi:10.…

Medical error: using storytelling and reflection to impact error response factors in family medicine residents. | PSNet

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June 05, 2019 - Study Medical error: using storytelling and reflection to impact error response factors in family medicine residents. Citation Text: Adkins S, Alta’any R, Brar K, et al. Medical error: using storytelling and reflection to impact error response factors in family medicine residents. J Med …

Preoperative site marking: are we adhering to good surgical practice? | PSNet

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August 02, 2017 - Study Preoperative site marking: are we adhering to good surgical practice? Citation Text: Bathla S, Chadwick M, Nevins EJ, et al. Preoperative Site Marking. J Patient Saf. 2021;17(6):e503-e508. doi:10.1097/pts.0000000000000398. Copy Citation Format: DOI Google Scholar BibT…

Debunking the myth that the majority of medical errors are attributed to communication. | PSNet

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February 14, 2024 - Journal Article Debunking the myth that the majority of medical errors are attributed to communication. Citation Text: Clapper TC, Ching K. Debunking the myth that the majority of medical errors are attributed to communication. Med Educ. 2020;54(1):74-81. doi:10.1111/medu.13821. Copy C…

Blood bank specimen mislabeling: a College of American Pathologists Q-Probes study of 41,333 blood bank specimens in 30 institutions. | PSNet

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November 16, 2022 - Study Blood bank specimen mislabeling: a College of American Pathologists Q-Probes study of 41,333 blood bank specimens in 30 institutions. Citation Text: Novis DA, Lindholm PF, Ramsey G, et al. Blood Bank Specimen Mislabeling: A College of American Pathologists Q-Probes Study of 41 333 …

Resident participation does not affect surgical outcomes, despite introduction of new techniques. | PSNet

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September 23, 2020 - Study Resident participation does not affect surgical outcomes, despite introduction of new techniques. Citation Text: Patel SP, Gauger PG, Brown DL, et al. Resident participation does not affect surgical outcomes, despite introduction of new techniques. J Am Coll Surg. 2010;211(4):540…

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