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Psn-Pdf (pdf file)
psnet.ahrq.gov/node/45397/psn-pdfAugust 10, 2016 - Many well-known hospitals fail to score high in Medicare rankings. August 10, 2016 Rau J. National Public Radio. July 27, 2016. https://psnet.ahrq.gov/issue/many-well-known-hospitals-fail-score-high-medicare-rankings Although quality rating systems have yet to receive approval across the health care industry, they… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/50709/psn-pdfDecember 04, 2019 - Cognitive engineering to improve patient safety and outcomes in cardiothoracic surgery December 4, 2019 Zenati MA, Kennedy-Metz L, Dias RD. Cognitive Engineering to Improve Patient Safety and Outcomes in Cardiothoracic Surgery. Semin Thorac Cardiovasc Surg. 2019. doi:10.1053/j.semtcvs.2019.10.011. https://psnet.ah… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/44132/psn-pdfMay 13, 2015 - Adverse outcomes: why bad things happen to good people. May 13, 2015 Sonnenberg A. Adverse outcomes: why bad things happen to good people. Clin Gastroenterol Hepatol. 2015;13(5):820-3.e1. doi:10.1016/j.cgh.2014.07.064. https://psnet.ahrq.gov/issue/adverse-outcomes-why-bad-things-happen-good-people This commentary… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/35598/psn-pdfJuly 10, 2008 - Residents report on adverse events and their causes. July 10, 2008 Jagsi R, Kitch BT, Weinstein DF, et al. Residents report on adverse events and their causes. Arch Intern Med. 2005;165(22):2607-13. https://psnet.ahrq.gov/issue/residents-report-adverse-events-and-their-causes This survey demonstrated that more tha… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/50425/psn-pdfSeptember 04, 2019 - Why doctors still offer treatments that may not help. September 4, 2019 Frakt A. New York Times. August 26, 2019. https://psnet.ahrq.gov/issue/why-doctors-still-offer-treatments-may-not-help The slow adoption of improvement innovations is a persistent challenge to high-quality and safe patient care. This newspaper… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/40883/psn-pdfFebruary 10, 2012 - Consensus statement on effective communication of urgent diagnoses and significant, unexpected diagnoses in surgical pathology and cytopathology from the College of American Pathologists and Association of Directors of Anatomic and Surgical Pathology. February 10, 2012 Nakhleh RE, Myers JL, Allen TC, et al. Conse… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/47708/psn-pdfFebruary 13, 2019 - The role of purple pens in learning to prescribe. February 13, 2019 Kinston R, McCarville N, Hassell A. The role of purple pens in learning to prescribe. Clin Teach. 2019;16(6):598-603. doi:10.1111/tct.12991. https://psnet.ahrq.gov/issue/role-purple-pens-learning-prescribe Interventions utilizing color as visual c… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/837608/psn-pdfSeptember 06, 2023 - Harm Caused by Delays in Transferring Patients to the Right Place of Care. September 6, 2023 Farnborough, UK: Healthcare Safety Investigation Branch; August 2023. https://psnet.ahrq.gov/issue/harm-caused-delays-transferring-patients-right-place-care Handoffs between prehospital emergency medical services (EMS) pro… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/851653/psn-pdfJuly 26, 2023 - Content analysis of nurses' reflections on medication errors in a regional hospital. July 26, 2023 Issacs AN, RAYMOND A, KENT B. Content analysis of nurses’ reflections on medication errors in a regional hospital. Contemp Nurse. 2023;59(3):202-213. doi:10.1080/10376178.2023.2220432. https://psnet.ahrq.gov/issue/co… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/44227/psn-pdfNovember 19, 2018 - A scholarly pathway in quality improvement and patient safety. November 19, 2018 Ferguson CC, Lamb G. A Scholarly Pathway in Quality Improvement and Patient Safety. Acad Med. 2015;90(10):1358-62. doi:10.1097/ACM.0000000000000772. https://psnet.ahrq.gov/issue/scholarly-pathway-quality-improvement-and-patient-safety… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/47871/psn-pdfMarch 27, 2019 - Closing the disclosure gap: medical errors in pediatrics. March 27, 2019 Lin M, Famiglietti H. Closing the Disclosure Gap: Medical Errors in Pediatrics. Pediatrics. 2019;143(4). doi:10.1542/peds.2019-0221. https://psnet.ahrq.gov/issue/closing-disclosure-gap-medical-errors-pediatrics Disclosure of errors and advers… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/60875/psn-pdfSeptember 02, 2020 - Understanding context specificity: the effect of contextual factors on clinical reasoning. September 2, 2020 Konopasky A, Artino AR, Battista A, et al. Understanding context specificity: the effect of contextual factors on clinical reasoning. Diagnosis (Berl). 2020;79(3):257-264. doi:10.1515/dx-2020-0016. https://… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/46422/psn-pdfNovember 29, 2017 - Framework for direct observation of performance and safety in healthcare. November 29, 2017 Catchpole K, Neyens DM, Abernathy J, et al. Framework for direct observation of performance and safety in healthcare. BMJ Qual Saf. 2017;26(12):1015-1021. doi:10.1136/bmjqs-2016-006407. https://psnet.ahrq.gov/issue/framewor… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/43772/psn-pdfJune 24, 2019 - Betsy Lehman Center for Patient Safety. June 24, 2019 501 Boylston Street, 5th Floor, Boston, MA, 02116 info@BetsyLehmanCenterMA.gov https://psnet.ahrq.gov/issue/betsy-lehman-center-patient-safety The Betsy Lehman Center is a nonregulatory Massachusetts state agency named for Betsy Lehman, the Boston Globe columni… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/46927/psn-pdfApril 04, 2018 - Clinician Well-Being Knowledge Hub. April 4, 2018 Washington, DC: National Academy of Medicine. https://psnet.ahrq.gov/issue/clinician-well-being-knowledge-hub Clinician burnout can detract from individual wellness, patient safety, and organizational health. This website serves as a companion to a collaborative ef… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/39227/psn-pdfJanuary 13, 2010 - Executive summary of the American College of Obstetricians and Gynecologists Presidential Task Force on Patient Safety in the Office Setting: reinvigorating safety in office-based gynecologic surgery. January 13, 2010 Erickson TB, Kirkpatrick DH, DeFrancesco MS, et al. Executive summary of the American College of … -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/46438/psn-pdfSeptember 20, 2017 - Communicating Clearly About Medicines: Proceedings of a Workshop. September 20, 2017 National Academies of Sciences, Engineering, and Medicine. Washington, DC: The National Academies Press: 2017. ISBN: 9780309461856. https://psnet.ahrq.gov/issue/communicating-clearly-about-medicines-proceedings-workshop Patient h… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/836835/psn-pdfMarch 30, 2022 - Bias in mental health diagnosis gets in the way of treatment. March 30, 2022 Garb HN. Psyche. March 22, 2022. https://psnet.ahrq.gov/issue/bias-mental-health-diagnosis-gets-way-treatment A wide array of biases can affect clinical judgement and contribute to diagnostic error. This article discusses the impact of i… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/36838/psn-pdfApril 19, 2011 - A very public failure: lessons for quality improvement in healthcare organisations from the Bristol Royal Infirmary. April 19, 2011 Walshe K, Offen N. A very public failure: lessons for quality improvement in healthcare organisations from the Bristol Royal Infirmary. Qual Health Care. 2001;10(4):250-6. https://psn… -
Psn-Pdf (pdf file)
psnet.ahrq.gov/node/61003/psn-pdfOctober 07, 2020 - Making Complaints Count: Supporting Complaints Handling in the NHS and UK Government Departments. October 7, 2020 Manchester, UK: The Parliamentary and Health Service Ombudsman; July 15, 2020. ISBN 9781528620666. https://psnet.ahrq.gov/issue/making-complaints-count-supporting-complaints-handling-nhs-and-uk- gover…
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