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psnet.ahrq.gov/node/38559/psn-pdf
June 16, 2009 - Regional surveillance of emergency-department visits for
outpatient adverse drug events.
June 16, 2009
Capuano A, Irpino A, Gallo M, et al. Regional surveillance of emergency-department visits for outpatient
adverse drug events. Eur J Clin Pharmacol. 2009;65(7):721-8. doi:10.1007/s00228-009-0641-8.
https://psnet.a…
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psnet.ahrq.gov/node/37895/psn-pdf
July 09, 2008 - Accidents, claiming, and regional subcultures: are
medical errors and malpractice lawsuits related to social
capital?
July 9, 2008
Williams J. Accidents, claiming, and regional subcultures: Are medical errors and malpractice lawsuits
related to social capital? J Safety Res. 2008;39(3). doi:10.1016/j.jsr.2008.01.00…
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psnet.ahrq.gov/issue/hsmr-new-approach-measuring-hospital-mortality-trends-canada
June 22, 2015 - report describes a new metric used to analyze mortality rates in Canadian health care and also includes region-specific
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psnet.ahrq.gov/node/40732/psn-pdf
November 23, 2011 - Increasing adoption of computerized provider order entry,
and persistent regional disparities, in US emergency
departments.
November 23, 2011
Pallin DJ, Sullivan AF, Espinola JA, et al. Increasing adoption of computerized provider order entry, and
persistent regional disparities, in US emergency departments. Ann E…
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psnet.ahrq.gov/node/33667/psn-pdf
April 01, 2008 - We thank
PeaceHealth Whatcom region, and particularly Connie, for granting us permission to post the
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psnet.ahrq.gov/node/40575/psn-pdf
July 06, 2011 - Student-observed surgical safety practices across an
urban regional health authority.
July 6, 2011
Spence J, Goodwin B, Enns C, et al. Student-observed surgical safety practices across an urban regional
health authority. BMJ Qual Saf. 2011;20(7):580-6. doi:10.1136/bmjqs.2010.044826.
https://psnet.ahrq.gov/issue/st…
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psnet.ahrq.gov/node/46905/psn-pdf
October 13, 2018 - Association of hospital participation in a regional trauma
quality improvement collaborative with patient outcomes.
October 13, 2018
Hemmila MR, Cain-Nielsen AH, Jakubus JL, et al. Association of Hospital Participation in a Regional
Trauma Quality Improvement Collaborative With Patient Outcomes. JAMA Surg. 2018;153…
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psnet.ahrq.gov/node/45529/psn-pdf
October 11, 2017 - Increasing compliance with the World Health Organization
surgical safety checklist—a regional health system's
experience.
October 11, 2017
Gitelis ME, Kaczynski A, Shear T, et al. Increasing compliance with the World Health Organization Surgical
Safety Checklist-A regional health system's experience. Am J Surg. 20…
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psnet.ahrq.gov/node/33655/psn-pdf
August 01, 2007 - The PeaceHealth Governance Journey in Support of
Quality and Safety
August 1, 2007
Haughom JL. The PeaceHealth Governance Journey in Support of Quality and Safety. PSNet [internet].
2007.
https://psnet.ahrq.gov/perspective/peacehealth-governance-journey-support-quality-and-safety
Perspective
In recent years, the…
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psnet.ahrq.gov/node/39522/psn-pdf
May 12, 2010 - Reporting trends in a regional medication error data-
sharing system.
May 12, 2010
Anderson J, Ramanujam R, Hensel DJ, et al. Reporting trends in a regional medication error data-sharing
system. Health Care Manag Sci. 2010;13(1):74-83.
https://psnet.ahrq.gov/issue/reporting-trends-regional-medication-error-data-sh…
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psnet.ahrq.gov/node/39715/psn-pdf
May 25, 2011 - Barriers to incident notification in a regional prehospital
setting.
May 25, 2011
Jennings PA, Stella J. Barriers to incident notification in a regional prehospital setting. Emerg Med J.
2011;28(6):526-9. doi:10.1136/emj.2010.090738.
https://psnet.ahrq.gov/issue/barriers-incident-notification-regional-prehospital-…
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psnet.ahrq.gov/node/46143/psn-pdf
June 14, 2017 - Report of the Announced Inspection of Medication Safety
at the Midland Regional Hospital Tullamore, County
Offaly.
June 14, 2017
Dublin, Ireland: Health Information and Quality Authority; May 2017.
https://psnet.ahrq.gov/issue/report-announced-inspection-medication-safety-midland-regional-hospital-
tullamore-coun…
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psnet.ahrq.gov/node/34570/psn-pdf
March 07, 2005 - Measuring the Success of the Regional Medication Safety
Program for Hospitals.
March 7, 2005
Pelczarski K, Fricker M, Morris J. Philadelphia, PA: Health Care Improvement Foundation; 2005.
https://psnet.ahrq.gov/issue/measuring-success-regional-medication-safety-program-hospitals
The Regional Medication Safety Prog…
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psnet.ahrq.gov/issue/impact-regionalized-care-concordance-plan-and-preventable-adverse-events-general-medicine
November 16, 2022 - Study
Impact of regionalized care on concordance of plan and preventable adverse events on general medicine services.
Citation Text:
Mueller SK, Schnipper JL, Giannelli K, et al. Impact of regionalized care on concordance of plan and preventable adverse events on general medicine service…
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psnet.ahrq.gov/node/38829/psn-pdf
January 03, 2017 - Implementing standardized operating room briefings and
debriefings at a large regional medical center.
January 3, 2017
Berenholtz SM, Schumacher K, Hayanga AJ, et al. Implementing standardized operating room briefings
and debriefings at a large regional medical center. Jt Comm J Qual Patient Saf. 2009;35(8):391-7.
…
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psnet.ahrq.gov/node/49661/psn-pdf
August 01, 2012 - Residual Anesthesia: Tepid Burn
August 1, 2012
Kurrek MM, Twersky RS. Residual Anesthesia: Tepid Burn. PSNet [internet]. 2012.
https://psnet.ahrq.gov/web-mm/residual-anesthesia-tepid-burn
The Case
A 42-year-old Filipino man presented to an outpatient surgery center for scheduled repair of an anal fistula.
The pat…
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psnet.ahrq.gov/web-mm/wrong-side-bedside-paravertebral-block-preventing-preventable
August 10, 2019 - Wrong-side Bedside Paravertebral Block: Preventing the Preventable
Citation Text:
Barrington MJ, Uda Y. Wrong-side Bedside Paravertebral Block: Preventing the Preventable. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2017.
Copy C…
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psnet.ahrq.gov/node/49791/psn-pdf
April 01, 2017 - Wrong-side Bedside Paravertebral Block: Preventing the
Preventable
April 1, 2017
Barrington MJ, Uda Y. Wrong-side Bedside Paravertebral Block: Preventing the Preventable. PSNet
[internet]. 2017.
https://psnet.ahrq.gov/web-mm/wrong-side-bedside-paravertebral-block-preventing-preventable
The Case
An 84-year-old wo…
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psnet.ahrq.gov/web-mm/diagnostic-overshadowing-dangers
February 12, 2020 - In the ED, the patient complained of pain in her epigastric region and back. … A CT scan of her abdomen revealed multiple fractures at thoracic and lumbar spinal region with possible … The patient was admitted to the ward, still tachycardic and complaining of pain in the epigastric region
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psnet.ahrq.gov/sites/default/files/2021-06/final_spotlight_miscommunication_possible_artifact_06.21.2021.pdf
January 01, 2021 - film as a normal left shoulder
radiograph but noted a “…soft tissue density in the left
suprahilar region … follow-up X-ray without any knowledge of or
follow-up for the “soft tissue density” in the left suprahilar
region … the
referring clinician
– As the abnormal finding of a “soft tissue density in the
left suprahilar region