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psnet.ahrq.gov/issue/evaluating-teamwork-simulated-obstetric-environment
November 04, 2009 - Study
Evaluating teamwork in a simulated obstetric environment.
Citation Text:
Morgan PJ, Pittini R, Regehr G, et al. Evaluating teamwork in a simulated obstetric environment. Anesthesiology. 2007;106(5):907-915.
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psnet.ahrq.gov/perspective/health-care-data-science-quality-improvement-and-patient-safety
October 01, 2016 - time trying to understand how to repurpose electronic health record and billing data for these new purposes … However, most electronic health data is not automatically useful for these other purposes. … A great deal of additional work is usually required to make it useful for new purposes like patient safety
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psnet.ahrq.gov/primer/surgical-site-infections
December 15, 2024 - Both the NHSN and NSQIP definitions are widely used for both quality improvement and research purposes
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psnet.ahrq.gov/node/852700/psn-pdf
August 30, 2023 - In Conversation with... Patricia McGaffigan about Beyond
the Pandemic: Creating Total Systems Safety
August 30, 2023
McGaffigan P, Van CM, Mossburg S. In Conversation with.. Patricia McGaffigan about Beyond the
Pandemic: Creating Total Systems Safety . PSNet [internet]. 2023.
https://psnet.ahrq.gov/perspective/con…
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psnet.ahrq.gov/issue/engaging-front-line-tapping-hospital-wide-quality-and-safety-initiatives
March 20, 2019 - Commentary
Engaging the front line: tapping into hospital-wide quality and safety initiatives.
Citation Text:
Wolpaw J, Schwengel D, Hensley N, et al. Engaging the Front Line: Tapping into Hospital-Wide Quality and Safety Initiatives. J Cardiothorac Vasc Anesth. 2018;32(1):522-533. doi:1…
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psnet.ahrq.gov/issue/consequences-whistle-blowing-integrative-review
November 16, 2022 - Review
The consequences of whistle-blowing: an integrative review.
Citation Text:
Lim CR, Zhang MWB, Hussain SF, et al. The Consequences of Whistle-blowing: An Integrative Review. J Patient Saf. 2021;17(6):e497-e502. doi:10.1097/PTS.0000000000000396.
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psnet.ahrq.gov/issue/implementation-specialized-pharmacy-team-monitor-high-risk-medications-during-discharge
September 23, 2020 - Commentary
Implementation of a specialized pharmacy team to monitor high-risk medications during discharge.
Citation Text:
Martin ES, Overstreet RL, Jackson-Khalil LR, et al. Implementation of a specialized pharmacy team to monitor high-risk medications during discharge. Am J Health S…
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psnet.ahrq.gov/issue/blurring-boundaries-scenario-based-simulation-clinical-setting
September 23, 2020 - Study
Blurring the boundaries: scenario-based simulation in a clinical setting.
Citation Text:
Kneebone RL, Kidd J, Nestel D, et al. Blurring the boundaries: scenario-based simulation in a clinical setting. Med Educ. 2005;39(6). doi:10.1111/j.1365-2929.2005.02110.x.
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psnet.ahrq.gov/issue/communication-during-trauma-resuscitation-do-we-know-what-happening
February 03, 2021 - Study
Communication during trauma resuscitation: do we know what is happening?
Citation Text:
Bergs EAG, Rutten FLPA, Tadros T, et al. Communication during trauma resuscitation: do we know what is happening? Injury. 2005;36(8):905-11.
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psnet.ahrq.gov/issue/omitted-and-unjustified-medications-discharge-summary
May 18, 2022 - Study
Omitted and unjustified medications in the discharge summary.
Citation Text:
Perren A, Previsdomini M, Cerutti B, et al. Omitted and unjustified medications in the discharge summary. Qual Saf Health Care. 2009;18(3):205-8. doi:10.1136/qshc.2007.024588.
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psnet.ahrq.gov/issue/problem-making-safety-ii-work-healthcare
April 28, 2021 - Commentary
The problem with making Safety-II work in healthcare.
Citation Text:
Verhagen MJ, de Vos MS, Sujan M, et al. The problem with making Safety-II work in healthcare. BMJ Qual Saf. 2022;31(5):402-408. doi:10.1136/bmjqs-2021-014396.
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psnet.ahrq.gov/issue/patient-safety-surgery-0
October 18, 2017 - Newsletter/Journal
Patient Safety in Surgery.
Citation Text:
Patient Safety in Surgery. Stahel PF, ed. BioMed Central. ISSN: 1754-9493.
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psnet.ahrq.gov/issue/organizing-patient-safety-failsafe-fantasies-and-pragmatic-practices
August 01, 2018 - Book/Report
Organizing Patient Safety: Failsafe Fantasies and Pragmatic Practices.
Citation Text:
Organizing Patient Safety: Failsafe Fantasies and Pragmatic Practices. Pedersen KZ. London, United Kingdom: Palgrave Macmillan; 2018. ISBN: 9781137537850.
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psnet.ahrq.gov/issue/national-reporting-and-learning-system-research-and-development
April 06, 2016 - Book/Report
National Reporting and Learning System Research and Development.
Citation Text:
National Reporting and Learning System Research and Development. Mayer E, Flott K, Callahan R, Darzi A. London, UK: NIHR Imperial Patient Safety Translational Research Centre; 2016.
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psnet.ahrq.gov/issue/health-literacy-and-medication-understanding-among-hospitalized-adults
April 05, 2013 - Study
Health literacy and medication understanding among hospitalized adults.
Citation Text:
Marvanova M, Roumie CL, Eden SK, et al. Health literacy and medication understanding among hospitalized adults. J Hosp Med. 2011;6(9):488-93. doi:10.1002/jhm.925.
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psnet.ahrq.gov/issue/medication-reconciliation-qualitative-analysis-clinicians-perceptions
October 10, 2015 - Study
Medication reconciliation: a qualitative analysis of clinicians' perceptions.
Citation Text:
Vogelsmeier A, Pepper GA, Oderda L, et al. Medication reconciliation: A qualitative analysis of clinicians' perceptions. Res Social Adm Pharm. 2013;9(4):419-30. doi:10.1016/j.sapharm.201…
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psnet.ahrq.gov/issue/functional-health-literacy-and-understanding-medications-discharge
April 24, 2018 - Study
Functional health literacy and understanding of medications at discharge.
Citation Text:
Maniaci MJ, Heckman MG, Dawson NL. Functional health literacy and understanding of medications at discharge. Mayo Clin Proc. 2008;83(5):554-8. doi:10.4065/83.5.554.
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psnet.ahrq.gov/web-mm/medication-safety-events-related-diagnostic-imaging
January 26, 2022 - Medication Safety Events Related to Diagnostic Imaging
Citation Text:
Sanchez L, Porras H, Lammers C. Medication Safety Events Related to Diagnostic Imaging. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2022.
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psnet.ahrq.gov/web-mm/bad-writing-wrong-medication
March 01, 2015 - Pharmacies can rescan these into the pharmacy system for documentation purposes, but they must still
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psnet.ahrq.gov/issue/collapse-sensemaking-organizations-mann-gulch-disaster
May 21, 2019 - Commentary
Classic
The collapse of sensemaking in organizations: the Mann Gulch disaster.
Citation Text:
Weick KE. The Collapse of Sensemaking in Organizations: The Mann Gulch Disaster. Admin Sci Q. 2006;38(4):628-652. doi:10.2307/2393339.
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