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psnet.ahrq.gov/issue/rural-hospital-information-technology-implementation-safety-and-quality-improvement-lessons
April 24, 2018 - Study
Rural hospital information technology implementation for safety and quality improvement: lessons learned.
Citation Text:
Tietze MF, Williams J, Galimbertti M. Rural hospital information technology implementation for safety and quality improvement: lessons learned. Comput Inform N…
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psnet.ahrq.gov/issue/improving-radiology-report-quality-rapidly-notifying-radiologist-report-errors
May 29, 2019 - Study
Improving radiology report quality by rapidly notifying radiologist of report errors.
Citation Text:
Minn MJ, Zandieh AR, Filice RW. Improving Radiology Report Quality by Rapidly Notifying Radiologist of Report Errors. J Digit Imaging. 2015;28(4):492-8. doi:10.1007/s10278-015-9781-…
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psnet.ahrq.gov/issue/reducing-error-anticoagulant-dosing-multidisciplinary-team-rounding-point-care
November 16, 2016 - Study
Reducing error in anticoagulant dosing via multidisciplinary team rounding at point of care.
Citation Text:
Sharma M, Krishnamurthy M, Snyder R, et al. Reducing error in anticoagulant dosing via multidisciplinary team rounding at point of care. Clin Pract. 2017;7(2). doi:10.4081/cp…
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psnet.ahrq.gov/issue/scaffolding-our-systems-patients-and-families-reaching-source-healthcare-resilience
February 23, 2022 - Commentary
Scaffolding our systems? Patients and families 'reaching in' as a source of healthcare resilience.
Citation Text:
O'Hara JK, Aase K, Waring J. Scaffolding our systems? Patients and families 'reaching in' as a source of healthcare resilience. BMJ Qual Saf. 2019;28(1):3-6. doi:1…
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psnet.ahrq.gov/issue/work-hours-regulations-house-staff-psychiatry-bad-or-good-residency-training
August 04, 2021 - Review
Work hours regulations for house staff in psychiatry: bad or good for residency training?
Citation Text:
Rasminsky S, Lomonaco A, Auchincloss E. Work Hours Regulations for House Staff in Psychiatry: Bad or Good for Residency Training? Academic Psychiatry. 2008;32(1). doi:10.1176/a…
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psnet.ahrq.gov/issue/occurrence-potential-patient-safety-events-among-trauma-patients-are-they-random
July 19, 2018 - Study
The occurrence of potential patient safety events among trauma patients: are they random?
Citation Text:
Chang DC, Handly N, Abdullah F, et al. The occurrence of potential patient safety events among trauma patients: are they random? Ann Surg. 2008;247(2):327-34. doi:10.1097/SLA.…
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psnet.ahrq.gov/issue/using-data-enhance-performance-and-improve-quality-and-safety-surgery
March 15, 2023 - Commentary
Using data to enhance performance and improve quality and safety in surgery.
Citation Text:
Goldenberg MG, Jung JJ, Grantcharov T. Using Data to Enhance Performance and Improve Quality and Safety in Surgery. JAMA Surg. 2017;152(10):972-973. doi:10.1001/jamasurg.2017.2888.
Co…
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psnet.ahrq.gov/issue/beyond-clinical-team-evaluating-human-factors-oriented-training-non-clinical-professionals
March 12, 2025 - Study
Beyond the clinical team: evaluating the human factors-oriented training of non-clinical professionals working in healthcare contexts.
Citation Text:
Lavelle M, Reedy GB, Attoe C, et al. Beyond the clinical team: evaluating the human factors-oriented training of non-clinical profes…
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psnet.ahrq.gov/issue/sustained-improvement-neonatal-intensive-care-unit-safety-attitudes-after-teamwork-training
March 26, 2015 - Study
Sustained improvement in neonatal intensive care unit safety attitudes after teamwork training.
Citation Text:
Murphy T, Laptook A, Bender J. Sustained Improvement in Neonatal Intensive Care Unit Safety Attitudes After Teamwork Training. J Patient Saf. 2018;14(3):174-180. doi:10.10…
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psnet.ahrq.gov/issue/applying-aviation-factors-oral-and-maxillofacial-surgery-human-element
September 23, 2020 - Commentary
Applying aviation factors to oral and maxillofacial surgery—the human element.
Citation Text:
Seager L, Smith DW, Patel A, et al. Applying aviation factors to oral and maxillofacial surgery--the human element. Br J Oral Maxillofac Surg. 2013;51(1):8-13. doi:10.1016/j.bjoms.2…
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psnet.ahrq.gov/issue/prevalence-and-patterns-potentially-avoidable-hospitalizations-us-long-term-care-setting
August 04, 2021 - Study
Prevalence and patterns of potentially avoidable hospitalizations in the US long-term care setting.
Citation Text:
Mcandrew RM, Grabowski DC, Dangi A, et al. Prevalence and patterns of potentially avoidable hospitalizations in the US long-term care setting. Int J Qual Health Care. …
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psnet.ahrq.gov/web-mm/turn-other-cheek
October 26, 2010 - Outcome of 6 years of protocol use for preventing wrong site office surgery. … February 10, 2012
Outcome of 6 years of protocol use for preventing wrong site office … August 2, 2015
Outcome of 6 years of protocol use for preventing wrong site office surgery
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psnet.ahrq.gov/web-mm/refused-medication-error
November 01, 2005 - is problematic on many levels, this commentary focuses on the three likely causes of the unfortunate outcome … transfer can be discussed and improved upon.( 11 ) Several best practices might have led to a different outcome … overcome those barriers to effectively communicate.( 7 ) Such practices might have led to a better outcome
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psnet.ahrq.gov/node/49466/psn-pdf
October 14, 2004 - studies cite practitioner communication
skills as a factor in malpractice.(1,2) Furthermore, the tragic outcome … /psnet.ahrq.gov/web-mm/hard-swallow
https://psnet.ahrq.gov//#references
were made NPO pending the outcome … clinicians at the time, could have led to follow-up actions to mitigate or avert an
adverse patient outcome
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psnet.ahrq.gov/node/49833/psn-pdf
June 01, 2018 - challenges us to
review potential system and cognitive factors that could have contributed to this outcome … This case represents the treatment of a stroke mimic or misdiagnosis that contributed to an adverse
outcome … Association of outcome with early stroke treatment: pooled
analysis of ATLANTIS, ECASS, and NINDS rt-PA
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psnet.ahrq.gov/issue/testing-classification-model-emergency-department-errors
March 02, 2010 - October 26, 2010
EMS helicopter crashes: what influences fatal outcome?
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psnet.ahrq.gov/issue/leadership-challenge-staff-nurse-perceptions-after-organizational-teamstepps-initiative
May 11, 2016 - May 11, 2016
A human factors intervention in a hospital--evaluating the outcome of a
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psnet.ahrq.gov/issue/did-hospital-engagement-networks-actually-improve-care
July 18, 2016 - surgery using criteria validated from the adult population: justifying the need for pediatric-focused outcome
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psnet.ahrq.gov/issue/systems-analysis-critical-incidents-london-protocol
April 06, 2016 - June 28, 2017
Improving the Measurement of Surgical Site Infection Risk Stratification/Outcome
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psnet.ahrq.gov/issue/safety-inpatient-pediatric-otolaryngology-service-many-small-errors-few-adverse-events
October 27, 2010 - surgery using criteria validated from the adult population: justifying the need for pediatric-focused outcome