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  1. IHI Skilled Nursing Facility Trigger Tool for Measuring Adverse Events. | PSNet

    psnet.ahrq.gov/issue/ihi-skilled-nursing-facility-trigger-tool-measuring-adverse-events
    February 15, 2017 - Book/Report IHI Skilled Nursing Facility Trigger Tool for Measuring Adverse Events. Citation Text: IHI Skilled Nursing Facility Trigger Tool for Measuring Adverse Events. Adler L, Moore J, Federico F. Cambridge, MA: Institute for Healthcare Improvement; November 2015. Copy Citation …

  2. How communication "failed" or "saved the day": counterfactual accounts of medical errors. | PSNet

    psnet.ahrq.gov/issue/how-communication-failed-or-saved-day-counterfactual-accounts-medical-errors
    September 21, 2022 - Study How communication "failed" or "saved the day": counterfactual accounts of medical errors. Citation Text: Street RL, Petrocelli JV, Amroze A, et al. How Communication “Failed” or “Saved the Day”: Counterfactual Accounts of Medical Errors. J Patient Exp. 2020;7(6):1247-1254. doi:10.1…

  3. Human factors engineering: its place and potential in OR safety. | PSNet

    psnet.ahrq.gov/issue/human-factors-engineering-its-place-and-potential-or-safety
    May 24, 2017 - Commentary Human factors engineering: its place and potential in OR safety. Citation Text: Criscitelli T. Human factors engineering: its place and potential in OR safety. AORN J. 2015;101(5):571-3. doi:10.1016/j.aorn.2015.02.013. Copy Citation Format: DOI Google Scholar Pub…

  4. Application of lean thinking to health care: issues and observations. | PSNet

    psnet.ahrq.gov/issue/application-lean-thinking-health-care-issues-and-observations
    May 28, 2015 - Commentary Application of lean thinking to health care: issues and observations. Citation Text: Joosten T, Bongers I, Janssen R. Application of lean thinking to health care: issues and observations. International Journal for Quality in Health Care. 2009;21(5). doi:10.1093/intqhc/mzp036…

  5. Mask shortage straps pharmacists who need them to keep medicines pure. | PSNet

    psnet.ahrq.gov/issue/mask-shortage-straps-pharmacists-who-need-them-keep-medicines-pure
    August 02, 2023 - Newspaper/Magazine Article Mask shortage straps pharmacists who need them to keep medicines pure. Citation Text: Mask shortage straps pharmacists who need them to keep medicines pure. Jewett C, Lupkin S. Health Shots. National Public Radio. March 20, 2020. Copy Citation …

  6. Safe handling of concentrated electrolyte products from outsourcing facilities during critical drug shortages. | PSNet

    psnet.ahrq.gov/issue/safe-handling-concentrated-electrolyte-products-outsourcing-facilities-during-critical-drug
    December 15, 2021 - Press Release/Announcement Safe handling of concentrated electrolyte products from outsourcing facilities during critical drug shortages. Citation Text: Safe handling of concentrated electrolyte products from outsourcing facilities during critical drug shortages. National Alert Network. …

  7. HCUP-US Overview

    hcup-us.ahrq.gov/overview.jsp
    February 01, 2022 - HCUP The Healthcare Cost and Utilization Project (HCUP, pronounced "H-Cup") is a family of healthcare databases and related software tools and products developed through a Federal-State-Industry partnership and sponsored by the Agency for Healthcare Research and Quality (AHRQ). HCUP databases bring together the data…

  8. The real malady of Marcel Proust and what it reveals about diagnostic errors in medicine. | PSNet

    psnet.ahrq.gov/issue/real-malady-marcel-proust-and-what-it-reveals-about-diagnostic-errors-medicine
    September 27, 2022 - Commentary The real malady of Marcel Proust and what it reveals about diagnostic errors in medicine. Citation Text: Douglas Y. The real malady of Marcel Proust and what it reveals about diagnostic errors in medicine. Med Hypotheses. 2016;90:14-8. doi:10.1016/j.mehy.2016.02.024. Copy Ci…

  9. Medical Harm: Historical, Conceptual, and Ethical Dimensions of Iatrogenic Illness. | PSNet

    psnet.ahrq.gov/issue/medical-harm-historical-conceptual-and-ethical-dimensions-iatrogenic-illness
    May 13, 2020 - Book/Report Classic Medical Harm: Historical, Conceptual, and Ethical Dimensions of Iatrogenic Illness. Citation Text: Medical Harm: Historical, Conceptual, and Ethical Dimensions of Iatrogenic Illness. Sharpe VA, Faden AI. Cambridge NY; Cambridge University…

  10. Machine learning in medicine. | PSNet

    psnet.ahrq.gov/issue/machine-learning-medicine
    March 13, 2024 - Commentary Classic Machine learning in medicine. Citation Text: Rajkomar A, Dean J, Kohane IS. Machine Learning in Medicine. New Engl J Med. 2019;380(14):1347-1358. doi:10.1056/NEJMra1814259. Copy Citation Format: DOI Google Scholar PubMed BibTeX E…

  11. Medical librarians supporting information systems project lifecycles toward improved patient safety. | PSNet

    psnet.ahrq.gov/issue/medical-librarians-supporting-information-systems-project-lifecycles-toward-improved-patient
    March 27, 2024 - Commentary Medical librarians supporting information systems project lifecycles toward improved patient safety. Citation Text: Saimbert MK, Zhang Y, Pierce J, et al. Medical librarians supporting information systems project lifecycles toward improved patient safety. Medical librarians …

  12. 2008 Update on Consumers' Views of Patient Safety and Quality Information. | PSNet

    psnet.ahrq.gov/issue/2008-update-consumers-views-patient-safety-and-quality-information
    October 02, 2013 - Book/Report 2008 Update on Consumers' Views of Patient Safety and Quality Information. Citation Text: 2008 Update on Consumers' Views of Patient Safety and Quality Information. Kaiser Family Foundation, Agency for Healthcare Research and Quality. Menlo Park, CA: Henry J. Kaiser Famil…

  13. Utilizing improvement science methods to improve physician compliance with proper hand hygiene. | PSNet

    psnet.ahrq.gov/issue/utilizing-improvement-science-methods-improve-physician-compliance-proper-hand-hygiene
    April 13, 2011 - Study Utilizing improvement science methods to improve physician compliance with proper hand hygiene. Citation Text: White CM, Statile AM, Conway PH, et al. Utilizing improvement science methods to improve physician compliance with proper hand hygiene. Pediatrics. 2012;129(4):e1042-50.…

  14. How to deliver safer and effective patient care: tips for team leaders and educators. | PSNet

    psnet.ahrq.gov/issue/how-deliver-safer-and-effective-patient-care-tips-team-leaders-and-educators
    April 24, 2018 - Commentary How to deliver safer and effective patient care: tips for team leaders and educators. Citation Text: Shah BJ. How to Deliver Safer and Effective Patient Care: Tips for Team Leaders and Educators. Gastroenterology. 2019;156(4):852-855. doi:10.1053/j.gastro.2019.02.017. Copy C…

  15. Predicting the future—big data, machine learning, and clinical medicine. | PSNet

    psnet.ahrq.gov/issue/predicting-future-big-data-machine-learning-and-clinical-medicine
    June 28, 2017 - Commentary Predicting the future—big data, machine learning, and clinical medicine. Citation Text: Obermeyer Z, Emanuel EJ. Predicting the future—big data, machine learning, and clinical medicine. N Engl J Med. 2016;375(13):1216-1219. doi:10.1056/nejmp1606181. Copy Citation Format:…

  16. Artificial Intelligence in Health Care: The Hope, the Hype, the Promise, the Peril. | PSNet

    psnet.ahrq.gov/issue/artificial-intelligence-health-care-hope-hype-promise-peril
    October 12, 2022 - Book/Report Artificial Intelligence in Health Care: The Hope, the Hype, the Promise, the Peril. Citation Text: Artificial Intelligence in Health Care: The Hope, the Hype, the Promise, the Peril. Matheny M, Israni ST, Ahmed M, et al, eds. Washington, DC: National Academy of Medicine. 2022…

  17. Textbook of Rapid Response Systems: Concept and Implementation. | PSNet

    psnet.ahrq.gov/issue/textbook-rapid-response-systems-concept-and-implementation
    September 30, 2010 - Book/Report Textbook of Rapid Response Systems: Concept and Implementation. Citation Text: Textbook Of Rapid Response Systems: Concept And Implementation. (DeVita MA, ed.). Springer; 2025. ISBN 9783031679513. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNo…

  18. Effect of a comprehensive obstetric patient safety program on compensation payments and sentinel events. | PSNet

    psnet.ahrq.gov/issue/effect-comprehensive-obstetric-patient-safety-program-compensation-payments-and-sentinel
    July 26, 2010 - Study Effect of a comprehensive obstetric patient safety program on compensation payments and sentinel events. Citation Text: Grunebaum A, Chervenak F, Skupski D. Effect of a comprehensive obstetric patient safety program on compensation payments and sentinel events. Am J Obstet Gyneco…

  19. Patient Engagement for Patient Safety: The Why, What, and How of Patient Engagement for Improving Patient Safety. | PSNet

    psnet.ahrq.gov/issue/patient-engagement-patient-safety-why-what-and-how-patient-engagement-improving-patient
    July 15, 2020 - Book/Report Patient Engagement for Patient Safety: The Why, What, and How of Patient Engagement for Improving Patient Safety. Citation Text: Patient Engagement for Patient Safety: The Why, What, and How of Patient Engagement for Improving Patient Safety. Kendir C, Fujisawa R, Brito Ferna…

  20. Ambiguity and workarounds as contributors to medical error. | PSNet

    psnet.ahrq.gov/issue/ambiguity-and-workarounds-contributors-medical-error
    December 23, 2008 - Commentary Ambiguity and workarounds as contributors to medical error. Citation Text: Spear SJ, Schmidhofer M. Ambiguity and workarounds as contributors to medical error. Ann Intern Med. 2005;142(8):627-630. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3 XM…
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