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psnet.ahrq.gov/issue/building-ambulatory-safety-program-academic-health-system
April 22, 2016 - Commentary
Building an ambulatory safety program at an academic health system.
Citation Text:
Desai S, Fiumara K, Kachalia A. Building an Ambulatory Safety Program at an Academic Health System. J Patient Saf. 2021;17(2):e84-e90. doi:10.1097/PTS.0000000000000594.
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psnet.ahrq.gov/issue/improving-patient-safety-avoiding-unread-imaging-exams-national-va-enterprise-electronic
March 12, 2025 - Study
Improving patient safety: avoiding unread imaging exams in the National VA enterprise electronic health record.
Citation Text:
Bastawrous S, Carney B. Improving Patient Safety: Avoiding Unread Imaging Exams in the National VA Enterprise Electronic Health Record. J Digit Imaging. 20…
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psnet.ahrq.gov/issue/patient-safety-operating-room-part-1-and-part-2
October 19, 2022 - Review
Patient safety in the operating room—part 1 and part 2.
Citation Text:
Poore SO, Sillah NM, Mahajan AY, et al. Patient safety in the operating room: II. Intraoperative and postoperative. Plast Reconstr Surg. 2012;130(5):1048-58. doi:10.1097/PRS.0b013e318267d531.
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psnet.ahrq.gov/issue/fumbled-handoffs-one-dropped-ball-after-another
April 10, 2024 - Commentary
Fumbled handoffs: one dropped ball after another.
Citation Text:
Gandhi TK. Fumbled handoffs: one dropped ball after another. Ann Intern Med. 2005;142(5):352-358.
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psnet.ahrq.gov/issue/evaluation-predevelopment-service-delivery-intervention-application-improve-clinical
March 06, 2013 - Study
Evaluation of a predevelopment service delivery intervention: an application to improve clinical handovers.
Citation Text:
Yao GL, Novielli N, Manaseki-Holland S, et al. Evaluation of a predevelopment service delivery intervention: an application to improve clinical handovers. BMJ …
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psnet.ahrq.gov/issue/creating-infrastructure-safety-event-reporting-and-analysis-multicenter-pediatric-emergency
October 08, 2013 - Study
Creating an infrastructure for safety event reporting and analysis in a multicenter pediatric emergency department network.
Citation Text:
Chamberlain JM, Shaw KN, Lillis KA, et al. Creating an infrastructure for safety event reporting and analysis in a multicenter pediatric emer…
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psnet.ahrq.gov/issue/corridor-care-emergency-department-managing-patient-care-non-clinical-areas-safely-and
May 19, 2021 - Commentary
'Corridor care' in the emergency department: managing patient care in non-clinical areas safely and efficiently.
Citation Text:
Williams C. ‘Corridor care’ in the emergency department: managing patient care in non-clinical areas safely and efficiently. Emerg Nurse. 2023;31(6):…
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psnet.ahrq.gov/issue/ahrq-announces-interest-health-services-research-reduce-emergency-department-boarding-and
November 12, 2008 - Press Release/Announcement
AHRQ announces interest in health services research to reduce emergency department boarding and hospital crowding.
Citation Text:
AHRQ announces interest in health services research to reduce emergency department boarding and hospital crowding. Agency for Healt…
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psnet.ahrq.gov/issue/incorrect-surgical-counts-qualitative-analysis
September 12, 2012 - Study
Incorrect surgical counts: a qualitative analysis.
Citation Text:
Rowlands A, Steeves R. Incorrect surgical counts: a qualitative analysis. AORN J. 2010;92(4):410-9. doi:10.1016/j.aorn.2010.01.019.
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digital.ahrq.gov/sites/default/files/docs/citation/uc1hs015182-bentley-final-report-2008.pdf
January 01, 2008 - This
includes patient demographics, patient lists, census, allergies, medications, orders, radiology … PACS is the system that sends radiology images electronically
and deletes the use of film. … Since
ARH utilizes PACS for radiology interpretation throughout the organization, and has centralized … Reported turn-around-times for lab and radiology reports previously at the larger facilities
(Hazard … Lab results and radiology images and reports are
11
electronically filed into the patient
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digital.ahrq.gov/sites/default/files/docs/citation/r21hs024327-ornstein-final-report-2018.pdf
January 01, 2018 - Text-based test reports (e.g. radiology) have a coded
(e.g., abnormal/normal at a minimum) interpretation … appreciated the value of this recommendation for laboratory data and
in certain circumstances for radiology … For example, many radiology tests and
procedures have several findings which can only be assessed as … laboratory, radiology) to call physicians directly with critical findings. … Text-based test reports (e.g. radiology) have a coded(e.g., abnormal/normal at a minimum) interpretation
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digital.ahrq.gov/sites/default/files/docs/publication/r18hs017190-chueh-final-report-2011.pdf
January 01, 2011 - These ACCORDs include 1) colorectal cancer screening and surveillance, 2) abnormal
radiology result … Abnormal radiology result: Patients 18 years old or older with an abnormal radiology
result (including … Abnormal radiology result: Patient requiring biopsy or consultation for abnormal imaging
finding or … • For abnormal radiology results: Compare (1) the proportion of abnormal radiology results
with
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol1/Johnson.pdf
January 01, 2004 - The Role of Patient Safety in the Device Purchasing Process
341
The Role of Patient Safety in the
Device Purchasing Process
Todd R. Johnson, Jiajie Zhang, Vimla L. Patel, Alla Keselman,
Xiaozhou Tang, Juliana J. Brixey, Danielle Paige, James P. Turley
Abstract
To examine how patient safety considerations a…
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psnet.ahrq.gov/perspective/conversation-hardeep-singh-md-mph
January 01, 2014 - But an interesting study in radiology highlighted the concrete role that interruptions can play in … sought to assess the effect of distractions from telephone interruptions on diagnostic performance by radiology … A local quality assurance project in this radiology department at a tertiary care pediatric center tracked … Using telephone logs from the radiology reading room, the authors found a slightly greater average number
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol2/Advances-Elder_18.pdf
February 19, 2008 - Only one site had its
own radiology suite and staff for plain films; all the others used nearby hospitals … and free
standing radiology centers for imaging and special tests.
6
Table 1. … No Yes No
Electronic health record No No No Yes
Outside laboratories used (N) 1 1 2 2
Outside radiology … While each
practice had preferred reference laboratories and radiology centers, a patient’s insurance
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psnet.ahrq.gov/web-mm/physical-diagnosis-lost-art
January 17, 2018 - SPOTLIGHT CASE
Physical Diagnosis: A Lost Art?
Citation Text:
Thompson GR, Verghese A. Physical Diagnosis: A Lost Art?. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2006.
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psnet.ahrq.gov/issue/infusional-chemotherapy-and-medication-errors-tertiary-care-pediatric-cancer-unit-resource
October 29, 2012 - Study
Infusional chemotherapy and medication errors in a tertiary care pediatric cancer unit in a resource-limited setting.
Citation Text:
Dhamija M, Kapoor G, Juneja A. Infusional chemotherapy and medication errors in a tertiary care pediatric cancer unit in a resource-limited setting. …
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psnet.ahrq.gov/issue/family-participation-during-intensive-care-unit-rounds-goals-and-expectations-parents-and
June 12, 2019 - Study
Family participation during intensive care unit rounds: goals and expectations of parents and health care providers in a tertiary pediatric intensive care unit.
Citation Text:
Stickney CA, Ziniel SI, Brett MS, et al. Family participation during intensive care unit rounds: goals and…
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psnet.ahrq.gov/issue/effectiveness-checklists-and-error-reporting-systems-enhancing-patient-safety-and-reducing
August 03, 2017 - Review
The effectiveness of checklists and error reporting systems in enhancing patient safety and reducing medical errors in hospital settings: a narrative review.
Citation Text:
Chance EA, Florence D, Sardi Abdoul I. The effectiveness of checklists and error reporting systems in enhanc…
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psnet.ahrq.gov/issue/patterns-error-interpretive-pathology
April 07, 2021 - Study
Patterns of error in interpretive pathology.
Citation Text:
Packer MDC, Ravinsky E, Azordegan N. Patterns of error in interpretive pathology. Am J Clin Pathol. 2022;157(5):767-773. doi:10.1093/ajcp/aqab190.
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