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psnet.ahrq.gov/issue/evaluation-12-strategies-obtaining-second-opinions-improve-interpretation-breast
November 03, 2015 - Study
Evaluation of 12 strategies for obtaining second opinions to improve interpretation of breast histopathology: simulation study.
Citation Text:
Elmore JG, Tosteson AN, Pepe MS, et al. Evaluation of 12 strategies for obtaining second opinions to improve interpretation of breast histo…
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psnet.ahrq.gov/issue/using-staff-perceptions-patient-safety-tool-improving-safety-culture-pediatric-hospital
October 04, 2011 - Study
Using staff perceptions on patient safety as a tool for improving safety culture in a pediatric hospital system.
Citation Text:
Edwards PJ, Scott T, Richardson P, et al. Using Staff Perceptions on Patient Safety as a Tool for Improving Safety Culture in a Pediatric Hospital Syste…
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psnet.ahrq.gov/issue/understanding-middle-managers-influence-implementing-patient-safety-culture
March 24, 2012 - Commentary
Understanding middle managers' influence in implementing patient safety culture.
Citation Text:
Gutberg J, Berta W. Understanding middle managers' influence in implementing patient safety culture. BMC Health Serv Res. 2017;17(1):582. doi:10.1186/s12913-017-2533-4.
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psnet.ahrq.gov/issue/delays-and-errors-cardiopulmonary-resuscitation-and-defibrillation-pediatric-residents-during
January 02, 2017 - Study
Delays and errors in cardiopulmonary resuscitation and defibrillation by pediatric residents during simulated cardiopulmonary arrests.
Citation Text:
Hunt EA, Vera K, Diener-West M, et al. Delays and errors in cardiopulmonary resuscitation and defibrillation by pediatric residents…
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psnet.ahrq.gov/issue/anybody-list-youre-more-worried-about-qualitative-analysis-exploring-functions-questions
January 22, 2016 - Study
"Anybody on this list that you're more worried about?" Qualitative analysis exploring the functions of questions during end of shift handoffs.
Citation Text:
O'Brien CM, Flanagan ME, Bergman AA, et al. "Anybody on this list that you're more worried about?" Qualitative analysis expl…
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psnet.ahrq.gov/issue/how-house-officers-cope-their-mistakes
June 26, 2015 - Study
Classic
How house officers cope with their mistakes.
Citation Text:
Wu AW, Folkman S, McPhee SJ, et al. How house officers cope with their mistakes. West J Med. 1993;159(5):565-569.
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Format:
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psnet.ahrq.gov/issue/electronic-medication-reconciliation-tools-aimed-healthcare-professionals-support-medication
December 02, 2020 - Review
Electronic medication reconciliation tools aimed at healthcare professionals to support medication reconciliation: a systematic review.
Citation Text:
Ciudad-Gutiérrez P, del Valle-Moreno P, Lora-Escobar SJ, et al. Electronic medication reconciliation tools aimed at healthcare pro…
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psnet.ahrq.gov/issue/identifying-and-encouraging-high-quality-healthcare-analysis-content-and-aims-patient-letters
September 14, 2022 - Study
Identifying and encouraging high-quality healthcare: an analysis of the content and aims of patient letters of compliment.
Citation Text:
Gillespie A, Reader TW. Identifying and encouraging high-quality healthcare: an analysis of the content and aims of patient letters of complimen…
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psnet.ahrq.gov/issue/implementing-receiver-driven-handoffs-emergency-department-reduce-miscommunication
December 05, 2018 - Study
Implementing receiver-driven handoffs to the emergency department to reduce miscommunication.
Citation Text:
Huth K, Stack AM, Hatoun J, et al. Implementing receiver-driven handoffs to the emergency department to reduce miscommunication. BMJ Qual Saf. 2021;30(3):208-215. doi:10.113…
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psnet.ahrq.gov/issue/handling-polypharmacy-qualitative-study-using-focus-group-interviews-older-patients-their
August 03, 2022 - Study
Handling polypharmacy--a qualitative study using focus group interviews with older patients, their relatives, and healthcare professionals.
Citation Text:
Mikkelsen TH, Søndergaard J, Kjaer NK, et al. Handling polypharmacy –a qualitative study using focus group interviews with olde…
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psnet.ahrq.gov/node/49508/psn-pdf
January 01, 2007 - Language Barrier
April 1, 2006
Flores G. Language Barrier. PSNet [internet]. 2006.
https://psnet.ahrq.gov/web-mm/language-barrier
The Case
A previously healthy 10-month-old girl was taken to a pediatrician's office by her monolingual Spanish-
speaking parents when they noted that their daughter had generalized we…
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psnet.ahrq.gov/issue/effect-lawsuits-professional-well-being-and-medical-error-rates-among-orthopaedic-surgeons
May 18, 2022 - Study
Effect of lawsuits on professional well-being and medical error rates among orthopaedic surgeons.
Citation Text:
Adelani MA, Hong Z, Miller AN. Effect of lawsuits on professional well-being and medical error rates among orthopaedic surgeons. J Am Acad Orthop Surg. 2023;31(16):893-9…
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psnet.ahrq.gov/issue/direct-oral-anticoagulant-related-medication-incidents-and-pharmacists-interventions-hospital
January 12, 2022 - Study
Direct oral anticoagulant-related medication incidents and pharmacists' interventions in hospital in-patients: evaluation using Reason's accident causation theory.
Citation Text:
Haque H, Alrowily A, Jalal Z, et al. Direct oral anticoagulant-related medication incidents and pharmac…
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psnet.ahrq.gov/issue/approaches-improving-continuity-care-medication-management-systematic-review
April 13, 2022 - Review
Approaches for improving continuity of care in medication management: a systematic review.
Citation Text:
Spinewine A, Claeys C, Foulon V, et al. Approaches for improving continuity of care in medication management: a systematic review. Int J Qual Health Care. 2013;25(4):403-17. d…
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psnet.ahrq.gov/issue/ask-me-routine-measurement-patient-experience-patient-safety-ambulatory-care-mixed-mode
April 14, 2021 - Study
ASK ME!-Routine measurement of patient experience with patient safety in ambulatory care: a mixed-mode survey
Citation Text:
Stahl K, Groene O. ASK ME!—Routine measurement of patient experience with patient safety in ambulatory care: A mixed-mode survey. PLoS ONE. 2021;16(12):e0259…
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psnet.ahrq.gov/issue/applying-medications-transitions-and-clinical-handoffs-toolkit-rural-primary-care-clinic
August 04, 2021 - Study
Applying the Medications at Transitions and Clinical Handoffs Toolkit in a rural primary care clinic: implications for nursing, patients, and caregivers.
Citation Text:
Jarrett T, Cochran J, Baus A. Applying the Medications at Transitions and Clinical Handoffs Toolkit in a rural pr…
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psnet.ahrq.gov/issue/medication-administration-errors-older-people-long-term-residential-care
June 26, 2019 - Study
Medication administration errors for older people in long-term residential care.
Citation Text:
Szczepura A, Wild D, Nelson S. Medication administration errors for older people in long-term residential care. BMC Geriatr. 2011;11:82. doi:10.1186/1471-2318-11-82.
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psnet.ahrq.gov/issue/scoping-review-communication-tools-applicable-patients-and-their-primary-care-providers-after
December 15, 2021 - Review
A scoping review of communication tools applicable to patients and their primary care providers after discharge from hospital.
Citation Text:
Spencer RA, Singh Punia H. A scoping review of communication tools applicable to patients and their primary care providers after discharge …
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psnet.ahrq.gov/issue/errors-medication-history-hospital-admission-prevalence-and-predicting-factors
October 14, 2020 - Study
Errors in medication history at hospital admission: prevalence and predicting factors.
Citation Text:
Hellström LM, Bondesson Å, Höglund P, et al. Errors in medication history at hospital admission: prevalence and predicting factors. BMC Clin Pharmacol. 2012;12(9):9. doi:10.1186/…
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psnet.ahrq.gov/issue/health-professional-networks-vector-improving-healthcare-quality-and-safety-systematic-review
December 13, 2023 - Review
Health professional networks as a vector for improving healthcare quality and safety: a systematic review.
Citation Text:
Cunningham FC, Ranmuthugala G, Plumb J, et al. Health professional networks as a vector for improving healthcare quality and safety: a systematic review. BMJ…