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Total Results: 6,859 records

Showing results for "operational".

  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49628/psn-pdf
    June 01, 2011 - Routine Goes Awry June 1, 2011 Huoh KC, Rosbe KW. Routine Goes Awry. PSNet [internet]. 2011. https://psnet.ahrq.gov/web-mm/routine-goes-awry The Case A 6-year-old girl with a history of asthma and chronic adenotonsillitis was referred to a surgeon and scheduled for a tonsillectomy and adenoidectomy. She was in ot…

  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/60653/psn-pdf
    April 25, 2020 - Health Care Delivery and Pharmacists During the COVID- 19 Pandemic June 29, 2020 Dopp AL, Fitall E, Hall KK, et al. Health Care Delivery and Pharmacists During the COVID-19 Pandemic. PSNet [internet]. 2020. https://psnet.ahrq.gov/perspective/health-care-delivery-and-pharmacists-during-covid-19-pandemic Medication…

  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/612828/psn-pdf
    February 23, 2022 - Delayed Diagnosis of Kidney Transplant Complications February 23, 2022 Kapa N, Morfín JA. Delayed Diagnosis of Kidney Transplant Complications. PSNet [internet]. 2022. https://psnet.ahrq.gov/web-mm/delayed-diagnosis-kidney-transplant-complications Objectives Recognition, early evaluation, and management of kidney …

  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49644/psn-pdf
    December 01, 2011 - Missing the Point—Eye Injury December 1, 2011 Sharma R, Brunette DD. Missing the Point—Eye Injury. PSNet [internet]. 2011. https://psnet.ahrq.gov/web-mm/missing-point-eye-injury The Case A 31-year-old woman presented to the emergency department (ED) after suffering multiple lacerations during an assault. The pati…

  5. Curated Article Libraries | PSNet

    psnet.ahrq.gov/curated-article-libraries
    March 18, 2025 - Curated Libraries Curated Libraries are groupings of PSNet content, curated by AHRQ and by other experts in the patient safety field. Watch the video to learn more about how this new feature works and how it can be of benefit to you. Latest PSNet…

  6. Organizational Change in the Face of Highly Public Errors—I. The Dana-Farber Cancer Institute Experience | PSNet

    psnet.ahrq.gov/perspective/organizational-change-face-highly-public-errors-i-dana-farber-cancer-institute
    December 23, 2020 - Organizational Change in the Face of Highly Public Errors—I. The Dana-Farber Cancer Institute Experience James B. Conway; Saul N. Weingart, MD, PhD | May 1, 2005  View more articles from the same authors. Citation Text: Conway JB, Weingart SN. Organizational Change…

  7. Emergence of Application-based Healthcare | PSNet

    psnet.ahrq.gov/perspective/emergence-application-based-healthcare
    August 05, 2022 - Emergence of Application-based Healthcare August 5, 2022  Also Read the Conversation View more articles from the same authors. Citation Text: Marvel FA, Dowell P, Mossburg SE. Emergence of Application-based Healthcare. PSNet [internet]. Rockville (MD): Agency fo…

  8. In Conversation With... Francoise Marvel, MD | PSNet

    psnet.ahrq.gov/perspective/conversation-francoise-marvel-md
    August 05, 2022 - In Conversation With... Francoise Marvel, MD August 5, 2022  Also Read the Essay Citation Text: In Conversation With.. Francoise Marvel, MD. PSNet [internet]. 2022.In Conversation With... Francoise Marvel, MD. PSNet [internet]. Rockville (MD): Agency for Healthcar…

  9. Rediscovering the Power of the Surgical M&M Conference: The M M Matrix | PSNet

    psnet.ahrq.gov/perspective/rediscovering-power-surgical-mm-conference-mm-matrix
    September 01, 2007 - Rediscovering the Power of the Surgical M&M Conference: The M+M Matrix Leo A. Gordon, MD | September 1, 2007  Also Read a Conversation View more articles from the same authors. Citation Text: Gordon LA. Rediscovering the Power of the Surgical M&M Conference: The…

  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/853774/psn-pdf
    September 27, 2023 - Delayed Evaluation of Abdominal Pain in an Elderly Patient. September 27, 2023 Klimkiv L, Utter GH, Barnes DK. Delayed Evaluation of Abdominal Pain in an Elderly Patient. PSNet [internet]. 2023. https://psnet.ahrq.gov/web-mm/delayed-evaluation-abdominal-pain-elderly-patient The Case An 85-year-old woman presente…

  11. Errors and Near Misses: What Health Care Could Learn From Aviation | PSNet

    psnet.ahrq.gov/perspective/errors-and-near-misses-what-health-care-could-learn-aviation
    September 01, 2006 - Errors and Near Misses: What Health Care Could Learn From Aviation Carl Macrae, PhD | December 1, 2016  Also Read a Conversation View more articles from the same authors. Citation Text: Macrae C. Errors and Near Misses: What Health Care Could Learn From Aviation…

  12. In Conversation with...Peter J. Pronovost, MD, PhD | PSNet

    psnet.ahrq.gov/perspective/conversation-withpeter-j-pronovost-md-phd-0
    October 01, 2010 - In Conversation with...Peter J. Pronovost, MD, PhD October 1, 2010  Also Read an Essay Citation Text: In Conversation with..Peter J. Pronovost, MD, PhD. PSNet [internet]. 2010.In Conversation with...Peter J. Pronovost, MD, PhD. PSNet [internet]. Rockville (MD): Ag…

  13. Healthcare failure mode and effect analysis in the chemotherapy preparation process. | PSNet

    psnet.ahrq.gov/issue/healthcare-failure-mode-and-effect-analysis-chemotherapy-preparation-process
    March 09, 2022 - Study Healthcare failure mode and effect analysis in the chemotherapy preparation process. Citation Text: Pueyo-López C, Sánchez-Cuervo M, Vélez-Díaz-Pallarés M, et al. Healthcare failure mode and effect analysis in the chemotherapy preparation process. J Oncol Pharm Pract. 2021;27(7):15…

  14. Creating a high-reliability health care system: improving performance on core processes of care at Johns Hopkins Medicine. | PSNet

    psnet.ahrq.gov/issue/creating-high-reliability-health-care-system-improving-performance-core-processes-care-johns
    January 27, 2016 - Study Creating a high-reliability health care system: improving performance on core processes of care at Johns Hopkins Medicine. Citation Text: Pronovost P, Armstrong M, Demski R, et al. Creating a high-reliability health care system: improving performance on core processes of care at Jo…

  15. Validity of unplanned admission to an intensive care unit as a measure of patient safety in surgical patients. | PSNet

    psnet.ahrq.gov/issue/validity-unplanned-admission-intensive-care-unit-measure-patient-safety-surgical-patients
    May 26, 2021 - Study Validity of unplanned admission to an intensive care unit as a measure of patient safety in surgical patients. Citation Text: Haller G, Myles PS, Wolfe R, et al. Validity of unplanned admission to an intensive care unit as a measure of patient safety in surgical patients. Anesthe…

  16. SBAR improves communication and safety climate and decreases incident reports due to communication errors in an anaesthetic clinic: a prospective intervention study. | PSNet

    psnet.ahrq.gov/issue/sbar-improves-communication-and-safety-climate-and-decreases-incident-reports-due
    June 01, 2016 - Study SBAR improves communication and safety climate and decreases incident reports due to communication errors in an anaesthetic clinic: a prospective intervention study. Citation Text: Randmaa M, Mårtensson G, Swenne CL, et al. SBAR improves communication and safety climate and decreas…

  17. Medical crisis checklists in the emergency department: a simulation-based multi-institutional randomised controlled trial. | PSNet

    psnet.ahrq.gov/issue/medical-crisis-checklists-emergency-department-simulation-based-multi-institutional
    February 16, 2022 - Study Medical crisis checklists in the emergency department: a simulation-based multi-institutional randomised controlled trial. Citation Text: Dryver E, Lundager Forberg J, Hård af Segerstad C, et al. Medical crisis checklists in the emergency department: a simulation-based multi-instit…

  18. Using Health Care Failure Mode and Effect Analysis: the VA National Center for Patient Safety's prospective risk analysis system. | PSNet

    psnet.ahrq.gov/issue/using-health-care-failure-mode-and-effect-analysis-va-national-center-patient-safetys
    January 17, 2012 - Study Classic Using Health Care Failure Mode and Effect Analysis: the VA National Center for Patient Safety's prospective risk analysis system. Citation Text: DeRosier JM, Stalhandske E, Bagian JP, et al. Using health care Failure Mode and Effect Analysis: the V…

  19. The new recommendations on duty hours from the ACGME Task Force. | PSNet

    psnet.ahrq.gov/issue/new-recommendations-duty-hours-acgme-task-force
    July 14, 2021 - Commentary Classic The new recommendations on duty hours from the ACGME Task Force. Citation Text: Nasca TJ, Day SH, Amis S, et al. The new recommendations on duty hours from the ACGME Task Force. N Engl J Med. 2010;363(2):e3. doi:10.1056/NEJMsb1005800. Copy…

  20. Development of prescribing indicators related to opioid-related harm in patients with chronic pain in primary care- a modified e-Delphi study. | PSNet

    psnet.ahrq.gov/issue/development-prescribing-indicators-related-opioid-related-harm-patients-chronic-pain-primary
    April 12, 2019 - Study Development of prescribing indicators related to opioid-related harm in patients with chronic pain in primary care- a modified e-Delphi study. Citation Text: Bansal N, Campbell SM, Lin C-Y, et al. Development of prescribing indicators related to opioid-related harm in patients with…
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