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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/852808/psn-pdf
    August 30, 2023 - Prolonged DKA in Pregnancy: A Case of Communication Breakdown. August 30, 2023 Marshall S, Boe NM. Prolonged DKA in Pregnancy: A Case of Communication Breakdown. PSNet [internet]. 2023. https://psnet.ahrq.gov/web-mm/prolonged-dka-pregnancy-case-communication-breakdown Disclosure of Relevant Financial Relationship…
  2. Spotlight (pdf file)

    psnet.ahrq.gov/sites/default/files/2023-08/spotlight_case_prolonged_dka_in_pregnancy_-_slides_-_revised.pdf
    January 01, 2023 - Spotlight Spotlight Prolonged DKA in Pregnancy: A Case of Communication Breakdown Source and Credits • This presentation is based on the August 2023 AHRQ WebM&M Spotlight Case o See the full article at https://psnet.ahrq.gov/webmm o CME credit is available o Commentary by: Sarah Marshall, MD and Nina M. …
  3. psnet.ahrq.gov/perspective/what-does-simulation-add-teamwork-training
    October 01, 2004 - What Does Simulation Add to Teamwork Training? David M. Gaba, MD | March 1, 2006  View more articles from the same authors. Citation Text: Gaba DM. What Does Simulation Add to Teamwork Training?. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and …
  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45123/psn-pdf
    May 07, 2018 - Hardwiring safety into the computer system: one hospital's actions to provide technology support for U- 500 insulin. May 7, 2018 ISMP Medication Safety Alert! Acute Care Edition. May 5, 2016;21:1-4. https://psnet.ahrq.gov/issue/hardwiring-safety-computer-system-one-hospitals-actions-provide-technology- support-u-…
  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/861838/psn-pdf
    January 31, 2024 - Adverse Drug Event (ADE) Surveillance and Pharmacist Counseling January 31, 2024 https://psnet.ahrq.gov/innovation/adverse-drug-event-ade-surveillance-and-pharmacist-counseling Summary Adverse events resulting from medications are a common occurrence that often go undetected, unreported, and unaddressed.1 The imp…
  6. psnet.ahrq.gov/perspective/health-plan-patient-safety-initiatives
    July 10, 2024 - Health Plan Patient Safety Initiatives Amy Helwig, MD, MS, FAAFP, Zoe Sousane, BS, Sarah Mossburg, RN, PhD | July 10, 2024  Also Read the Conversation View more articles from the same authors. Citation Text: Helwig A, Sousane Z, Mossburg S. Health Plan Patient S…
  7. psnet.ahrq.gov/perspective/conversation-withamy-helwig-about-health-plan-patient-safety-initiatives
    July 10, 2024 - In Conversation With...Amy Helwig about Health Plan Patient Safety Initiatives Amy Helwig, MD, MS, FAAFP, Zoe Sousane, BS, Sarah Mossburg, RN, PhD | July 10, 2024  Also Read the Essay View more articles from the same authors. Citation Text: Helwig A, Sousane Z, …
  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33856/psn-pdf
    April 01, 2018 - Patient Safety During Hospital Discharge April 1, 2018 Liang K, Alper E. Patient Safety During Hospital Discharge. PSNet [internet]. 2018. https://psnet.ahrq.gov/perspective/patient-safety-during-hospital-discharge Perspective Patients are admitted to the hospital in the United States 35 million times per year.(1)…
  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33629/psn-pdf
    March 01, 2006 - What Does Simulation Add to Teamwork Training? March 1, 2006 Gaba DM. What Does Simulation Add to Teamwork Training? PSNet [internet]. 2006. https://psnet.ahrq.gov/perspective/what-does-simulation-add-teamwork-training Editor's Note: In these point–counterpoint articles, Drs. Pratt and Sachs of Beth Israel Deacones…
  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49685/psn-pdf
    May 01, 2013 - Polypharmacy May 1, 2013 Guglielmo JB. Polypharmacy. PSNet [internet]. 2013. https://psnet.ahrq.gov/web-mm/polypharmacy The Case A 65-year-old man with schizophrenia receives his routine outpatient psychiatric care through an agency. His case manager visits him weekly regarding medication adherence, which include…
  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44236/psn-pdf
    October 13, 2015 - We thought we would be perfect: medication errors before and after the initiation of computerized physician order entry. October 13, 2015 Schwartzberg D, Ivanovic S, Patel S, et al. We thought we would be perfect: medication errors before and after the initiation of Computerized Physician Order Entry. J Surg Res. …
  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47489/psn-pdf
    November 21, 2018 - Impact of the Care Quality Commission on Provider Performance: Room for Improvement? November 21, 2018 Smithson R, Richardson E, Roberts J, et al. The King's Fund, Alliance Manchester Business School; September 2018. ISBN: 9781909029880. https://psnet.ahrq.gov/issue/impact-care-quality-commission-provider-performa…
  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45765/psn-pdf
    April 05, 2017 - Clinical reasoning in the context of active decision support during medication prescribing. April 5, 2017 Horsky J, Aarts J, Verheul L, et al. Clinical reasoning in the context of active decision support during medication prescribing. Int J Med Inform. 2017;97:1-11. doi:10.1016/j.ijmedinf.2016.09.004. https://psne…
  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/34694/psn-pdf
    February 10, 2011 - Computerized surveillance of adverse drug events in hospital patients. February 10, 2011 Classen DC, Pestotnik SL, Evans RS, et al. Computerized surveillance of adverse drug events in hospital patients. JAMA. 1991;266(20):2847-51. https://psnet.ahrq.gov/issue/computerized-surveillance-adverse-drug-events-hospital-…
  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/38690/psn-pdf
    April 07, 2010 - Are verbal orders a threat to patient safety? April 7, 2010 Wakefield DS, Wakefield BJ. Are verbal orders a threat to patient safety? Qual Saf Health Care. 2009;18(3):165-168. doi:10.1136/qshc.2009.034041. https://psnet.ahrq.gov/issue/are-verbal-orders-threat-patient-safety Verbal orders (VOs) are often complex co…
  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46359/psn-pdf
    September 21, 2017 - Parent–provider miscommunications in hospitalized children. September 21, 2017 Khan A, Furtak SL, Melvin P, et al. Parent-Provider Miscommunications in Hospitalized Children. Hosp Pediatr. 2017;7(9):505-515. doi:10.1542/hpeds.2016-0190. https://psnet.ahrq.gov/issue/parent-provider-miscommunications-hospitalized-ch…
  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/864851/psn-pdf
    March 20, 2024 - The Joint Commission's ongoing professional practice evaluation process: costly, ineffective, and potentially harmful to safety culture. March 20, 2024 Donnelly LF, Podberesky DJ, Towbin AJ, et al. The Joint Commission's ongoing professional practice evaluation process: costly, ineffective, and potentially harmful…
  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/858174/psn-pdf
    December 13, 2023 - Anaesthesia clinicians' perception of safety, workload, anxiety, and stress in a remote hybrid suite compared with the operating room. December 13, 2023 Schroeck H, Whitty MA, Martinez-Camblor P, et al. Anaesthesia clinicians' perception of safety, workload, anxiety, and stress in a remote hybrid suite compared wi…
  19. psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.84_slideshow.ppt
    December 01, 2004 - Spotlight Case [MONTH] 2003 Spotlight Case December 2004 Discharge Fumbles Source and Credits This presentation is based on the Dec. 2004 AHRQ WebM&M Spotlight Case in Hospital Medicine See the full article at http://webmm.ahrq.gov CME credit is available through the Web site Commentary by: Alan Forster, M…
  20. psnet.ahrq.gov/issue/schwartz-center-rounds-evaluation-interdisciplinary-approach-enhancing-patient-centered
    October 14, 2020 - Study The Schwartz Center Rounds: evaluation of an interdisciplinary approach to enhancing patient-centered communication, teamwork, and provider support. Citation Text: Lown BA, Manning CF. The Schwartz Center Rounds: evaluation of an interdisciplinary approach to enhancing patient-ce…

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