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8981. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/47120/psn-pdf
      July 18, 2018 - Complicated: medical missteps are not inevitable. July 18, 2018 Yurkiewicz IR. Complicated: Medical Missteps Are Not Inevitable. Health Aff (Millwood). 2018;37(7):1178- 1181. doi:10.1377/hlthaff.2017.1550. https://psnet.ahrq.gov/issue/complicated-medical-missteps-are-not-inevitable This commentary provides a clini…

8982. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/47899/psn-pdf
      April 24, 2019 - What words convey: the potential for patient narratives to inform quality improvement. April 24, 2019 Grob R, Schlesinger M, Barre LR, et al. What Words Convey: The Potential for Patient Narratives to Inform Quality Improvement. Milbank Q. 2019;97(1):176-227. doi:10.1111/1468-0009.12374. https://psnet.ahrq.gov/iss…

8983. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/34930/psn-pdf
      April 06, 2011 - "Going solid": a model of system dynamics and consequences for patient safety. April 6, 2011 Cook R, Rasmussen J. "Going solid": a model of system dynamics and consequences for patient safety. Qual Saf Health Care. 2005;14(2):130-4. https://psnet.ahrq.gov/issue/going-solid-model-system-dynamics-and-consequences-pa…

8984. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/43487/psn-pdf
      September 03, 2014 - Mentorship for newly appointed physicians: a strategy for enhancing patient safety? September 3, 2014 Harrison R, McClean S, Lawton R, et al. Mentorship for newly appointed physicians: a strategy for enhancing patient safety? J Patient Saf. 2014;10(3):159-67. doi:10.1097/PTS.0b013e31829e4b7e. https://psnet.ahrq.go…

8985. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/46677/psn-pdf
      June 25, 2018 - Diagnostic errors in paediatric cardiac intensive care. June 25, 2018 Bhat PN, Costello JM, Aiyagari R, et al. Diagnostic errors in paediatric cardiac intensive care. Cardiol Young. 2018;28(5):675-682. doi:10.1017/S1047951117002906. https://psnet.ahrq.gov/issue/diagnostic-errors-paediatric-cardiac-intensive-care R…

8986. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/42383/psn-pdf
      December 29, 2014 - Associations of patient safety outcomes with models of nursing care organization at unit level in hospitals. December 29, 2014 Dubois C-A, D'Amour D, Tchouaket E, et al. Associations of patient safety outcomes with models of nursing care organization at unit level in hospitals. Int J Qual Health Care. 2013;25(2):11…

8987. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/847735/psn-pdf
      May 30, 2023 - SOPS Ambulatory Surgery Center Survey: What You Need to Know. May 30, 2023 Agency for Healthcare Policy and Research: April 27, 2023. https://psnet.ahrq.gov/issue/sops-ambulatory-surgery-center-survey-what-you-need-know Ambulatory surgery centers (ASC) experience a variety of error types that can be exacerbated by…

8988. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/48049/psn-pdf
      May 29, 2019 - How one health system overcame resistance to a surgical checklist. May 29, 2019 Hilton K, Anderson A. Harv Bus Rev. May 20, 2019. https://psnet.ahrq.gov/issue/how-one-health-system-overcame-resistance-surgical-checklist This commentary describes how one health system worked to combat resistance to change associate…

8989. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/38269/psn-pdf
      October 01, 2024 - Nursing Home Survey on Patient Safety Culture. October 1, 2024 Rockville, MD: Agency for Healthcare Research and Quality; October 2020. https://psnet.ahrq.gov/issue/nursing-home-survey-patient-safety-culture Challenges to establishing and sustaining a safety culture in a nursing home include insufficient staffing …

8990. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/74215/psn-pdf
      October 25, 2011 - Race and the clinical diagnosis of depression in new primary care patients. October 25, 2011 Lukachko A, Olfson M. Race and the clinical diagnosis of depression in new primary care patients. Gen Hosp Psychiatry. 2011;34(1):98-100. doi:10.1016/j.genhosppsych.2011.09.008. https://psnet.ahrq.gov/issue/race-and-clinic…

8991. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/46160/psn-pdf
      June 07, 2017 - ISMP Guidelines for Optimizing Safe Subcutaneous Insulin Use in Adults. June 7, 2017 Horsham, PA: Institute for Safe Medication Practices; May 2017. https://psnet.ahrq.gov/issue/ismp-guidelines-optimizing-safe-subcutaneous-insulin-use-adults Insulin is a widely used medication that can contribute to serious patien…

8992. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/73680/psn-pdf
      January 01, 2022 - Interventions targeted at reducing diagnostic error: systematic review. September 8, 2021 Dave N, Bui S, Morgan C, et al. Interventions targeted at reducing diagnostic error: systematic review. BMJ Qual Saf. 2022;31(4):297-307. doi:10.1136/bmjqs-2020-012704. https://psnet.ahrq.gov/issue/interventions-targeted-redu…

8993. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/844551/psn-pdf
      February 15, 2023 - Emotional safety is patient safety. February 15, 2023 Lyndon A, Davis D-A, Sharma AE, et al. Emotional safety is patient safety. BMJ Qual Saf. 2023;32(7):369- 372. doi:10.1136/bmjqs-2022-015573. https://psnet.ahrq.gov/issue/emotional-safety-patient-safety Patient perspectives can provide unique insights into care …

8994. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/838925/psn-pdf
      March 03, 2025 - Improving Quality and Safety in Healthcare. March 3, 2025 Dixon-Woods M, Martin G, eds. Cambridge, UK: Cambridge University Press; 2022-2025. https://psnet.ahrq.gov/issue/improving-quality-and-safety-healthcare Improvement activities are complex initiatives that require synergistic actions by organizations to be s…

8995. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/850343/psn-pdf
      December 12, 2023 - Challenge Competition: Impact of Patient Safety Tools. December 12, 2023 Rockville, MD: Agency for Healthcare Research and Quality; 2023. https://psnet.ahrq.gov/issue/challenge-competition-impact-patient-safety-tools The Agency for Healthcare Research and Quality (AHRQ) offers many practical tools and resource…

8996. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/46727/psn-pdf
      August 21, 2021 - Alliance for Innovation on Maternal Health. August 21, 2021 American College of Obstetricians and Gynecologists. https://psnet.ahrq.gov/issue/alliance-innovation-maternal-health This website provides information from a multidisciplinary collaboration whose mission was to support safe health care for pregnant and p…

8997. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/74057/psn-pdf
      November 10, 2021 - Patient and clinician experiences of uncertainty in the diagnostic process: current understanding and future directions. November 10, 2021 Meyer AND, Giardina TD, Khawaja L, et al. Patient and clinician experiences of uncertainty in the diagnostic process: current understanding and future directions. Patient Educ …

8998. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/867603/psn-pdf
      March 15, 2025 - Request for Information Regarding the Impact of Ageism in Healthcare. January 22, 2025 Request for Information Regarding the Impact of Ageism in Healthcare. Agency for Healthcare Quality and Research. Fed Register. December 27, 2024. 89:105605-105606. https://psnet.ahrq.gov/issue/request-information-regarding-impa…

8999. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/73499/psn-pdf
      July 14, 2021 - Ethics & Governance of Artificial Intelligence for Health. July 14, 2021 Health Ethics & Governance, World Health Organization. Geneva, Switzerland: World Health Organization; 2021.  ISBN: 9789240029200 https://psnet.ahrq.gov/issue/ethics-governance-artificial-intelligence-health Advanced computing t…

9000. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/866524/psn-pdf
      August 14, 2024 - Generative artificial intelligence, patient safety and healthcare quality: a review. August 14, 2024 Howell MD. Generative artificial intelligence, patient safety and healthcare quality: a review. BMJ Qual Saf. 2024;33(11):748-754. doi:10.1136/bmjqs-2023-016690. https://psnet.ahrq.gov/issue/generative-artificial-i…