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psnet.ahrq.gov/perspective/conversation-jessica-behrhorst-about-evolution-root-cause-analysis
February 26, 2025 - In Conversation with Jessica Behrhorst about The Evolution of Root Cause Analysis
Jessica Behrhorst, MPH, CPPS, CPHRM, CPHQ; Bryan Gale, MA; Cindy Manaoat Van, MHSA, CPPS | February 26, 2025
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psnet.ahrq.gov/perspective/evolution-root-cause-analysis
February 26, 2025 - The Evolution of Root Cause Analysis
Jessica Behrhorst, MPH, CPPS, CPHRM, CPHQ; Bryan Gale, MA; Cindy Manaoat Van, MHSA, CPPS | February 26, 2025
Also Read the Conversation
View more articles from the same authors.
Citation Text:
Behrhorst J, Gale B, Van CM. Th…
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psnet.ahrq.gov/perspective/beyond-hospital-new-frontier-patient-safety
August 01, 2014 - Beyond the Hospital: the New Frontier of Patient Safety
Margaret Plews-Ogan, MD, MS | August 22, 2014
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Plews-Ogan M. Beyond the Hospital: the New Frontier of Patient Safety. PSNet …
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psnet.ahrq.gov/perspective/what-have-we-learned-about-safe-inpatient-handovers
March 01, 2011 - What Have We Learned About Safe Inpatient Handovers?
Sunil Kripalani, MD, MSc | March 1, 2011
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Citation Text:
Kripalani S. What Have We Learned About Safe Inpatient Handovers?. PSNet [internet]. …
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psnet.ahrq.gov/perspective/innovations-promoting-hand-hygiene-compliance
May 01, 2014 - Innovations in Promoting Hand Hygiene Compliance
Alexandre R. Marra, MD and Michael B. Edmond, MD, MPH, MPA | May 1, 2014
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Marra AR, Edmond MB. Innovations in Promoting Hand Hygie…
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psnet.ahrq.gov/node/33575/psn-pdf
March 15, 2025 - Patient Engagement and Safety
March 15, 2025
Patient Engagement and Safety. PSNet [internet]. 2019.
https://psnet.ahrq.gov/primer/patient-engagement-and-safety
PSNet primers are regularly reviewed and updated by the UC Davis PSNet Editorial Team to ensure that
they reflect current research and practice in the pati…
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psnet.ahrq.gov/node/33567/psn-pdf
June 15, 2024 - Handoffs
June 15, 2024
Handoffs and Signouts. PSNet [internet]. 2019.
https://psnet.ahrq.gov/primer/handoffs
PSNet primers are regularly reviewed and updated by the UC Davis PSNet Editorial Team to ensure that
they reflect current research and practice in the patient safety field. Last reviewed in 2024.
Backgroun…
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psnet.ahrq.gov/innovation/generalizability-medication-administration-discrepancy-detection-system-quantitative
November 04, 2020 - EMERGING INNOVATIONS
The generalizability of a medication administration discrepancy detection system: quantitative comparative analysis
Citation Text:
Kirkendall E, Huth H, Rauenbuehler B, et al. The generalizability of a medication administration discrepancy detection system: quantitative compar…
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psnet.ahrq.gov/perspective/risk-management-and-patient-safety
December 01, 2010 - July 3, 2014
Reporting of sentinel events in Swedish hospitals: a comparison of severe
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psnet.ahrq.gov/perspective/what-do-we-know-about-emergency-department-safety
June 01, 2010 - The workforce problem is particularly severe in rural areas. 4 ,5
Less experienced EPs make more errors
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psnet.ahrq.gov/web-mm/code-status-vs-care-status
September 30, 2020 - outside of the ICU over the weekend, the patient’s respiratory status deteriorated, reaching a level of severe
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psnet.ahrq.gov/node/33836/psn-pdf
June 01, 2017 - The Weekend Effect in Cardiology: Is It Real? If So, Can It
Be Fixed?
June 1, 2017
Martin VK, Mirnateghi N, Khoshchehreh M. The Weekend Effect in Cardiology: Is It Real? If So, Can It Be
Fixed? . PSNet [internet]. 2017.
https://psnet.ahrq.gov/perspective/weekend-effect-cardiology-it-real-if-so-can-it-be-fixed
Per…
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psnet.ahrq.gov/node/33802/psn-pdf
February 01, 2016 - Relationships Between Physician Professional
Satisfaction and Patient Safety
February 1, 2016
Friedberg MW. Relationships Between Physician Professional Satisfaction and Patient Safety. PSNet
[internet]. 2016.
https://psnet.ahrq.gov/perspective/relationships-between-physician-professional-satisfaction-and-patient-…
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.37_slideshow.ppt
November 01, 2003 - Spotlight Case [MONTH] 2003
Spotlight Case November 2003
The Missing Suction Tip
Source and Credits
This presentation is based on the Nov. 2003
AHRQ WebM&M Spotlight Case in Surgery
See the full article at http://webmm.ahrq.gov
CME credit is available through the Web site
Commentary by: Eric J. Thomas, MD,…
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psnet.ahrq.gov/node/33598/psn-pdf
June 15, 2024 - Falls
June 15, 2024
Falls. PSNet [internet]. 2019.
https://psnet.ahrq.gov/primer/falls
PSNet primers are regularly reviewed and updated by the UC Davis PSNet Editorial Team to ensure that
they reflect current research and practice in the patient safety field. Last reviewed in 2024.
Background
Falls are a common …
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psnet.ahrq.gov/node/33578/psn-pdf
September 15, 2024 - Human Factors Engineering
September 15, 2024
Human Factors Engineering. PSNet [internet]. 2019.
https://psnet.ahrq.gov/primer/human-factors-engineering
PSNet primers are regularly reviewed and updated by the UC Davis PSNet Editorial Team to ensure that
they reflect current research and practice in the patient safe…
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psnet.ahrq.gov/node/33563/psn-pdf
September 16, 2024 - Culture of Safety
September 16, 2024
Culture of Safety. PSNet [internet]. 2019.
https://psnet.ahrq.gov/primer/culture-safety
PSNet primers are regularly reviewed and updated by the UC Davis PSNet Editorial Team to ensure that
they reflect current research and practice in the patient safety field. Last reviewed in …
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psnet.ahrq.gov/primer/disruptive-and-unprofessional-behavior
September 15, 2024 - Disruptive and Unprofessional Behavior
Citation Text:
Disruptive and Unprofessional Behavior. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2019.
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psnet.ahrq.gov/primer/disclosure-errors
September 15, 2024 - Disclosure of Errors
Citation Text:
Disclosure of Errors. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2019.
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…
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psnet.ahrq.gov/primer/patient-engagement-and-safety
August 30, 2023 - Patient Engagement and Safety
Citation Text:
Patient Engagement and Safety. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2019.
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Format:
Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged Pu…