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  1. Promoting patient safety through prospective risk identification: example from peri-operative care. | PSNet

    psnet.ahrq.gov/issue/promoting-patient-safety-through-prospective-risk-identification-example-peri-operative-care
    September 23, 2020 - Study Promoting patient safety through prospective risk identification: example from peri-operative care. Citation Text: Smith AF, Boult M, Woods I, et al. Promoting patient safety through prospective risk identification: example from peri-operative care. Qual Saf Health Care. 2010;19(…

  2. "That was a close call": endorsing a broad definition of near misses in health care. | PSNet

    psnet.ahrq.gov/issue/was-close-call-endorsing-broad-definition-near-misses-health-care
    August 31, 2016 - Commentary "That was a close call": endorsing a broad definition of near misses in health care. Citation Text: Marks CM, Kasda E, Paine LA, et al. "That was a close call": endorsing a broad definition of near misses in health care. Jt Comm J Qual Patient Saf. 2013;39(10):475-479. Cop…

  3. Changing the work environment in ICUs to achieve patient-focused care: the time has come. | PSNet

    psnet.ahrq.gov/issue/changing-work-environment-icus-achieve-patient-focused-care-time-has-come
    April 05, 2023 - Commentary Changing the work environment in ICUs to achieve patient-focused care: the time has come. Citation Text: McCauley K, Irwin RS. Changing the work environment in ICUs to achieve patient-focused care: the time has come. Chest. 2006;130(5):1571-8. Copy Citation Format: …

  4. Association between elements of electronic health record systems and the weekend effect in urgent general surgery. | PSNet

    psnet.ahrq.gov/issue/association-between-elements-electronic-health-record-systems-and-weekend-effect-urgent
    November 04, 2015 - Study Association between elements of electronic health record systems and the weekend effect in urgent general surgery. Citation Text: Kothari A, Brownlee SA, Blackwell RH, et al. Association Between Elements of Electronic Health Record Systems and the Weekend Effect in Urgent General S…

  5. Retained foreign bodies: risk and outcomes at the national level. | PSNet

    psnet.ahrq.gov/issue/retained-foreign-bodies-risk-and-outcomes-national-level
    May 29, 2019 - Study Retained foreign bodies: risk and outcomes at the national level. Citation Text: Al-Qurayshi ZH, Hauch AT, Slakey DP, et al. Retained foreign bodies: risk and outcomes at the national level. J Am Coll Surg. 2015;220(4):749-759. doi:10.1016/j.jamcollsurg.2014.12.015. Copy Citation…

  6. A prospective hazard and improvement analytic approach to predicting the effectiveness of medication error interventions. | PSNet

    psnet.ahrq.gov/issue/prospective-hazard-and-improvement-analytic-approach-predicting-effectiveness-medication
    December 04, 2013 - Study A prospective hazard and improvement analytic approach to predicting the effectiveness of medication error interventions. Citation Text: Karnon J, McIntosh A, Dean JE, et al. A prospective hazard and improvement analytic approach to predicting the effectiveness of medication erro…

  7. Barcode medication administration software technology use in the emergency department and medication error rates. | PSNet

    psnet.ahrq.gov/issue/barcode-medication-administration-software-technology-use-emergency-department-and-medication
    November 04, 2015 - Study Barcode medication administration software technology use in the emergency department and medication error rates. Citation Text: Gauthier-Wetzel HE. Barcode medication administration software technology use in the emergency department and medication error rates. Comput Inform Nurs.…

  8. Toward a theoretical approach to medical error reporting system research and design. | PSNet

    psnet.ahrq.gov/issue/toward-theoretical-approach-medical-error-reporting-system-research-and-design
    November 30, 2011 - Study Toward a theoretical approach to medical error reporting system research and design. Citation Text: Karsh B-T, Escoto KH, Beasley JW, et al. Toward a theoretical approach to medical error reporting system research and design. Appl Ergon. 2006;37(3):283-95. Copy Citation Form…

  9. Human factors and simulation in emergency medicine. | PSNet

    psnet.ahrq.gov/issue/human-factors-and-simulation-emergency-medicine
    November 16, 2022 - Commentary Human factors and simulation in emergency medicine. Citation Text: Hayden EM, Wong AH, Ackerman J, et al. Human Factors and Simulation in Emergency Medicine. Acad Emerg Med. 2018;25(2):221-229. doi:10.1111/acem.13315. Copy Citation Format: DOI Google Scholar PubM…

  10. Medical errors in orthopaedics. Results of an AAOS member survey. | PSNet

    psnet.ahrq.gov/issue/medical-errors-orthopaedics-results-aaos-member-survey
    August 04, 2021 - Study Medical errors in orthopaedics. Results of an AAOS member survey. Citation Text: Wong DA, Herndon JH, Canale T, et al. Medical errors in orthopaedics. Results of an AAOS member survey. J Bone Joint Surg Am. 2009;91(3):547-57. doi:10.2106/JBJS.G.01439. Copy Citation Format: …

  11. Variability in the concentrations of intravenous drug infusions prepared in a critical care unit. | PSNet

    psnet.ahrq.gov/issue/variability-concentrations-intravenous-drug-infusions-prepared-critical-care-unit
    March 02, 2011 - Study Variability in the concentrations of intravenous drug infusions prepared in a critical care unit. Citation Text: Wheeler DW, Degnan BA, Sehmi JS, et al. Variability in the concentrations of intravenous drug infusions prepared in a critical care unit. Intensive Care Med. 2008;34(8…

  12. 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…

  13. Health services under pressure: a scoping review and development of a taxonomy of adaptive strategies. | PSNet

    psnet.ahrq.gov/issue/health-services-under-pressure-scoping-review-and-development-taxonomy-adaptive-strategies
    January 22, 2020 - Commentary Health services under pressure: a scoping review and development of a taxonomy of adaptive strategies. Citation Text: Page B, Irving D, Amalberti R, et al. Health services under pressure: a scoping review and development of a taxonomy of adaptive strategies. BMJ Qual Saf. 2023…

  14. Mistreatment in health care among women in Appalachia. | PSNet

    psnet.ahrq.gov/issue/mistreatment-health-care-among-women-appalachia
    October 04, 2023 - Study Mistreatment in health care among women in Appalachia. Citation Text: Alspaugh A, Swan LET, Auerbach SL, et al. Mistreatment in health care among women in Appalachia. Cult Health Sex. 2023;25(12):1690-1706. doi:10.1080/13691058.2023.2176547. Copy Citation Format: DOI …

  15. Patient safety systems in the primary health care of diabetes—a story of missed opportunities? | PSNet

    psnet.ahrq.gov/issue/patient-safety-systems-primary-health-care-diabetes-story-missed-opportunities
    March 28, 2011 - Review Patient safety systems in the primary health care of diabetes—a story of missed opportunities? Citation Text: Taub N, Baker R, Khunti K, et al. Patient safety systems in the primary health care of diabetes—a story of missed opportunities? Diabet Med. 2010;27(11):1322-6. Copy C…

  16. The power of written word: reflection reduces errors of omission. | PSNet

    psnet.ahrq.gov/issue/power-written-word-reflection-reduces-errors-omission
    April 24, 2018 - Study The power of written word: reflection reduces errors of omission. Citation Text: Rao A, Heidemann LA, Hartley S, et al. The power of written word: reflection reduces errors of omission. Clin Teach. 2024;21(1):e13630. doi:10.1111/tct.13630. Copy Citation Format: DOI Go…

  17. Retrieval medicine: a review and guide for UK practitioners. Part 2: safety in patient retrieval systems. | PSNet

    psnet.ahrq.gov/issue/retrieval-medicine-review-and-guide-uk-practitioners-part-2-safety-patient-retrieval-systems
    March 09, 2016 - Commentary Retrieval medicine: a review and guide for UK practitioners. Part 2: safety in patient retrieval systems. Citation Text: Hearns S, Shirley PJ. Retrieval medicine: a review and guide for UK practitioners. Part 2: safety in patient retrieval systems. Emerg Med J. 2006;23(12):9…

  18. Design for patient safety: a systems-based risk identification framework. | PSNet

    psnet.ahrq.gov/issue/design-patient-safety-systems-based-risk-identification-framework
    February 03, 2021 - Study Emerging Classic Design for patient safety: a systems-based risk identification framework. Citation Text: Simsekler MCE, Ward JR, Clarkson J. Design for patient safety: a systems-based risk identification framework. Ergonomics. 2018;61(8):1046-1064. doi:10…

  19. Impact of participation in the California Healthcare-Associated Infection Prevention Initiative on adoption and implementation of evidence-based practices for patient safety and health care–associated infection rates in a cohort of acute care general hospitals. | PSNet

    psnet.ahrq.gov/issue/impact-participation-california-healthcare-associated-infection-prevention-initiative
    September 28, 2011 - Study Impact of participation in the California Healthcare-Associated Infection Prevention Initiative on adoption and implementation of evidence-based practices for patient safety and health care–associated infection rates in a cohort of acute care general hospitals. Citation Text: Hal…

  20. Race differences in a malpractice event database in a large healthcare system. | PSNet

    psnet.ahrq.gov/issue/race-differences-malpractice-event-database-large-healthcare-system
    December 15, 2021 - Study Race differences in a malpractice event database in a large healthcare system. Citation Text: Thomas AD, Pandit C, Krevat S. Race differences in a malpractice event database in a large healthcare system. J Patient Saf. 2023;19(2):67-70. doi:10.1097/pts.0000000000001090. Copy Cita…
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