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  1. Toward the development of the perfect medical team: critical components for adaptation. | PSNet

    psnet.ahrq.gov/issue/toward-development-perfect-medical-team-critical-components-adaptation
    February 09, 2022 - Review Emerging Classic Toward the development of the perfect medical team: critical components for adaptation. Citation Text: Gregory ME, Hughes AM, Benishek LE, et al. Toward the development of the perfect medical team: critical components for adaptation. J Pa…

  2. Do HSMRs really measure patient safety?  | PSNet

    psnet.ahrq.gov/issue/do-hsmrs-really-measure-patient-safety
    June 22, 2009 - Special or Theme Issue Do HSMRs really measure patient safety?  Citation Text: Do HSMRs really measure patient safety?  Leatt P; Wen E; Sandoval C; Zelmer J; Webster G; Jarman B; McKinley J; Gibson D; Ardal S; Zahn C; Baker M; MacNaughton J; Flemming C; Bell R; Figler S; Brien SE; Gh…

  3. Goals and Priorities for Health Care Organizations to Improve Safety Using Health IT. Revised Report. | PSNet

    psnet.ahrq.gov/issue/goals-and-priorities-health-care-organizations-improve-safety-using-health-it-revised-report
    May 13, 2015 - Book/Report Goals and Priorities for Health Care Organizations to Improve Safety Using Health IT. Revised Report. Citation Text: Goals and Priorities for Health Care Organizations to Improve Safety Using Health IT. Revised Report. Graber ML, Bailey R, Johnston D. RTI International; Washi…

  4. Variation in hospital mortality associated with inpatient surgery. | PSNet

    psnet.ahrq.gov/issue/variation-hospital-mortality-associated-inpatient-surgery
    August 02, 2015 - Study Classic Variation in hospital mortality associated with inpatient surgery. Citation Text: Ghaferi AA, Birkmeyer JD, Dimick JB. Variation in hospital mortality associated with inpatient surgery. N Engl J Med. 2009;361(14):1368-75. doi:10.1056/NEJMsa090304…

  5. From HRO to HERO: making health equity a core system capability. | PSNet

    psnet.ahrq.gov/issue/hro-hero-making-health-equity-core-system-capability
    September 30, 2020 - Commentary From HRO to HERO: making health equity a core system capability. Citation Text: Moy E, Hausmann LRM, Clancy CM. From HRO to HERO: making health equity a core system capability. Am J Med Qual. 2022;37(1):81-83. doi:10.1097/jmq.0000000000000020. Copy Citation Format: …

  6. Lost in translation: challenges and opportunities in physician-to-physician communication during patient handoffs. | PSNet

    psnet.ahrq.gov/issue/lost-translation-challenges-and-opportunities-physician-physician-communication-during
    April 12, 2011 - Study Lost in translation: challenges and opportunities in physician-to-physician communication during patient handoffs. Citation Text: Solet DJ, Norvell M, Rutan GH, et al. Lost in translation: challenges and opportunities in physician-to-physician communication during patient handoff…

  7. The impact of power on health care team performance and patient safety: a review of the literature. | PSNet

    psnet.ahrq.gov/issue/impact-power-health-care-team-performance-and-patient-safety-review-literature
    February 01, 2023 - Review The impact of power on health care team performance and patient safety: a review of the literature. Citation Text: Stevens EL, Hulme A, Salmon PM. The impact of power on health care team performance and patient safety: a review of the literature. Ergonomics. 2021;64(8):1072-1090. …

  8. What can patient safety teach us about clinician burnout? | PSNet

    psnet.ahrq.gov/issue/what-can-patient-safety-teach-us-about-clinician-burnout
    January 07, 2011 - Commentary What can patient safety teach us about clinician burnout? Citation Text: Wu AW, Dzau VJ. What Can Patient Safety Teach Us About Clinician Burnout? Ann Intern Med. 2019;171(12):933-934. doi:10.7326/m19-2397. Copy Citation Format: DOI Google Scholar BibTeX EndNote …

  9. Managing near-miss reporting in hospitals: the dynamics between staff members’ willingness to report and management’s handling of near-miss events. | PSNet

    psnet.ahrq.gov/issue/managing-near-miss-reporting-hospitals-dynamics-between-staff-members-willingness-report-and
    March 30, 2016 - Study Managing near-miss reporting in hospitals: the dynamics between staff members’ willingness to report and management’s handling of near-miss events. Citation Text: Caspi H, Perlman Y, Westreich S. Managing near-miss reporting in hospitals: the dynamics between staff members’ willing…

  10. National patterns of codeine prescriptions for children in the emergency department. | PSNet

    psnet.ahrq.gov/issue/national-patterns-codeine-prescriptions-children-emergency-department
    November 16, 2022 - Study National patterns of codeine prescriptions for children in the emergency department. Citation Text: Kaiser S, Asteria-Peñaloza R, Vittinghoff E, et al. National patterns of codeine prescriptions for children in the emergency department. Pediatrics. 2014;133(5):e1139-47. doi:10.1542…

  11. Analysis of a medication safety intervention in the pediatric emergency department. | PSNet

    psnet.ahrq.gov/issue/analysis-medication-safety-intervention-pediatric-emergency-department
    August 02, 2012 - Study Analysis of a medication safety intervention in the pediatric emergency department. Citation Text: Samuels-Kalow ME, Tassone R, Manning W, et al. Analysis of a medication safety intervention in the pediatric emergency department. JAMA Netw Open. 2024;7(1):e2351629. doi:10.1001/jama…

  12. The Institute of Medicine report on medical errors—could it do harm? | PSNet

    psnet.ahrq.gov/issue/institute-medicine-report-medical-errors-could-it-do-harm
    February 18, 2011 - Commentary Classic The Institute of Medicine report on medical errors—could it do harm? Citation Text: Brennan TA. The Institute of Medicine report on medical errors--could it do harm? N Engl J Med. 2002;342(15):1123-1125. doi:10.1056/nejm200004133421510. Co…

  13. The confused and bewildered hospital: adverse event discovery, pay-for-performance, and big data tools as halfway technologies. | PSNet

    psnet.ahrq.gov/issue/confused-and-bewildered-hospital-adverse-event-discovery-pay-performance-and-big-data-tools
    September 23, 2020 - Commentary The confused and bewildered hospital: adverse event discovery, pay-for-performance, and big data tools as halfway technologies. Citation Text: Furrow BR. The confused and bewildered hospital: adverse event discovery, pay-for-performance, and big data tools as halfway technolog…

  14. National Scorecard on Rates of Hospital-Acquired Conditions 2010 to 2015: Interim Data From National Efforts to Make Health Care Safer. | PSNet

    psnet.ahrq.gov/issue/national-scorecard-rates-hospital-acquired-conditions-2010-2015-interim-data-national-efforts
    December 24, 2008 - Book/Report National Scorecard on Rates of Hospital-Acquired Conditions 2010 to 2015: Interim Data From National Efforts to Make Health Care Safer. Citation Text: National Scorecard on Rates of Hospital-Acquired Conditions 2010 to 2015: Interim Data From National Efforts to Make Health C…

  15. IOM: shorten residents' work shifts to reduce fatigue, improve patient safety. | PSNet

    psnet.ahrq.gov/issue/iom-shorten-residents-work-shifts-reduce-fatigue-improve-patient-safety
    January 31, 2024 - Journal Article IOM: shorten residents' work shifts to reduce fatigue, improve patient safety. Citation Text: Kuehn BM. IOM: Shorten residents' work shifts to reduce fatigue, improve patient safety. JAMA. 2009;301(3):259-61. doi:10.1001/jama.2008.940. Copy Citation Format: …

  16. Using portable digital technology for clinical care and critical incidents: a new model. | PSNet

    psnet.ahrq.gov/issue/using-portable-digital-technology-clinical-care-and-critical-incidents-new-model
    June 29, 2011 - Commentary Using portable digital technology for clinical care and critical incidents: a new model. Citation Text: Bolsin S, Faunce T, Colson M. Using portable digital technology for clinical care and critical incidents: a new model. Aust Health Rev. 2005;29(3):297-305. Copy Citation…

  17. Transferring aviation practices into clinical medicine for the promotion of high reliability. | PSNet

    psnet.ahrq.gov/issue/transferring-aviation-practices-clinical-medicine-promotion-high-reliability
    September 12, 2018 - Review Transferring aviation practices into clinical medicine for the promotion of high reliability. Citation Text: Powell-Dunford N, McPherson MK, Pina JS, et al. Transferring Aviation Practices into Clinical Medicine for the Promotion of High Reliability. Aerosp Med Hum Perform. 2017;8…

  18. Framing patient safety initiatives: working model and case example. | PSNet

    psnet.ahrq.gov/issue/framing-patient-safety-initiatives-working-model-and-case-example
    April 05, 2017 - Commentary Framing patient safety initiatives: working model and case example. Citation Text: Kruger N, Hurley A, Gustafson M. Framing patient safety initiatives: working model and case example. J Nurs Adm. 2006;36(4):200-204. Copy Citation Format: Google Scholar PubMed B…

  19. Discrepant advanced directives and code status orders: a preventable medical error. | PSNet

    psnet.ahrq.gov/issue/discrepant-advanced-directives-and-code-status-orders-preventable-medical-error
    October 31, 2018 - Journal Article Discrepant advanced directives and code status orders: a preventable medical error. Citation Text: Meisenberg B, Zaidi S, Franks L, et al. Discrepant Advanced Directives and Code Status Orders: A Preventable Medical Error. J Hosp Med. 2019;14(10):716-718. doi:10.12788/jhm…

  20. Educating medical trainees on medication reconciliation: a systematic review. | PSNet

    psnet.ahrq.gov/issue/educating-medical-trainees-medication-reconciliation-systematic-review
    October 16, 2019 - Review Educating medical trainees on medication reconciliation: a systematic review. Citation Text: Ramjaun A, Sudarshan M, Patakfalvi L, et al. Educating medical trainees on medication reconciliation: a systematic review. BMC Med Educ. 2015;15:33. doi:10.1186/s12909-015-0306-5. Copy C…
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