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psnet.ahrq.gov/issue/investigating-causes-adverse-events
October 03, 2017 - Commentary
Investigating the causes of adverse events.
Citation Text:
Sanchez JA, Lobdell KW, Moffatt-Bruce SD, et al. Investigating the Causes of Adverse Events. Ann Thorac Surg. 2017;103(6):1693-1699. doi:10.1016/j.athoracsur.2017.04.001.
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psnet.ahrq.gov/issue/american-geriatrics-society-2023-updated-ags-beers-criteria-potentially-inappropriate
June 12, 2019 - Organizational Policy/Guidelines
American Geriatrics Society 2023 updated AGS Beers Criteria for Potentially Inappropriate Medication Use in Older Adults.
Citation Text:
American Geriatrics Society 2023 updated AGS Beers Criteria for Potentially Inappropriate Medication Use in Older Adul…
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psnet.ahrq.gov/issue/partnership-patients
October 30, 2019 - Government Resource
Partnership for Patients.
Citation Text:
Partnership for Patients. Washington, DC: US Department of Health and Human Services.
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psnet.ahrq.gov/issue/inability-providers-predict-unplanned-readmissions
December 05, 2007 - Study
Inability of providers to predict unplanned readmissions.
Citation Text:
Allaudeen N, Schnipper JL, Orav J, et al. Inability of providers to predict unplanned readmissions. J Gen Intern Med. 2011;26(7):771-6. doi:10.1007/s11606-011-1663-3.
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psnet.ahrq.gov/issue/guidelines-prevention-intravascular-catheter-related-infections
January 22, 2014 - Clinical Guideline
Guidelines for the prevention of intravascular catheter-related infections.
Citation Text:
O'Grady NP, Alexander M, Burns LA, et al. Guidelines for the prevention of intravascular catheter-related infections. American journal of infection control. 2011;39(4 Suppl 1):…
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psnet.ahrq.gov/issue/cms-changes-reimbursement-hais-setting-research-agenda
May 03, 2018 - Commentary
CMS changes in reimbursement for HAIs: setting a research agenda.
Citation Text:
Stone PW, Glied SA, McNair PD, et al. CMS changes in reimbursement for HAIs: setting a research agenda. Med Care. 2010;48(5):433-9. doi:10.1097/MLR.0b013e3181d5fb3f.
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psnet.ahrq.gov/issue/how-policy-makers-can-smooth-way-communication-and-resolution-programs
December 19, 2018 - Commentary
How policy makers can smooth the way for communication-and-resolution programs.
Citation Text:
Sage WM, Gallagher TH, Armstrong S, et al. How policy makers can smooth the way for communication-and- resolution programs. Health Aff (Millwood). 2014;33(1):11-9. doi:10.1377/hlthaf…
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psnet.ahrq.gov/issue/narrativizing-nursing-students-experiences-medical-errors-during-clinicals
September 28, 2010 - Study
Narrativizing nursing students' experiences with medical errors during clinicals.
Citation Text:
Noland CM, Carmack HJ. Narrativizing Nursing Students' Experiences With Medical Errors During Clinicals. Qual Health Res. 2015;25(10):1423-34. doi:10.1177/1049732314562892.
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psnet.ahrq.gov/issue/enhancing-effectiveness-team-debriefings-medical-simulation-more-best-practices
March 17, 2021 - Commentary
Enhancing the effectiveness of team debriefings in medical simulation: more best practices.
Citation Text:
Lyons R, Lazzara EH, Benishek LE, et al. Enhancing the effectiveness of team debriefings in medical simulation: more best practices. Jt Comm J Qual Patient Saf. 2015;41(3…
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psnet.ahrq.gov/issue/hospital-performance-trends-national-quality-measures-and-association-joint-commission
September 20, 2011 - Study
Hospital performance trends on national quality measures and the association with Joint Commission accreditation.
Citation Text:
Schmaltz SP, Williams SC, Chassin MR, et al. Hospital performance trends on national quality measures and the association with joint commission accre…
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psnet.ahrq.gov/issue/reimagining-healthcare-teams-leveraging-patient-clinician-ai-triad-improve-diagnostic-safety
September 13, 2023 - Book/Report
Reimagining Healthcare Teams: Leveraging the Patient-Clinician-AI Triad To Improve Diagnostic Safety.
Citation Text:
Reimagining Healthcare Teams: Leveraging the Patient-Clinician-AI Triad To Improve Diagnostic Safety. James C, Singh K, Valley TS, et al. Rockville, MD; Agency…
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psnet.ahrq.gov/issue/limits-checklists-handoff-and-narrative-thinking
July 01, 2017 - Commentary
The limits of checklists: handoff and narrative thinking.
Citation Text:
Hilligoss B, Moffatt-Bruce SD. The limits of checklists: handoff and narrative thinking. BMJ Qual Saf. 2014;23(7):528-33. doi:10.1136/bmjqs-2013-002705.
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psnet.ahrq.gov/issue/liquid-medication-dosing-errors-hispanic-parents-role-health-literacy-and-english-proficiency
December 14, 2016 - Study
Liquid medication dosing errors by Hispanic parents: role of health literacy and English proficiency.
Citation Text:
Harris LM, Dreyer BP, Mendelsohn A, et al. Liquid Medication Dosing Errors by Hispanic Parents: Role of Health Literacy and English Proficiency. Acad Pediatr. 2017;1…
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psnet.ahrq.gov/issue/iv-push-medications-survey-results-part-1-and-part-2
December 12, 2018 - Newspaper/Magazine Article
IV push medications survey results—part 1 and part 2.
Citation Text:
IV push medications survey results—part 1 and part 2. ISMP Medication Safety Alert! Acute Care Edition. November 1, 2018;23:1-5. November 15, 2018;23:1-5.
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psnet.ahrq.gov/issue/documenting-diagnosis-exploring-impact-electronic-health-records-diagnostic-safety
August 16, 2023 - Book/Report
Documenting Diagnosis: Exploring the Impact of Electronic Health Records on Diagnostic Safety.
Citation Text:
Miller K, Ratwani R, Hose B-Z, et al. Documenting Diagnosis: Exploring The Impact Of Electronic Health Records On Diagnostic Safety. Rockville, MD: Agency for Healthc…
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psnet.ahrq.gov/issue/health-literacy-past-present-and-future-workshop-summary
December 17, 2014 - Meeting/Conference Proceedings
Health Literacy: Past, Present, and Future: Workshop Summary.
Citation Text:
Health Literacy: Past, Present, and Future: Workshop Summary. Alper J; Roundtable on Health Literacy; Board on Population Health and Public Health Practice; Institute of Medicine. …
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psnet.ahrq.gov/issue/improving-medication-administration-safety-community-hospital-setting-using-lean-methodology
September 23, 2020 - Commentary
Improving medication administration safety in a community hospital setting using Lean methodology.
Citation Text:
Critchley S. Improving medication administration safety in a community hospital setting using Lean methodology. J Nurs Care Qual. 2015;30(4):345-351. doi:10.1097/N…
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psnet.ahrq.gov/issue/safety-measurement-and-monitoring-healthcare-framework-guide-clinical-teams-and-healthcare
September 24, 2018 - qualitative study of concerns that influence the willingness of English National Health Service staff to recommend
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psnet.ahrq.gov/issue/giving-voice-quality-and-safety-matters-board-level-qualitative-study-experiences-executive
August 12, 2014 - qualitative study of concerns that influence the willingness of English National Health Service staff to recommend
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psnet.ahrq.gov/issue/racial-and-ethnic-disparities-patient-safety
March 03, 2011 - qualitative study of concerns that influence the willingness of English National Health Service staff to recommend