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  1. psnet.ahrq.gov/issue/effect-therapeutic-interchange-medication-reconciliation-during-hospitalization-and-upon
    November 20, 2013 - Study Effect of therapeutic interchange on medication reconciliation during hospitalization and upon discharge in a geriatric population. Citation Text: Wang JS, Fogerty RL, Horwitz LI. Effect of therapeutic interchange on medication reconciliation during hospitalization and upon dischar…
  2. psnet.ahrq.gov/issue/relationship-between-patient-safety-climate-and-occupational-safety-climate-healthcare-multi
    January 21, 2015 - Study The relationship between patient safety climate and occupational safety climate in healthcare—a multi-level investigation. Citation Text: Pousette A, Larsman P, Eklöf M, et al. The relationship between patient safety climate and occupational safety climate in healthcare – A multi-l…
  3. psnet.ahrq.gov/issue/improving-ambulatory-prescribing-safety-handheld-decision-support-system-randomized
    July 30, 2014 - Study Improving ambulatory prescribing safety with a handheld decision support system: a randomized controlled trial. Citation Text: Berner ES, Houston TK, Ray MN, et al. Improving ambulatory prescribing safety with a handheld decision support system: a randomized controlled trial. J A…
  4. psnet.ahrq.gov/issue/frequency-and-clinical-importance-pages-sent-wrong-physician
    October 31, 2011 - Study Frequency and clinical importance of pages sent to the wrong physician. Citation Text: Wong BM, Quan S, Cheung M, et al. Frequency and clinical importance of pages sent to the wrong physician. Arch Intern Med. 2009;169(11):1072-3. doi:10.1001/archinternmed.2009.117. Copy Citation…
  5. psnet.ahrq.gov/issue/accuracy-global-trigger-tool-higher-identification-adverse-events-greater-harm-diagnostic
    November 17, 2021 - Study The accuracy of the Global Trigger Tool is higher for the identification of adverse events of greater harm: a diagnostic test study. Citation Text: Moraes SM, Ferrari TCA, Beleigoli A. The accuracy of the Global Trigger Tool is higher for the identification of adverse events of gre…
  6. psnet.ahrq.gov/issue/organizational-and-safety-culture-canadian-intensive-care-units-relationship-size-intensive
    November 21, 2016 - Study Organizational and safety culture in Canadian intensive care units: relationship to size of intensive care unit and physician management model. Citation Text: Dodek P, Wong H, Jaswal D, et al. Organizational and safety culture in Canadian intensive care units: relationship to siz…
  7. psnet.ahrq.gov/issue/organization-specific-and-modifiable-inpatient-safety-composite-measure
    June 14, 2023 - Commentary An organization-specific and modifiable inpatient safety composite measure. Citation Text: Smith PK, Amster A. An Organization-Specific and Modifiable Inpatient Safety Composite Measure. Jt Comm J Qual Patient Saf. 2019;45(4):304-314. doi:10.1016/j.jcjq.2018.11.005. Copy Cit…
  8. www.ahrq.gov/patient-safety/settings/hospital/candor/modules/checklist4.html
    August 01, 2022 - CANDOR Event Checklist AHRQ Communication and Optimal Resolution Toolkit Purpose: To provide a checklist for the required actions that need to be taken following an event. Who should use this tool?   The Communication and Optimal Resolution (CANDOR) Response Team or designee, unless otherwise indicated. …
  9. www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/candor/module4/mod4-event-checklist.pdf
    April 01, 2016 - Purpose: To provide a checklist for the required actions that need to be taken following an event. Who should use this tool? The Communication and Optimal Resolution Toolkit (CANDOR) Response Team or designee, unless otherwise indicated. How to use this tool: Use the checklist to ensure that appropriate action is t…
  10. psnet.ahrq.gov/issue/enhancing-patient-safety-pediatric-emergency-department-teams-communication-and-lessons-crew
    April 26, 2023 - Commentary Enhancing patient safety in the pediatric emergency department: teams, communication, and lessons from crew resource management. Citation Text: Pruitt CM, Liebelt EL. Enhancing patient safety in the pediatric emergency department: teams, communication, and lessons from crew …
  11. psnet.ahrq.gov/issue/quantitative-analysis-content-ems-handoff-critically-ill-and-injured-patients-emergency
    August 04, 2021 - Study Quantitative analysis of the content of EMS handoff of critically ill and injured patients to the emergency department. Citation Text: Goldberg SA, Porat A, Strother CG, et al. Quantitative Analysis of the Content of EMS Handoff of Critically Ill and Injured Patients to the Emergen…
  12. psnet.ahrq.gov/issue/patient-safety-perception-within-hospitals-examination-job-type-handoffs-and-information
    December 18, 2014 - Study Patient safety perception within hospitals: an examination of job type, handoffs and information exchange, and hospital management support. Citation Text: Ming Y, Meehan R. Patient safety perception within hospitals: an examination of job type, handoffs and information exchange, an…
  13. psnet.ahrq.gov/issue/improving-organizational-climate-quality-and-quality-care-does-membership-collaborative-help
    December 14, 2016 - Study Improving organizational climate for quality and quality of care: does membership in a collaborative help? Citation Text: Nembhard IM, Northrup V, Shaller D, et al. Improving organizational climate for quality and quality of care: does membership in a collaborative help? Med Car…
  14. psnet.ahrq.gov/issue/nature-and-causes-unintended-events-reported-10-internal-medicine-departments
    August 17, 2016 - Study The nature and causes of unintended events reported at 10 internal medicine departments. Citation Text: Lubberding S, Zwaan L, Timmermans D, et al. The nature and causes of unintended events reported at 10 internal medicine departments. J Patient Saf. 2011;7(4):224-31. doi:10.109…
  15. psnet.ahrq.gov/issue/implementation-diagnostic-pauses-ambulatory-setting
    January 31, 2024 - Study Implementation of diagnostic pauses in the ambulatory setting. Citation Text: Huang GC, Kriegel G, Wheaton C, et al. Implementation of diagnostic pauses in the ambulatory setting. BMJ Qual Saf. 2018;27(6):492-497. doi:10.1136/bmjqs-2017-007192. Copy Citation Format: D…
  16. psnet.ahrq.gov/issue/implementation-simulation-training-during-covid-19-pandemic-new-york-hospital-experience
    February 15, 2023 - Commentary Implementation of simulation training during the COVID-19 pandemic: a New York hospital experience. Citation Text: Pan D, Rajwani K. Implementation of simulation training during the COVID-19 pandemic: a New York hospital experience. Simul Healthc. 2020;16(1):46-51. doi:10.1097…
  17. psnet.ahrq.gov/issue/addressing-ambulatory-safety-and-malpractice-massachusetts-promises-project
    August 14, 2017 - Commentary Addressing ambulatory safety and malpractice: the Massachusetts PROMISES project. Citation Text: Schiff G, Nieva HR, Griswold P, et al. Addressing Ambulatory Safety and Malpractice: The Massachusetts PROMISES Project. Health Serv Res. 2016;51 Suppl 3:2634-2641. doi:10.1111/147…
  18. psnet.ahrq.gov/issue/preparing-clinicians-transitioning-patients-across-care-settings-and-home-through-simulation
    August 04, 2021 - Commentary Preparing clinicians for transitioning patients across care settings and into the home through simulation. Citation Text: Molloy MA, Cary MP, Brennan-Cook J, et al. Preparing Clinicians for Transitioning Patients Across Care Settings and Into the Home Through Simulation. Home …
  19. psnet.ahrq.gov/issue/medication-reconciliation-improvement-utilizing-process-redesign-and-clinical-decision
    November 16, 2022 - Study Medication reconciliation improvement utilizing process redesign and clinical decision support. Citation Text: Rungvivatjarus T, Kuelbs CL, Miller L, et al. Medication Reconciliation Improvement Utilizing Process Redesign and Clinical Decision Support. Jt Comm J Qual Patient Saf. …
  20. psnet.ahrq.gov/issue/using-patient-safetyquality-improvement-model-assess-telehealth-psychiatry-and-behavioral
    September 27, 2023 - Commentary Using a patient safety/quality improvement model to assess telehealth for psychiatry and behavioral health services among special populations during COVID-19 and beyond. Citation Text: Using a patient safety/quality improvement model to assess telehealth for psychiatry and beh…