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psnet.ahrq.gov/issue/healthcare-professionals-views-feedback-patient-safety-culture-assessment
October 25, 2023 - Study
Healthcare professionals' views on feedback of a patient safety culture assessment.
Citation Text:
Zwijnenberg NC, Hendriks M, Hoogervorst-Schilp J, et al. Healthcare professionals' views on feedback of a patient safety culture assessment. BMC Health Serv Res. 2016;16:199. doi:10.1…
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psnet.ahrq.gov/issue/learning-preventable-deaths-exploring-case-record-reviewers-narratives-using-change-analysis
June 17, 2014 - Study
Learning from preventable deaths: exploring case record reviewers' narratives using change analysis.
Citation Text:
Hogan H, Healey F, Neale G, et al. Learning from preventable deaths: exploring case record reviewers' narratives using change analysis. J R Soc Med. 2014;107(9):365-7…
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psnet.ahrq.gov/issue/development-theoretical-framework-factors-affecting-patient-safety-incident-reporting
January 19, 2016 - Review
Development of a theoretical framework of factors affecting patient safety incident reporting: a theoretical review of the literature.
Citation Text:
Archer S, Hull L, Soukup T, et al. Development of a theoretical framework of factors affecting patient safety incident reporting: a…
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psnet.ahrq.gov/issue/impact-improving-teamwork-patient-outcomes-surgery-systematic-review
May 13, 2020 - Review
The impact of improving teamwork on patient outcomes in surgery: a systematic review.
Citation Text:
Sun R, Marshall DC, Sykes MC, et al. The impact of improving teamwork on patient outcomes in surgery: A systematic review. Int J Surg. 2018;53:171-177. doi:10.1016/j.ijsu.2018.03.0…
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psnet.ahrq.gov/issue/increasing-patient-safety-neonates-handoff-communication-during-delivery-call
March 19, 2019 - Commentary
Increasing patient safety with neonates via handoff communication during delivery: a call for interprofessional health care team training across GME and CME.
Citation Text:
Vanderbilt AA, Pappada SM, Stein H, et al. Increasing patient safety with neonates via handoff communica…
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psnet.ahrq.gov/issue/reduced-duty-hours-model-senior-internal-medicine-residents-qualitative-analysis-residents
June 25, 2014 - Study
A reduced duty hours model for senior internal medicine residents: a qualitative analysis of residents' experiences and perceptions.
Citation Text:
Mathew R, Gundy S, Ulic D, et al. A Reduced Duty Hours Model for Senior Internal Medicine Residents: A Qualitative Analysis of Residen…
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psnet.ahrq.gov/issue/measuring-harm-and-informing-quality-improvement-welsh-nhs-longitudinal-welsh-national
October 12, 2016 - Book/Report
Measuring harm and informing quality improvement in the Welsh NHS: the longitudinal Welsh national adverse events study.
Citation Text:
Mayor S, Baines E, Vincent CA, et al. Measuring Harm And Informing Quality Improvement In The Welsh Nhs: The Longitudinal Welsh National Adv…
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psnet.ahrq.gov/issue/deficiencies-care-coordination-and-facility-response-patient-suicide-minneapolis-va-health
September 30, 2020 - Book/Report
Deficiencies in Care Coordination and Facility Response to a Patient Suicide at the Minneapolis VA Health Care System, Minnesota.
Citation Text:
Deficiencies in Care Coordination and Facility Response to a Patient Suicide at the Minneapolis VA Health Care System, Minnesota. W…
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psnet.ahrq.gov/issue/evaluation-physician-informatics-tool-improve-patient-handoffs
January 07, 2015 - Study
Evaluation of a physician informatics tool to improve patient handoffs.
Citation Text:
Flanagan ME, Patterson ES, Frankel RM, et al. Evaluation of a physician informatics tool to improve patient handoffs. J Am Med Inform Assoc. 2009;16(4):509-15. doi:10.1197/jamia.M2892.
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psnet.ahrq.gov/issue/checkpoint-simple-tool-measure-surgical-safety-checklist-implementation-fidelity
December 06, 2023 - Study
CheckPOINT: a simple tool to measure Surgical Safety Checklist implementation fidelity.
Citation Text:
Moyal-Smith R, Etheridge JC, Turley N, et al. CheckPOINT: a simple tool to measure Surgical Safety Checklist implementation fidelity. BMJ Qual Saf. 2024;33(4):223-231. doi:10.1136…
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psnet.ahrq.gov/issue/cardiac-surgery-errors-results-uk-national-reporting-and-learning-system
May 24, 2012 - Study
Cardiac surgery errors: results from the UK National Reporting and Learning System.
Citation Text:
Martinez EA, Shore AD, Colantuoni E, et al. Cardiac surgery errors: results from the UK National Reporting and Learning System. Int J Qual Health Care. 2011;23(2):151-8. doi:10.1093/i…
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psnet.ahrq.gov/issue/surgeons-and-systems-working-together-drive-safety-and-quality
February 02, 2022 - Commentary
Surgeons and systems working together to drive safety and quality.
Citation Text:
Hawkins RB, Nallamothu BK. Surgeons and systems working together to drive safety and quality. BMJ Qual Saf. 2023;32(4):181-184. doi:10.1136/bmjqs-2022-015045.
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psnet.ahrq.gov/issue/ct-suspected-appendicitis-children-analysis-diagnostic-errors
August 20, 2018 - Study
CT for suspected appendicitis in children: an analysis of diagnostic errors.
Citation Text:
Taylor GA, Callahan MJ, Rodriguez D, et al. CT for suspected appendicitis in children: an analysis of diagnostic errors. Pediatr Radiol. 2006;36(4):331-7.
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Format:
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psnet.ahrq.gov/issue/validation-electronic-trigger-measure-missed-diagnosis-stroke-emergency-departments
May 18, 2022 - Study
Validation of an electronic trigger to measure missed diagnosis of stroke in emergency departments.
Citation Text:
Vaghani V, Wei L, Mushtaq U, et al. Validation of an electronic trigger to measure missed diagnosis of stroke in emergency departments. J Am Med Inform Assoc. 2021;28(…
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psnet.ahrq.gov/issue/policies-and-practices-related-role-board-certification-and-recertification-pediatricians
February 03, 2011 - Study
Policies and practices related to the role of board certification and recertification of pediatricians in hospital privileging.
Citation Text:
Freed GL, Uren RL, Hudson EJ, et al. Policies and practices related to the role of board certification and recertification of pediatricia…
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psnet.ahrq.gov/issue/sbar-improves-nurse-physician-communication-and-reduces-unexpected-death-pre-and-post
November 21, 2018 - Study
SBAR improves nurse–physician communication and reduces unexpected death: a pre and post intervention study.
Citation Text:
De Meester K, Verspuy M, Monsieurs KG, et al. SBAR improves nurse-physician communication and reduces unexpected death: a pre and post intervention study. Re…
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psnet.ahrq.gov/node/38079/psn-pdf
February 15, 2011 - Improvement Global Trigger Tool methodology and evaluates a refined process to improve
the interrater reliability … The authors found that a high level of interrater reliability was
possible with well-trained primary
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psnet.ahrq.gov/node/46783/psn-pdf
January 24, 2018 - PSNet interview, the president and chief executive
officer of The Joint Commission discusses high reliability … /psnet.ahrq.gov/perspective/conversation-mark-chassin-md-mpp-mph
https://psnet.ahrq.gov/primer/high-reliability
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psnet.ahrq.gov/node/34087/psn-pdf
June 16, 2011 - experiences in non-health
care industries also suggested the importance of culture on creating high reliability … psnet.ahrq.gov/primer/culture-safety
https://psnet.ahrq.gov/issue/organizational-culture-source-high-reliability
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psnet.ahrq.gov/issue/healthcare-climate-framework-measuring-and-improving-patient-safety
November 02, 2010 - Interview
In Conversation with Timothy Vogus about High Reliability … Patient Safety
February 26, 2025
Perspective
High Reliability … April 5, 2023
High-reliability organizations (HROs): what they know that we don't (Part