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psnet.ahrq.gov/issue/supporting-psychiatric-hospital-culture-safety
March 11, 2020 - Study
Supporting a psychiatric hospital culture of safety.
Citation Text:
Mahoney JS, Ellis TE, Garland G, et al. Supporting a psychiatric hospital culture of safety. J Am Psychiatr Nurses Assoc. 2012;18(5):299-306. doi:10.1177/1078390312460577.
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psnet.ahrq.gov/issue/teamwork-obstetric-critical-care
January 31, 2024 - Review
Teamwork in obstetric critical care.
Citation Text:
Guise J-M, Segel S. Teamwork in obstetric critical care. Best Pract Res Clin Obstet Gynaecol. 2008;22(5):937-51. doi:10.1016/j.bpobgyn.2008.06.010.
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psnet.ahrq.gov/issue/physician-motivation-listening-what-pay-performance-programs-and-quality-improvement
January 02, 2017 - Commentary
Physician motivation: listening to what pay-for-performance programs and quality improvement collaboratives are telling us.
Citation Text:
Herzer KR, Pronovost P. Physician Motivation: Listening to What Pay-for-Performance Programs and Quality Improvement Collaboratives Are Te…
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psnet.ahrq.gov/issue/safety-academic-medical-center-transforming-challenges-ingredients-improvement
February 17, 2011 - Review
Safety in the academic medical center: transforming challenges into ingredients for improvement.
Citation Text:
Blumenthal D, Ferris T. Safety in the academic medical center: transforming challenges into ingredients for improvement. Acad Med. 2006;81(9):817-22.
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psnet.ahrq.gov/issue/hospital-admissions-due-adverse-drug-reactions-report-boston-collaborative-drug-surveillance
March 01, 2023 - Study
Classic
Hospital admissions due to adverse drug reactions: a report from the Boston Collaborative Drug Surveillance Program.
Citation Text:
Miller RR. Hospital admissions due to adverse drug reactions. A report from the Boston Collaborative Drug Surveill…
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psnet.ahrq.gov/issue/white-paper-recommendation-systems-based-practice-competency
December 18, 2017 - Commentary
White paper on recommendation for systems-based practice competency.
Citation Text:
Stalter AM, Phillips JM, Dolansky MA. QSEN Institute RN-BSN Task Force: White Paper on Recommendation for Systems-Based Practice Competency. J Nurs Care Qual. 2017;32(4):354-358. doi:10.1097/NC…
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psnet.ahrq.gov/issue/fostering-patient-safety-competencies-using-multiple-patient-simulation-experiences
January 12, 2022 - Study
Fostering patient safety competencies using multiple-patient simulation experiences.
Citation Text:
Ironside PM, Jeffries PR, Martin A. Fostering patient safety competencies using multiple-patient simulation experiences. Nurs Outlook. 2009;57(6):332-7. doi:10.1016/j.outlook.2009.0…
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psnet.ahrq.gov/issue/communication-about-harm-reduction-patients-who-have-opioid-use-disorder
January 02, 2017 - Commentary
Communication about harm reduction with patients who have opioid use disorder.
Citation Text:
Hawk M, Jawa R, Kay ES. Communication about harm reduction with patients who have opioid use disorder. JAMA. 2025;333(2):163-164. doi:10.1001/jama.2024.21307.
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psnet.ahrq.gov/issue/understanding-vs-competency-case-accuracy-checking-dispensed-medicines-pharmacy
December 11, 2013 - Study
Understanding vs. competency: the case of accuracy checking dispensed medicines in pharmacy.
Citation Text:
James L, Davies G, Kinchin I, et al. Understanding vs. competency: the case of accuracy checking dispensed medicines in pharmacy. Adv Health Sci Educ Theory Pract. 2010;15(…
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psnet.ahrq.gov/issue/model-disruptive-surgeon-behavior-perioperative-environment
February 05, 2020 - Study
A model of disruptive surgeon behavior in the perioperative environment.
Citation Text:
Cochran A, Elder WB. A model of disruptive surgeon behavior in the perioperative environment. J Am Coll Surg. 2014;219(3):390-8. doi:10.1016/j.jamcollsurg.2014.05.011.
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psnet.ahrq.gov/issue/error-omission-simple-checklist-approach-improving-operating-room-safety
August 03, 2022 - Commentary
The error of omission: a simple checklist approach for improving operating room safety.
Citation Text:
Rosenfield LK, Chang DS. The error of omission: a simple checklist approach for improving operating room safety. Plast Reconstr Surg. 2009;123(1):399-402. doi:10.1097/PRS.0…
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psnet.ahrq.gov/issue/sins-omission-getting-too-little-medical-care-may-be-greatest-threat-patient-safety
March 06, 2005 - Study
Sins of omission. Getting too little medical care may be the greatest threat to patient safety.
Citation Text:
Hayward RA, Asch SM, Hogan MM, et al. Sins of omission: getting too little medical care may be the greatest threat to patient safety. J Gen Intern Med. 2005;20(8):686-91…
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psnet.ahrq.gov/issue/teaching-medication-reconciliation-through-simulation-patient-safety-initiative-second-year
May 04, 2010 - Commentary
Teaching medication reconciliation through simulation: a patient safety initiative for second year medical students.
Citation Text:
Lindquist LA, Gleason KM, McDaniel MR, et al. Teaching medication reconciliation through simulation: a patient safety initiative for second yea…
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www.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/modules/teamwork/culture-checkup-tool.html
July 01, 2023 - Culture Checkup Tool
AHRQ Safety Program for Perinatal Care
Problem statement: Improving safety culture in a patient care area takes time.
What is culture? Attitudes reflect the norms, values, and beliefs in the unit and, in turn, create the culture. No matter what instrument you use to assess…
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psnet.ahrq.gov/issue/medical-error-disclosure-training-evidence-values-based-ethical-environments
October 15, 2016 - Study
Medical error disclosure training: evidence for values-based ethical environments.
Citation Text:
Rathert C, Phillips W. Medical Error Disclosure Training: Evidence for Values-Based Ethical Environments. Journal of Business Ethics. 2010;97(3). doi:10.1007/s10551-010-0520-3.
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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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digital.ahrq.gov/ahrq-funded-projects/annual-conference-health-it-analytics-2021-2023
January 01, 2023 - Annual Conferences on Health IT & Analytics 2021-2023
Project Final Report ( PDF , 2.51 MB) Disclaimer
Disclaimer
The findings and conclusions in this document are those of the author(s), who are responsible for its content, and do not necessarily represent the views of AHRQ. No …
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psnet.ahrq.gov/issue/health-technology-quality-and-safety-learning-health-system
February 09, 2022 - Commentary
Health technology, quality and safety in a learning health system.
Citation Text:
Borycki EM, Kushniruk AW. Health technology, quality and safety in a learning health system. Healthc Manage Forum. 2023;51(2):212-221. doi:10.1177/08404704221139383.
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integrationacademy.ahrq.gov/news-and-events/news/nofo-released-innovation-behavioral-health-model
July 22, 2024 - An official website of the Department of Health & Human Services
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psnet.ahrq.gov/issue/improving-diagnosis-health-care
September 12, 2018 - Book/Report
Classic
Improving Diagnosis in Health Care.
Citation Text:
Improving Diagnosis in Health Care. Committee on Diagnostic Error in Health Care, National Academies of Science, Engineering, and Medicine. Washington, DC: National Academies Press; 2015. ISB…