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  1. Communication during trauma resuscitation: do we know what is happening? | PSNet

    psnet.ahrq.gov/issue/communication-during-trauma-resuscitation-do-we-know-what-happening
    February 03, 2021 - Study Communication during trauma resuscitation: do we know what is happening? Citation Text: Bergs EAG, Rutten FLPA, Tadros T, et al. Communication during trauma resuscitation: do we know what is happening? Injury. 2005;36(8):905-11. Copy Citation Format: Google Scholar …

  2. Physician understanding and ability to communicate harms and benefits of common medical treatments. | PSNet

    psnet.ahrq.gov/issue/physician-understanding-and-ability-communicate-harms-and-benefits-common-medical-treatments
    September 28, 2016 - Study Physician understanding and ability to communicate harms and benefits of common medical treatments. Citation Text: Krouss M, Croft LD, Morgan DJ. Physician Understanding and Ability to Communicate Harms and Benefits of Common Medical Treatments. JAMA Intern Med. 2016;176(10):1565-1…

  3. The complexity, diversity, and science of primary care teams. | PSNet

    psnet.ahrq.gov/issue/complexity-diversity-and-science-primary-care-teams
    November 18, 2016 - Review Emerging Classic The complexity, diversity, and science of primary care teams. Citation Text: Fiscella K, McDaniel SH. The complexity, diversity, and science of primary care teams. Amer Psychol. 2018;73(4):451-467. doi:10.1037/amp0000244. Copy Citation …

  4. Influences on the adoption of patient safety innovation in primary care: a qualitative exploration of staff perspectives. | PSNet

    psnet.ahrq.gov/issue/influences-adoption-patient-safety-innovation-primary-care-qualitative-exploration-staff
    April 25, 2018 - Study Influences on the adoption of patient safety innovation in primary care: a qualitative exploration of staff perspectives. Citation Text: Litchfield I, Gill P, Avery T, et al. Influences on the adoption of patient safety innovation in primary care: a qualitative exploration of staff…

  5. Acute stroke chameleons in a university hospital: risk factors, circumstances, and outcomes. | PSNet

    psnet.ahrq.gov/issue/acute-stroke-chameleons-university-hospital-risk-factors-circumstances-and-outcomes
    March 05, 2025 - Study Acute stroke chameleons in a university hospital: risk factors, circumstances, and outcomes. Citation Text: Richoz B, Hugli O, Dami F, et al. Acute stroke chameleons in a university hospital: Risk factors, circumstances, and outcomes. Neurology. 2015;85(6):505-11. doi:10.1212/WNL.0…

  6. A systematic review of the performance characteristics of clinical event monitor signals used to detect adverse drug events in the hospital setting. | PSNet

    psnet.ahrq.gov/issue/systematic-review-performance-characteristics-clinical-event-monitor-signals-used-detect
    March 28, 2012 - Review A systematic review of the performance characteristics of clinical event monitor signals used to detect adverse drug events in the hospital setting. Citation Text: Handler S, Altman RL, Perera S, et al. A systematic review of the performance characteristics of clinical event mon…

  7. Assessment of bias in patient safety reporting systems categorized by physician gender, race and ethnicity, and faculty rank: a qualitative study. | PSNet

    psnet.ahrq.gov/issue/assessment-bias-patient-safety-reporting-systems-categorized-physician-gender-race-and
    June 22, 2022 - Study Assessment of bias in patient safety reporting systems categorized by physician gender, race and ethnicity, and faculty rank: a qualitative study. Citation Text: doi:https://doi.org/10.1001/jamanetworkopen.2022.13234. Copy Citation Format: DOI BibTeX EndNote X3 XML E…

  8. The high cost of low-frequency events: the anatomy and economics of surgical mishaps. | PSNet

    psnet.ahrq.gov/issue/high-cost-low-frequency-events-anatomy-and-economics-surgical-mishaps
    October 19, 2022 - Study Classic The high cost of low-frequency events: the anatomy and economics of surgical mishaps. Citation Text: Couch NP, Tilney NL, Rayner AA, et al. The high cost of low-frequency events: the anatomy and economics of surgical mishaps. N Engl J Med. 1981;3…

  9. The Armstrong Institute Resident/Fellow Scholars: a multispecialty curriculum to train future leaders in patient safety and quality improvement. | PSNet

    psnet.ahrq.gov/issue/armstrong-institute-residentfellow-scholars-multispecialty-curriculum-train-future-leaders
    October 19, 2022 - Commentary The Armstrong Institute Resident/Fellow Scholars: a multispecialty curriculum to train future leaders in patient safety and quality improvement. Citation Text: Rinke ML, Mock CK, Persing NM, et al. The Armstrong Institute Resident/Fellow Scholars: A Multispecialty Curriculum t…

  10. Use of medical emergency team (MET) responses to detect medical errors. | PSNet

    psnet.ahrq.gov/issue/use-medical-emergency-team-met-responses-detect-medical-errors
    April 06, 2011 - Study Use of medical emergency team (MET) responses to detect medical errors. Citation Text: Braithwaite RS, Devita MA, Mahidhara R, et al. Use of medical emergency team (MET) responses to detect medical errors. Qual Saf Health Care. 2004;13(4):255-259. Copy Citation Format: …

  11. Review of alternatives to root cause analysis: developing a robust system for incident report analysis. | PSNet

    psnet.ahrq.gov/issue/review-alternatives-root-cause-analysis-developing-robust-system-incident-report-analysis
    November 14, 2018 - Review Review of alternatives to root cause analysis: developing a robust system for incident report analysis. Citation Text: Hagley G, Mills PD, Watts B, et al. Review of alternatives to root cause analysis: developing a robust system for incident report analysis. BMJ Open Qual. 2019;8(…

  12. An adverse event screening tool based on routinely collected hospital-acquired diagnoses. | PSNet

    psnet.ahrq.gov/issue/adverse-event-screening-tool-based-routinely-collected-hospital-acquired-diagnoses
    July 23, 2008 - Study An adverse event screening tool based on routinely collected hospital-acquired diagnoses. Citation Text: Brand CA, Tropea J, Gorelik A, et al. An adverse event screening tool based on routinely collected hospital-acquired diagnoses. Int J Qual Health Care. 2012;24(3):266-78. doi:10…

  13. Impact of resident participation on morbidity and mortality in neurosurgical procedures: an analysis of 16,098 patients. | PSNet

    psnet.ahrq.gov/issue/impact-resident-participation-morbidity-and-mortality-neurosurgical-procedures-analysis-16098
    June 17, 2014 - Study Impact of resident participation on morbidity and mortality in neurosurgical procedures: an analysis of 16,098 patients. Citation Text: Bydon M, Abt NB, De la Garza-Ramos R, et al. Impact of resident participation on morbidity and mortality in neurosurgical procedures: an analysis …

  14. Workforce planning and safe workload in sterile compounding hospital pharmacy services. | PSNet

    psnet.ahrq.gov/issue/workforce-planning-and-safe-workload-sterile-compounding-hospital-pharmacy-services
    October 19, 2022 - Study Workforce planning and safe workload in sterile compounding hospital pharmacy services. Citation Text: Chaker A, Omair I, Mohamed WH, et al. Workforce planning and safe workload in sterile compounding hospital pharmacy services. Am J Health Syst Pharm. 2022;79(3):187–192. doi:10.10…

  15. Can we make airway management (even) safer?—lessons from national audit. | PSNet

    psnet.ahrq.gov/issue/can-we-make-airway-management-even-safer-lessons-national-audit
    March 01, 2023 - Review Can we make airway management (even) safer?—lessons from national audit. Citation Text: Woodall N, Frerk C, Cook TM. Can we make airway management (even) safer?--lessons from national audit. Anaesthesia. 2011;66 Suppl 2:27-33. doi:10.1111/j.1365-2044.2011.06931.x. Copy Citatio…

  16. Patient care, square-rigger sailing, and safety. | PSNet

    psnet.ahrq.gov/issue/patient-care-square-rigger-sailing-and-safety
    November 16, 2022 - Commentary Patient care, square-rigger sailing, and safety. Citation Text: Henkind SJ, Sinnett C. Patient care, square-rigger sailing, and safety. JAMA. 2008;300(14):1691-3. doi:10.1001/jama.300.14.1691. Copy Citation Format: DOI Google Scholar PubMed BibTeX EndNote X3 XM…

  17. A conceptual framework to reduce inpatient preventable deaths. | PSNet

    psnet.ahrq.gov/issue/conceptual-framework-reduce-inpatient-preventable-deaths
    April 24, 2018 - Study A conceptual framework to reduce inpatient preventable deaths. Citation Text: Davis DP, Aguilar SA, Lawrence B, et al. A Conceptual Framework to Reduce Inpatient Preventable Deaths. Jt Comm J Qual Patient Saf. 2018;44(7):413-420. doi:10.1016/j.jcjq.2018.01.003. Copy Citation …

  18. Elopement: evidence-based mitigation and management. | PSNet

    psnet.ahrq.gov/issue/elopement-evidence-based-mitigation-and-management
    October 19, 2022 - Study Elopement: evidence-based mitigation and management. Citation Text: Marlett JE, Vacovsky BA, Krug EA, et al. Elopement: evidence‐based mitigation and management. Worldviews Evid Based Nurs. 2024;20(6):634-641. doi:10.1111/wvn.12683. Copy Citation Format: DOI Google Sc…

  19. Improving surgical complications and patient safety at the nation's largest military hospital: an analysis of National Surgical Quality Improvement Program data. | PSNet

    psnet.ahrq.gov/issue/improving-surgical-complications-and-patient-safety-nations-largest-military-hospital
    November 09, 2022 - Study Improving surgical complications and patient safety at the nation's largest military hospital: an analysis of National Surgical Quality Improvement Program data. Citation Text: Maturo S, Hughes C, Kallingal G, et al. Improving Surgical Complications and Patient Safety at the Nation…

  20. The frequency of diagnostic errors in radiologic reports depends on the patient's age. | PSNet

    psnet.ahrq.gov/issue/frequency-diagnostic-errors-radiologic-reports-depends-patients-age
    March 09, 2022 - Study The frequency of diagnostic errors in radiologic reports depends on the patient's age. Citation Text: Diaz S, Ekberg O. The frequency of diagnostic errors in radiologic reports depends on the patient's age. Acta Radiol. 2010;51(8):934-8. doi:10.3109/02841851.2010.503192. Copy C…
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