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  1. CDS Repository Working Group Charter (doc file)

    cds.ahrq.gov/sites/default/files/cds/artifact/476/CDS%20Connect%20Pilot%20Site%20Training%20Plan_Final_0.docx
    July 23, 2024 - CDS Repository Working Group Charter CDS Connect Pilot Site Training Plan PURPOSE: Develop a training plan to get pilot site providers up to speed on the overall project, the pilot objectives and the CDS Connect Pain Management CDS. TARGET AUDIENCE: Prescribing clinicians at each of the pilot site locations. Qu…

  2. EU to tackle issue of patient safety. | PSNet

    psnet.ahrq.gov/issue/eu-tackle-issue-patient-safety
    September 06, 2023 - Newspaper/Magazine Article EU to tackle issue of patient safety. Citation Text: Watson R. EU to tackle issue of patient safety. BMJ (Clinical research ed.). 2005;330(7496):866. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged …

  3. The role of communication in paediatric drug safety. | PSNet

    psnet.ahrq.gov/issue/role-communication-paediatric-drug-safety
    July 08, 2008 - Review The role of communication in paediatric drug safety. Citation Text: Stebbing C, Wong ICK, Kaushal R, et al. The role of communication in paediatric drug safety. Arch Dis Child. 2007;92(5):440-5. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3 XML EndN…

  4. Diagnostic errors in primary care: lessons learned. | PSNet

    psnet.ahrq.gov/issue/diagnostic-errors-primary-care-lessons-learned
    September 12, 2011 - Study Diagnostic errors in primary care: lessons learned. Citation Text: Ely JW, Kaldjian LC, D'Alessandro DM. Diagnostic errors in primary care: lessons learned. J Am Board Fam Med. 2012;25(1):87-97. doi:10.3122/jabfm.2012.01.110174. Copy Citation Format: DOI Google Scho…

  5. Patient safety education: what was, what is, and what will be? | PSNet

    psnet.ahrq.gov/issue/patient-safety-education-what-was-what-and-what-will-be
    April 10, 2019 - Commentary Patient safety education: what was, what is, and what will be? Citation Text: Klamen D, Sanserino K, Skolnik PJ. Patient Safety Education: What Was, What Is, and What Will Be? Teach Learn Med. 2013;25(sup1). doi:10.1080/10401334.2013.842906. Copy Citation Format: …

  6. Patient safety culture in nephrology nurse practice settings: initial findings. | PSNet

    psnet.ahrq.gov/issue/patient-safety-culture-nephrology-nurse-practice-settings-initial-findings
    August 10, 2022 - Study Patient safety culture in nephrology nurse practice settings: initial findings. Citation Text: Patient safety culture in nephrology nurse practice settings: initial findings. Ulrich B, Kear T. Nephrol Nurs J. 2014;41:459-476. Copy Citation Save Save to your …

  7. Communication and Resolution After an Adverse Health Care Incident. | PSNet

    psnet.ahrq.gov/issue/communication-and-resolution-after-adverse-health-care-incident
    August 01, 2014 - Legislation/Regulation Communication and Resolution After an Adverse Health Care Incident. Citation Text: Communication and Resolution After an Adverse Health Care Incident. Pettersen B, Tate J, Tipper K, McKean H. Colorado Senate Bill 19-201. Copy Citation Save S…

  8. Measurement and training of TeamSTEPPS dimensions using the Medical Team Performance Assessment Tool. | PSNet

    psnet.ahrq.gov/issue/measurement-and-training-teamstepps-dimensions-using-medical-team-performance-assessment-tool
    March 09, 2009 - Commentary Measurement and training of TeamSTEPPS dimensions using the Medical Team Performance Assessment Tool. Citation Text: Lineberry M, Bryan E, Brush T, et al. Measurement and training of TeamSTEPPS dimensions using the Medical Team Performance Assessment Tool. Jt Comm J Qual Pat…

  9. Mistake-proofing healthcare: why stopping processes may be a good start. | PSNet

    psnet.ahrq.gov/issue/mistake-proofing-healthcare-why-stopping-processes-may-be-good-start
    March 14, 2022 - Commentary Mistake-proofing healthcare: why stopping processes may be a good start. Citation Text: Grout JR, Toussaint JS. Mistake-proofing healthcare: Why stopping processes may be a good start. Bus Horiz. 2009;53(2):149-156. doi:10.1016/j.bushor.2009.10.007. Copy Citation Forma…

  10. Medication Safety Officer's Handbook. | PSNet

    psnet.ahrq.gov/issue/medication-safety-officers-handbook
    September 01, 2018 - Book/Report Medication Safety Officer's Handbook. Citation Text: Medication Safety Officer's Handbook. Larson CM, Saine D, eds. Bethesda, MD: American Society of Health-System Pharmacists; 2013. ISBN: 9781585282104. Copy Citation Save Save to your library Pr…

  11. Health Care Opinion Leaders' Views on the Quality and Safety of Health Care in the United States. | PSNet

    psnet.ahrq.gov/issue/health-care-opinion-leaders-views-quality-and-safety-health-care-united-states
    April 12, 2006 - Book/Report Health Care Opinion Leaders' Views on the Quality and Safety of Health Care in the United States. Citation Text: Health Care Opinion Leaders' Views on the Quality and Safety of Health Care in the United States. Shea KK, Shih A, Davis K. New York, NY: The Commonwealth Fund…

  12. Health Care Leader Action Guide to Reduce Avoidable Readmissions. | PSNet

    psnet.ahrq.gov/issue/health-care-leader-action-guide-reduce-avoidable-readmissions
    March 14, 2018 - Book/Report Health Care Leader Action Guide to Reduce Avoidable Readmissions. Citation Text: Health Care Leader Action Guide to Reduce Avoidable Readmissions. Osei-Anto A, Joshi M, Audet AJ, Berman A, Jencks SF. New York, NY: The Commonwealth Fund, The John Hartford Foundation, Healt…

  13. Confronting Racism in Health Care: Moving from Proclamations to New Practices. | PSNet

    psnet.ahrq.gov/issue/confronting-racism-health-care-moving-proclamations-new-practices
    July 31, 2012 - Book/Report Confronting Racism in Health Care: Moving from Proclamations to New Practices. Citation Text: Confronting Racism in Health Care: Moving from Proclamations to New Practices. Hostetter M, Klein S. New York, NY: Commonwealth Fund;  October 18, 2021 Copy Citation …

  14. Broken Trust: Making Patient Safety More than Just a Promise. | PSNet

    psnet.ahrq.gov/issue/broken-trust-making-patient-safety-more-just-promise
    October 07, 2020 - Book/Report Broken Trust: Making Patient Safety More than Just a Promise. Citation Text: Broken Trust: Making Patient Safety More than Just a Promise. Manchester, UK: Parliamentary and Health Service Ombudsman; June 2023. ISBN: 9781528642446. Copy Citation Save …

  15. Checklists, safety, my culture and me. | PSNet

    psnet.ahrq.gov/issue/checklists-safety-my-culture-and-me
    June 19, 2019 - Commentary Checklists, safety, my culture and me. Citation Text: Raghunathan K. Checklists, safety, my culture and me. BMJ Qual Saf. 2012;21(7):617-20. doi:10.1136/bmjqs-2011-000608. Copy Citation Format: DOI Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML Endno…

  16. Safety paradoxes and safety culture. | PSNet

    psnet.ahrq.gov/issue/safety-paradoxes-and-safety-culture
    February 06, 2008 - Commentary Safety paradoxes and safety culture. Citation Text: Reason J. Safety paradoxes and safety culture. Inj Control Safety Promot. 2003;7(1):3-14. doi:10.1076/1566-0974(200003)7:1;1-v;ft003. Copy Citation Format: DOI Google Scholar BibTeX EndNote X3 XML EndNote 7 XML …

  17. Beyond the organisational accident: the need for "error wisdom" on the frontline. | PSNet

    psnet.ahrq.gov/issue/beyond-organisational-accident-need-error-wisdom-frontline
    November 18, 2015 - Commentary Beyond the organisational accident: the need for "error wisdom" on the frontline. Citation Text: Reason J. Beyond the organisational accident: the need for "error wisdom" on the frontline. Qual Saf Health Care. 2004;13 Suppl 2:ii28-33. Copy Citation Format: Goo…

  18. Medical error: the second victim. | PSNet

    psnet.ahrq.gov/issue/medical-error-second-victim-0
    February 17, 2017 - Commentary Medical error: the second victim. Citation Text: McCay L, Wu AW. Medical error: the second victim. Br J Hosp Med (Lond). 2012;73(10):C146-148. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId RIS Do…

  19. Integration of a formalized handoff system into the surgical curriculum: resident perspectives and early results. | PSNet

    psnet.ahrq.gov/issue/integration-formalized-handoff-system-surgical-curriculum-resident-perspectives-and-early
    May 25, 2016 - Study Integration of a formalized handoff system into the surgical curriculum: resident perspectives and early results. Citation Text: Telem DA. Integration of a Formalized Handoff System Into the Surgical Curriculum. Archives of Surgery. 2011;146(1). doi:10.1001/archsurg.2010.294. Cop…

  20. The evolution of error: error management, cognitive constraints, and adaptive decision-making biases. | PSNet

    psnet.ahrq.gov/issue/evolution-error-error-management-cognitive-constraints-and-adaptive-decision-making-biases
    June 03, 2020 - Review The evolution of error: error management, cognitive constraints, and adaptive decision-making biases. Citation Text: Johnson DDP, Blumstein DT, Fowler JH, et al. The evolution of error: error management, cognitive constraints, and adaptive decision-making biases. Trends Ecol Evo…
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