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psnet.ahrq.gov/issue/organisational-culture-variation-across-hospitals-and-connection-patient-safety-climate
March 17, 2010 - Study
Organisational culture: variation across hospitals and connection to patient safety climate.
Citation Text:
Speroff T, Nwosu S, Greevy R, et al. Organisational culture: variation across hospitals and connection to patient safety climate. Qual Saf Health Care. 2010;19(6):592-6. do…
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psnet.ahrq.gov/issue/learning-mistakes-easier-said-done-group-and-organizational-influences-detection-and
September 25, 2024 - Study
Classic
Learning from mistakes is easier said than done: group and organizational influences on the detection and correction of human error.
Citation Text:
Edmondson AC. Learning from Mistakes is Easier Said Than Done: Group and Organizational Influences o…
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psnet.ahrq.gov/issue/its-all-about-patient-safety-ethnographic-study-how-pharmacy-staff-construct-medicines-safety
October 06, 2021 - Study
'It's all about patient safety': an ethnographic study of how pharmacy staff construct medicines safety in the context of polypharmacy.
Citation Text:
Fudge N, Swinglehurst D. ‘It's all about patient safety’: an ethnographic study of how pharmacy staff construct medicines safety in…
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psnet.ahrq.gov/issue/systematic-review-frequency-and-quality-reporting-patient-and-public-involvement-patient
February 17, 2021 - Review
Systematic review on the frequency and quality of reporting patient and public involvement in patient safety research.
Citation Text:
Hammoud S, Alsabek L, Rogers L, et al. Systematic review on the frequency and quality of reporting patient and public involvement in patient safety…
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psnet.ahrq.gov/issue/machine-learning-approach-reclassifying-miscellaneous-patient-safety-event-reports
July 22, 2020 - Study
A machine learning approach to reclassifying miscellaneous patient safety event reports.
Citation Text:
Fong A, Behzad S, Pruitt Z, et al. A machine learning approach to reclassifying miscellaneous patient safety event reports. J Patient Saf. 2021;17(8):e829-e833. doi:10.1097/pts.0…
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psnet.ahrq.gov/node/33834/psn-pdf
May 22, 2017 - Opioid Overdose as a Patient Safety Problem
May 22, 2017
Murimi IB, Alexander CG. Opioid Overdose as a Patient Safety Problem. PSNet [internet]. 2017.
https://psnet.ahrq.gov/perspective/opioid-overdose-patient-safety-problem
Perspective
Opioids serve a valuable role in the treatment of acute pain and pain associat…
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psnet.ahrq.gov/node/49473/psn-pdf
March 01, 2005 - On O.R. Off?
March 1, 2005
Leonard M. On O.R. Off? PSNet [internet]. 2005.
https://psnet.ahrq.gov/web-mm/or
The Case
An elderly man was admitted to the vascular surgery service with rest pain in his leg. Angiography
demonstrated peripheral artery disease with anatomy suitable for revascularization. A consulting
…
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psnet.ahrq.gov/innovation/critical-radiology-alert-process
November 16, 2022 - Critical Radiology Alert Process
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October 30, 2024
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psnet.ahrq.gov/perspective/conversation-dave-debronkart
June 01, 2014 - contained more expertise than that of the physician.( 28 ) Health 2.0 expanded upon this concept by promoting
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psnet.ahrq.gov/perspective/identifying-adverse-events-not-present-admission-can-we-do-it
October 01, 2008 - I don't believe that we need many more policies promoting public reporting and transparency, or pay for
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psnet.ahrq.gov/issue/when-doctors-share-visit-notes-patients-study-patient-and-doctor-perceptions-documentation
October 27, 2021 - Study
When doctors share visit notes with patients: a study of patient and doctor perceptions of documentation errors, safety opportunities and the patient–doctor relationship.
Citation Text:
Bell SK, Mejilla R, Anselmo M, et al. When doctors share visit notes with patients: a study of p…
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psnet.ahrq.gov/issue/validity-unplanned-admission-intensive-care-unit-measure-patient-safety-surgical-patients
May 26, 2021 - Study
Validity of unplanned admission to an intensive care unit as a measure of patient safety in surgical patients.
Citation Text:
Haller G, Myles PS, Wolfe R, et al. Validity of unplanned admission to an intensive care unit as a measure of patient safety in surgical patients. Anesthe…
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psnet.ahrq.gov/issue/vital-signs-trends-emergency-department-visits-suspected-opioid-overdoses-united-states-july
January 23, 2019 - Study
Vital signs: trends in emergency department visits for suspected opioid overdoses- United States, July 2016- September 2017.
Citation Text:
Vivolo-Kantor AM, Seth P, Gladden M, et al. Vital Signs: Trends in Emergency Department Visits for Suspected Opioid Overdoses - United States,…
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psnet.ahrq.gov/issue/potentially-preventable-30-day-hospital-readmissions-childrens-hospital
July 11, 2017 - Study
Potentially preventable 30-day hospital readmissions at a children's hospital.
Citation Text:
Toomey SL, Peltz A, Loren S, et al. Potentially Preventable 30-Day Hospital Readmissions at a Children's Hospital. Pediatrics. 2016;138(2). doi:10.1542/peds.2015-4182.
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psnet.ahrq.gov/issue/top-patient-safety-strategies-can-be-encouraged-adoption-now
September 20, 2011 - Commentary
The top patient safety strategies that can be encouraged for adoption now.
Citation Text:
Shekelle PG, Pronovost P, Wachter R, et al. The top patient safety strategies that can be encouraged for adoption now. Ann Intern Med. 2013;158(5 Pt 2):365-8. doi:10.7326/0003-4819-158-…
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psnet.ahrq.gov/issue/structured-approach-ehr-surveillance-diagnostic-error-acute-care-exploratory-analysis-two
October 16, 2024 - Study
A structured approach to EHR surveillance of diagnostic error in acute care: an exploratory analysis of two institutionally-defined case cohorts.
Citation Text:
Malik MA, Motta-Calderon D, Piniella N, et al. A structured approach to EHR surveillance of diagnostic error in acute car…
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psnet.ahrq.gov/issue/using-event-reports-real-time-identify-and-mitigate-patient-safety-concerns-during-covid-19
March 23, 2022 - Commentary
Using event reports in real-time to identify and mitigate patient safety concerns during the COVID-19 pandemic.
Citation Text:
Kasda EM, Robson C, Saunders J, et al. Using event reports in real-time to identify and mitigate patient safety concerns during the COVID-19 pandemic.…
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psnet.ahrq.gov/issue/engineering-care-transitions-clinician-perceptions-barriers-safe-medication-management-during
July 20, 2022 - Study
Engineering care transitions: clinician perceptions of barriers to safe medication management during transitions of patient care.
Citation Text:
Hannum SM, Abebe E, Xiao Y, et al. Engineering care transitions: clinician perceptions of barriers to safe medication management during t…
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psnet.ahrq.gov/issue/medication-related-hospital-readmissions-within-30-days-discharge-prevalence-preventability
April 27, 2022 - Study
Medication-related hospital readmissions within 30 days of discharge: prevalence, preventability, type of medication errors and risk factors.
Citation Text:
Uitvlugt EB, Janssen MJA, Siegert CEH, et al. Medication-related hospital readmissions within 30 days of discharge: prevalenc…
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psnet.ahrq.gov/issue/going-covid-19-gemba-using-observation-and-high-reliability-strategies-achieve-safety-time
May 12, 2021 - Commentary
Going to the COVID-19 Gemba: using observation and high reliability strategies to achieve safety in a time of crisis.
Citation Text:
Thull-Freedman J, Mondoux S, Stang A, et al. Going to the COVID-19 Gemba: Using observation and high reliability strategies to achieve safety in…