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psnet.ahrq.gov/issue/qualitative-study-speaking-out-about-patient-safety-concerns-intensive-care-units
August 21, 2013 - Hierarchy and poor communication are well-recognized barriers that prevent team members from speaking
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psnet.ahrq.gov/issue/enhancing-patient-safety-and-quality-care-improving-usability-electronic-health-record
March 04, 2011 - unintended consequences have also emerged, and the potential for health IT to cause harm is now well recognized
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psnet.ahrq.gov/issue/what-stops-hospital-clinical-staff-following-protocols-analysis-incidence-and-factors-behind
September 09, 2015 - Furthermore, in these cases nearly 70% of providers recognized that the criteria were met and 76% were
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psnet.ahrq.gov/issue/maximizing-ability-health-it-and-ai-improve-patient-safety
May 22, 2015 - 21, 2023
View More
Related Resources
Errors in the EMR: under-recognized
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psnet.ahrq.gov/innovation/handshake-antimicrobial-stewardship-model-recognize-and-prevent-diagnostic-errors
September 08, 2021 - EMERGING INNOVATIONS
Handshake antimicrobial stewardship as a model to recognize and prevent diagnostic errors
Citation Text:
Searns JB, Williams MC, MacBrayne CE, et al. Handshake antimicrobial stewardship as a model to recognize and prevent diagnostic errors. Diagnosis (Berl). 2020;8(3):347-352.…
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psnet.ahrq.gov/issue/handshake-antimicrobial-stewardship-model-recognize-and-prevent-diagnostic-errors
September 29, 2021 - Study
Handshake antimicrobial stewardship as a model to recognize and prevent diagnostic errors.
Citation Text:
Searns JB, Williams MC, MacBrayne CE, et al. Handshake antimicrobial stewardship as a model to recognize and prevent diagnostic errors. Diagnosis (Berl). 2021;8(3):347-352. doi…
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psnet.ahrq.gov/issue/consumers-perspectives-their-involvement-recognizing-and-responding-patient-deterioration
February 28, 2024 - Study
Consumers' perspectives on their involvement in recognizing and responding to patient deterioration—developing a model for consumer reporting.
Citation Text:
King L, Peacock G, Crotty M, et al. Consumers' perspectives on their involvement in recognizing and responding to patient de…
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psnet.ahrq.gov/node/49855/psn-pdf
March 01, 2019 - which-line-ordering-provider-or-proceduralist
When the patient presented for apheresis treatment, providers recognized … In medicine, such a system would have recognized the inappropriate order and
prevented it from being … future, it is possible that the CDS would have
identified the error (perhaps because it would have recognized
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psnet.ahrq.gov/issue/frontline-nurses-clinical-judgment-recognizing-understanding-and-responding-patient
December 01, 2021 - Study
Frontline nurses' clinical judgment in recognizing, understanding, and responding to patient deterioration: a qualitative study.
Citation Text:
Dresser S, Teel C, Peltzer J. Frontline nurses' clinical judgment in recognizing, understanding, and responding to patient deterioration: …
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psnet.ahrq.gov/node/49767/psn-pdf
August 21, 2016 - could be avoided with interoperability, inadequate availability of
patient information is a widely recognized … Inadequate availability of patient information is a widely recognized problem that results in patient
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psnet.ahrq.gov/web-mm/one-dose-two-errors
September 29, 2017 - In this case, an ID specialist reviewing significant microbiology results would likely have recognized … care.( 12 ) Had this care model been in place, it is likely that an ICU nurse or pharmacist would have recognized … In this case, a strong audit and feedback team would likely have recognized that there was no indication
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psnet.ahrq.gov/node/33663/psn-pdf
September 15, 2008 - Both also
recognized that, in a health care system as large and diverse as AHS, the journey needed to … Beginning in 2004, we brought in a series of nationally recognized
experts (including Drs. … AHS leaders, many of
whom were present at the IHI conference, immediately recognized this as a major
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psnet.ahrq.gov/node/847041/psn-pdf
April 05, 2023 - Frontline nurses' clinical judgment in recognizing,
understanding, and responding to patient deterioration: a
qualitative study.
April 5, 2023
Dresser S, Teel C, Peltzer J. Frontline nurses' clinical judgment in recognizing, understanding, and
responding to patient deterioration: a qualitative study. Int J Nurs St…
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psnet.ahrq.gov/node/867339/psn-pdf
December 11, 2024 - Hospital nurses and physicians' experiences practicing
patient safety work to recognize deteriorating patients: a
qualitative study.
December 11, 2024
Berg AMN, Werner A, Knutsen IR, et al. Hospital nurses and physicians’ experiences practicing patient
safety work to recognize deteriorating patients: a qualitative…
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psnet.ahrq.gov/node/866636/psn-pdf
January 01, 2025 - Hospital commitments to address diagnostic errors: an
assessment of 95 US hospitals.
September 4, 2024
Campione Russo A, Tilly J?L, Kaufman L, et al. Hospital commitments to address diagnostic errors: an
assessment of 95 US hospitals. J Hosp Med. 2025;20(2):120-134. doi:10.1002/jhm.13485.
https://psnet.ahrq.gov/is…
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psnet.ahrq.gov/node/862155/psn-pdf
February 07, 2024 - Society of Critical Care Medicine Guidelines on
Recognizing and Responding to Clinical Deterioration
Outside the ICU: 2023.
February 7, 2024
Honarmand K, Wax RS, Penoyer D, et al. Society of Critical Care Medicine Guidelines on Recognizing and
Responding to Clinical Deterioration Outside the ICU: 2023. Crit Care M…
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psnet.ahrq.gov/node/48099/psn-pdf
July 24, 2019 - Consumers' perspectives on their involvement in
recognizing and responding to patient
deterioration—developing a model for consumer
reporting.
July 24, 2019
King L, Peacock G, Crotty M, et al. Consumers' perspectives on their involvement in recognizing and
responding to patient deterioration-Developing a model fo…
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psnet.ahrq.gov/node/863641/psn-pdf
February 28, 2024 - TeamSTEPPS has been implemented internationally and was recognized by the World Innovation Summit
in … In 2023, AHRQ recognized the need to further amend TeamSTEPPS to adapt to the evolving healthcare
landscape
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psnet.ahrq.gov/issue/reducing-preventable-medication-safety-events-recognizing-renal-risk
June 27, 2011 - Study
Reducing preventable medication safety events by recognizing renal risk.
Citation Text:
Fields W, Tedeschi C, Foltz J, et al. Reducing preventable medication safety events by recognizing renal risk. Clin Nurse Spec. 2008;22(2):73-8; quiz 79-80. doi:10.1097/01.NUR.0000311795.69476…
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psnet.ahrq.gov/node/60693/psn-pdf
July 15, 2020 - Incoming interns recognize inadequate physical
examination as a cause of patient harm.
July 15, 2020
Russo S, Berg K, Davis JJ, et al. Incoming interns recognize inadequate physical examination as a cause
of patient harm. J Med Educ Curric Dev. 2020;7:238212052092899. doi:10.1177/2382120520928993.
https://psnet.ah…