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February 17, 2011 - Revisiting duty-hour limits — IOM recommendations for
patient safety and resident education.
February 17, 2011
Iglehart JK. Revisiting duty-hour limits--IOM recommendations for patient safety and resident education. N
Engl J Med. 2008;359(25):2633-5. doi:10.1056/NEJMp0808736.
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May 08, 2019 - A mixed-method study of practitioners' perspectives on
issues related to EHR medication reconciliation at a
health system.
May 8, 2019
Rangachari P, Dellsperger KC, Fallaw D, et al. A Mixed-Method Study of Practitioners' Perspectives on
Issues Related to EHR Medication Reconciliation at a Health System. Qual Manag…
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July 12, 2017 - Optimizing a Business Case for Safe Health Care: An
Integrated Approach to Safety and Finance.
July 12, 2017
Institute for Healthcare Improvement, National Patient Safety Foundation. Cambridge, MA: Institute for
Healthcare Improvement; 2017.
https://psnet.ahrq.gov/issue/optimizing-business-case-safe-health-care-in…
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March 24, 2021 - Clinical data sharing improves quality measurement and
patient safety.
March 24, 2021
D’Amore JD, McCrary LK, Denson J, et al. Clinical data sharing improves quality measurement and patient
safety. J Am Med Inform Assoc. 2021;28(7):1534-1542. doi:10.1093/jamia/ocab039.
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June 22, 2022 - Parent participation in morbidity and mortality review:
parent and physician perspectives.
June 22, 2022
de Loizaga SR, Clarke-Myers K, R Khoury P, et al. Parent participation in morbidity and mortality review:
parent and physician perspectives. J Patient Exp. 2022;9:237437352211026.
doi:10.1177/23743735221102674.…
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February 17, 2011 - Disciplinary action by medical boards and prior behavior
in medical schools.
February 17, 2011
Papadakis MA, Teherani A, Banach MA, et al. Disciplinary action by medical boards and prior behavior in
medical school. N Engl J Med. 2005;353(25):2673-82.
https://psnet.ahrq.gov/issue/disciplinary-action-medical-boards-…
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October 18, 2023 - Ranking of the Rate of State Medical Boards’ Serious
Disciplinary Actions, 2019-2021.
October 18, 2023
Wolfe SW, Oshel RE. Washington, DC: Public Citizen; August 16, 2023.
https://psnet.ahrq.gov/issue/ranking-rate-state-medical-boards-serious-disciplinary-actions-2019-2021
There are recognized systemic w…
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June 27, 2018 - Medication Without Harm: WHO's Third Global Patient
Safety Challenge.
June 27, 2018
Geneva, Switzerland: World Health Association; 2017.
https://psnet.ahrq.gov/issue/medication-without-harm-whos-third-global-patient-safety-challenge
Adverse drug events are likely the most common source of preventable harm in both …
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September 21, 2022 - Exploration of a rapid response team model of care: a
descriptive dual methods study.
September 21, 2022
Shiell A, Fry M, Elliott D, et al. Exploration of a rapid response team model of care: a descriptive dual
methods study. Intensive Crit Care Nurs. 2022;73:103294. doi:10.1016/j.iccn.2022.103294.
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June 03, 2016 - Learning from failure: the need for independent safety
investigation in healthcare.
June 3, 2016
Macrae C, Vincent CA. Learning from failure: the need for independent safety investigation in healthcare. J
R Soc Med. 2014;107(11):439-443. doi:10.1177/0141076814555939.
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June 06, 2018 - Principles of automation for patient safety in intensive
care: learning from aviation.
June 6, 2018
Dominiczak J, Khansa L. Principles of Automation for Patient Safety in Intensive Care: Learning From
Aviation. Jt Comm J Qual Patient Saf. 2018;44(6):366-371. doi:10.1016/j.jcjq.2017.11.008.
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September 25, 2024 - Peer support to promote surgeon well-being: the APSA
program experience.
September 25, 2024
Fall F, Hu YY, Walker S, et al. Peer support to promote surgeon well-being: the APSA program experience.
J Pediatr Surg. 2024;59(9):1665-1671. doi:10.1016/j.jpedsurg.2023.12.022.
https://psnet.ahrq.gov/issue/peer-support-pr…
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September 18, 2019 - Adapting cognitive task analysis to investigate clinical
decision making and medication safety incidents.
September 18, 2019
Russ AL, Militello LG, Glassman PA, et al. Adapting Cognitive Task Analysis to Investigate Clinical
Decision Making and Medication Safety Incidents. J Patient Saf. 2019;15(3):191-197.
doi:10…
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psnet.ahrq.gov/node/47761/psn-pdf
May 22, 2019 - Clinicians' perceptions of opioid error–contributing
factors in inpatient palliative care services: a qualitative
study.
May 22, 2019
Heneka N, Bhattarai P, Shaw T, et al. Clinicians' perceptions of opioid error-contributing factors in inpatient
palliative care services: A qualitative study. Palliat Med. 2019;33(4…
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September 25, 2024 - Adverse Events Among In-Hospital Medicare Patients in
2021 and 2022.
September 25, 2024
Rodrick D, Timashenka A, Umscheid C. Adverse Events Among In-Hospital Medicare Patients In 2021 And
2022. Rockville, MD: Agency for Healthcare Research and Quality; 2024. AHRQ Publication no. 24-0084
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August 17, 2017 - Preventing harm in the ICU—building a culture of safety
and engaging patients and families.
August 17, 2017
Thornton KC, Schwarz JJ, Gross K, et al. Preventing Harm in the ICU-Building a Culture of Safety and
Engaging Patients and Families. Crit Care Med. 2017;45(9):1531-1537.
doi:10.1097/CCM.0000000000002556.
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July 13, 2022 - Factors associated with malpractice claim payout: an
analysis of closed emergency department claims.
July 13, 2022
Gupta K, Szymonifka J, Rivadeneira NA, et al. Factors associated with malpractice claim payout: an
analysis of closed emergency department claims. Jt Comm J Qual Patient Saf. 2022;48(9):492-496.
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March 04, 2015 - How informatics nurses use bar code technology to
reduce medication errors.
March 4, 2015
Gann M. How informatics nurses use bar code technology to reduce medication errors. Nursing (Brux).
2015;45(3):60-6. doi:10.1097/01.NURSE.0000458923.18468.37.
https://psnet.ahrq.gov/issue/how-informatics-nurses-use-bar-code-t…
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psnet.ahrq.gov/node/45041/psn-pdf
September 28, 2016 - Structure and outcomes of interdisciplinary rounds in
hospitalized medicine patients: a systematic review and
suggested taxonomy.
September 28, 2016
Bhamidipati S, Elliott DJ, Justice EM, et al. Structure and outcomes of interdisciplinary rounds in
hospitalized medicine patients: A systematic review and suggested …
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January 08, 2016 - A framework for engaging physicians in quality and
safety.
January 8, 2016
Taitz JM, Lee TH, Sequist TD. A framework for engaging physicians in quality and safety. BMJ Qual Saf.
2012;21(9):722-728. doi:10.1136/bmjqs-2011-000167.
https://psnet.ahrq.gov/issue/framework-engaging-physicians-quality-and-safety
Promoti…