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  1. psnet.ahrq.gov/issue/diagnostic-errors-intensive-care-unit-systematic-review-autopsy-studies
    March 10, 2021 - Review Diagnostic errors in the intensive care unit: a systematic review of autopsy studies. Citation Text: Winters BD, Custer J, Galvagno SM, et al. Diagnostic errors in the intensive care unit: a systematic review of autopsy studies. BMJ Qual Saf. 2012;21(11):894-902. doi:10.1136/bmj…
  2. psnet.ahrq.gov/issue/are-teaching-hospitals-treated-fairly-hospital-acquired-condition-reduction-program
    July 11, 2018 - Study Are teaching hospitals treated fairly in the Hospital-Acquired Condition Reduction Program? Citation Text: Mohajer MA, Joiner KA, Nix DE. Are Teaching Hospitals Treated Fairly in the Hospital-Acquired Condition Reduction Program? Acad Med. 2018;93(12):1827-1832. doi:10.1097/ACM.000…
  3. psnet.ahrq.gov/issue/effect-computerized-provider-order-entry-systems-clinical-care-and-work-processes-emergency
    May 25, 2011 - Review The effect of computerized provider order entry systems on clinical care and work processes in emergency departments: a systematic review of the quantitative literature. Citation Text: Georgiou A, Prgomet M, Paoloni R, et al. The effect of computerized provider order entry syst…
  4. psnet.ahrq.gov/issue/qualitative-study-speaking-out-about-patient-safety-concerns-intensive-care-units
    August 21, 2013 - Study A qualitative study of speaking out about patient safety concerns in intensive care units. Citation Text: Tarrant C, Leslie M, Bion J, et al. A qualitative study of speaking out about patient safety concerns in intensive care units. Soc Sci Med. 2017;193:8-15. doi:10.1016/j.socscim…
  5. psnet.ahrq.gov/issue/swarming-improve-patient-care-novel-approach-root-cause-analysis
    September 23, 2020 - Study "SWARMing" to improve patient care: a novel approach to root cause analysis. Citation Text: Li J, Boulanger B, Norton J, et al. "SWARMing" to Improve Patient Care: A Novel Approach to Root Cause Analysis. Jt Comm J Qual Patient Saf. 2015;41(11):494-501. Copy Citation Format: …
  6. psnet.ahrq.gov/issue/assessment-health-information-technology-related-outpatient-diagnostic-delays-us-veterans
    June 24, 2020 - Study Assessment of health information technology-related outpatient diagnostic delays in the US Veterans Affairs health care system: a qualitative study of aggregated root cause analysis data. Citation Text: Powell L, Sittig DF, Chrouser K, et al. Assessment of health information techno…
  7. psnet.ahrq.gov/issue/costs-intravenous-adverse-drug-events-academic-and-nonacademic-intensive-care-units
    August 11, 2021 - Study Costs of intravenous adverse drug events in academic and nonacademic intensive care units. Citation Text: Nuckols TK, Paddock SM, Bower AG, et al. Costs of intravenous adverse drug events in academic and nonacademic intensive care units. Med Care. 2009;46(1):17-24. doi:10.1097/m…
  8. psnet.ahrq.gov/issue/medication-errors-associated-code-situations-us-hospitals-direct-and-collateral-damage
    June 29, 2011 - Study Medication errors associated with code situations in U.S. hospitals: direct and collateral damage. Citation Text: Lipshutz AKM, Morlock LL, Shore AD, et al. Medication Errors Associated with Code Situations in U.S. Hospitals: Direct and Collateral Damage. Jt Comm J Qual Patient Saf…
  9. psnet.ahrq.gov/issue/health-economic-evaluation-infection-prevention-and-control-program-are-quality-and-patient
    June 02, 2021 - Study Health economic evaluation of an infection prevention and control program: are quality and patient safety programs worth the investment? Citation Text: Raschka S, Dempster L, Bryce E. Health economic evaluation of an infection prevention and control program: are quality and patien…
  10. psnet.ahrq.gov/issue/hospital-acquired-functional-decline-and-clinical-outcomes-older-cardiac-surgical-patients
    February 06, 2019 - Study Hospital-acquired functional decline and clinical outcomes in older cardiac surgical patients: a multicenter prospective cohort study. Citation Text: Morisawa T, Saitoh M, Otsuka S, et al. Hospital-acquired functional decline and clinical outcomes in older cardiac surgical patients…
  11. psnet.ahrq.gov/issue/association-surgical-task-during-training-team-skill-acquisition-among-surgical-residents
    March 12, 2025 - Study Association of a surgical task during training with team skill acquisition among surgical residents: the missing piece in multidisciplinary team training. Citation Text: Sparks JL, Crouch DL, Sobba K, et al. Association of a Surgical Task During Training With Team Skill Acquisition…
  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/867635/psn-pdf
    February 26, 2025 - Diagnostic safety: needs assessment and informed curriculum at an academic children's hospital. February 26, 2025 Congdon M, Rasooly IR, Toto RL, et al. Diagnostic safety: needs assessment and informed curriculum at an academic children's hospital. Pediatr Qual Saf. 2024;9(6):e773. doi:10.1097/pq9.0000000000000773.…
  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46127/psn-pdf
    May 31, 2017 - Liquid medication dosing errors by Hispanic parents: role of health literacy and English proficiency. May 31, 2017 Harris LM, Dreyer BP, Mendelsohn A, et al. Liquid Medication Dosing Errors by Hispanic Parents: Role of Health Literacy and English Proficiency. Acad Pediatr. 2017;17(4):403-410. doi:10.1016/j.acap.20…
  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/837596/psn-pdf
    June 29, 2022 - Association of patient and family reports of hospital safety climate with language proficiency in the US. June 29, 2022 Khan A, Parente V, Baird JD, et al. Association of patient and family reports of hospital safety climate with language proficiency in the US. JAMA Pediatr. 2022;176(8):776-786. doi:10.1001/jamape…
  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/867132/psn-pdf
    November 13, 2024 - Large language model influence on diagnostic reasoning: a randomized clinical trial. November 13, 2024 Goh E, Gallo R, Hom J, et al. Large language model influence on diagnostic reasoning: a randomized clinical trial. JAMA Netw Open. 2024;7(10):e2440969. doi:10.1001/jamanetworkopen.2024.40969. https://psnet.ahrq.g…
  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/864380/psn-pdf
    March 13, 2024 - Stepped-wedge cluster RCT to assess the effects of an electronic medication system on medication administration errors. March 13, 2024 Westbrook JI, Li L, Woods AL, et al. Stepped-wedge cluster RCT to assess the effects of an electronic medication system on medication administration errors. Stud Health Technol Inf…
  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/842420/psn-pdf
    January 11, 2023 - Using the Assessment of Reasoning Tool to facilitate feedback about diagnostic reasoning. January 11, 2023 Cohen AL, Sur M, Falco C, et al. Using the Assessment of Reasoning Tool to facilitate feedback about diagnostic reasoning. Diagnosis (Berl). 2022;9(4):476-484. doi:10.1515/dx-2022-0020. https://psnet.ahrq.gov…
  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/837505/psn-pdf
    June 22, 2022 - Parent participation in morbidity and mortality review: parent and physician perspectives. June 22, 2022 de Loizaga SR, Clarke-Myers K, R Khoury P, et al. Parent participation in morbidity and mortality review: parent and physician perspectives. J Patient Exp. 2022;9:237437352211026. doi:10.1177/23743735221102674.…
  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/38057/psn-pdf
    September 10, 2008 - Randomized controlled trial of a pictogram-based intervention to reduce liquid medication dosing errors and improve adherence among caregivers of young children.  September 10, 2008 Yin S, Dreyer BP, van Schaick L, et al. Randomized controlled trial of a pictogram-based intervention to reduce liquid medication do…
  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44730/psn-pdf
    December 08, 2015 - Why studying human behavior is a critical component of patient safety. December 8, 2015 Su L. Why Studying Human Behavior is a Critical Component of Patient Safety. Curr Probl Pediatr Adolesc Health Care. 2015;45(12):367-9. doi:10.1016/j.cppeds.2015.10.004. https://psnet.ahrq.gov/issue/why-studying-human-behavior-…

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