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  1. Three quarters of preventable patient harm stems from situation awareness breakdowns: recognizing and addressing the core issue. | PSNet

    psnet.ahrq.gov/issue/three-quarters-preventable-patient-harm-stems-situation-awareness-breakdowns-recognizing-and
    September 11, 2009 - Newspaper/Magazine Article Three quarters of preventable patient harm stems from situation awareness breakdowns: recognizing and addressing the core issue. Citation Text: Three quarters of preventable patient harm stems from situation awareness breakdowns: recognizing and addressing the …

  2. Before you make that big decision... | PSNet

    psnet.ahrq.gov/issue/you-make-big-decision
    March 05, 2025 - Commentary Before you make that big decision... Citation Text: Kahneman D, Lovallo D, Sibony O. Before you make that big decision.. Harv Bus Rev. 2011;89(6):50-60, 137. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId…

  3. Instrument readiness: an important link to patient safety. | PSNet

    psnet.ahrq.gov/issue/instrument-readiness-important-link-patient-safety
    January 05, 2011 - Commentary Instrument readiness: an important link to patient safety. Citation Text: McNamara SA. Instrument readiness: an important link to patient safety. AORN J. 2011;93(1):160-4. doi:10.1016/j.aorn.2010.09.027. Copy Citation Format: DOI Google Scholar PubMed BibTeX En…

  4. Science-based training in patient safety and quality. | PSNet

    psnet.ahrq.gov/issue/science-based-training-patient-safety-and-quality
    May 06, 2009 - Commentary Science-based training in patient safety and quality. Citation Text: Pronovost P, Weisfeldt ML. Science-based training in patient safety and quality. Ann Intern Med. 2012;157(2):141-3. doi:10.7326/0003-4819-157-2-201207170-00457. Copy Citation Format: DOI Google …

  5. Culture change at the source: a medical school tackles patient safety. | PSNet

    psnet.ahrq.gov/issue/culture-change-source-medical-school-tackles-patient-safety
    April 12, 2023 - Commentary Culture change at the source: a medical school tackles patient safety. Citation Text: Meiris DC, Clarke JL, Nash DB. Culture change at the source: a medical school tackles patient safety. Am J Med Qual. 2006;21(1):9-12. Copy Citation Format: Google Scholar PubM…

  6. Creative education for rapid response team implementation. | PSNet

    psnet.ahrq.gov/issue/creative-education-rapid-response-team-implementation
    October 13, 2018 - Commentary Creative education for rapid response team implementation. Citation Text: Johnson AL. Creative education for rapid response team implementation. J Contin Educ Nurs. 2009;40(1):38-42. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7…

  7. Tubing safety in the obstetric setting: preventing medication errors. | PSNet

    psnet.ahrq.gov/issue/tubing-safety-obstetric-setting-preventing-medication-errors
    November 04, 2020 - Commentary Tubing safety in the obstetric setting: preventing medication errors. Citation Text: Broussard BS. Tubing safety in the obstetric setting: preventing medication errors. Nurs Womens Health. 2009;13(2):155-158. doi:10.1111/j.1751-486X.2009.01407.x. Copy Citation Format: …

  8. Patient safety and office-based anesthesia. | PSNet

    psnet.ahrq.gov/issue/patient-safety-and-office-based-anesthesia
    August 13, 2014 - Review Patient safety and office-based anesthesia. Citation Text: Urman RD, Punwani N, Shapiro FE. Patient safety and office-based anesthesia. Curr Opin Anaesthesiol. 2012;25(6):648-53. doi:10.1097/ACO.0b013e3283593094. Copy Citation Format: DOI Google Scholar PubMed BibTeX…

  9. Disclosing errors that affect multiple patients. | PSNet

    psnet.ahrq.gov/issue/disclosing-errors-affect-multiple-patients
    April 19, 2017 - Commentary Disclosing errors that affect multiple patients. Citation Text: Chafe R, Levinson W, Sullivan T. Disclosing errors that affect multiple patients. CMAJ. 2009;180(11):1125-7. doi:10.1503/cmaj.081016. Copy Citation Format: DOI Google Scholar PubMed BibTeX EndNote …

  10. Organization and representation of patient safety data: current status and issues around generalizability and scalability. | PSNet

    psnet.ahrq.gov/issue/organization-and-representation-patient-safety-data-current-status-and-issues-around
    January 21, 2011 - Commentary Organization and representation of patient safety data: current status and issues around generalizability and scalability. Citation Text: Boxwala AA, Dierks M, Keenan M, et al. Organization and representation of patient safety data: current status and issues around generalizab…

  11. Clinicians in quality improvement: a new career pathway in academic medicine. | PSNet

    psnet.ahrq.gov/issue/clinicians-quality-improvement-new-career-pathway-academic-medicine
    June 09, 2015 - Commentary Clinicians in quality improvement: a new career pathway in academic medicine. Citation Text: Shojania KG, Levinson W. Clinicians in quality improvement: a new career pathway in academic medicine. JAMA. 2009;301(7):766-8. doi:10.1001/jama.2009.140. Copy Citation Format:…

  12. Is "first do no harm" a lost concept in medical education? | PSNet

    psnet.ahrq.gov/issue/first-do-no-harm-lost-concept-medical-education
    December 01, 2004 - Commentary Is "first do no harm" a lost concept in medical education? Citation Text: O'Leary D. Is "first do no harm" a lost concept in medical education. MedGenMed. 2006;8(3):77. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML Endnote tagg…

  13. Are you using checklists? Check! | PSNet

    psnet.ahrq.gov/issue/are-you-using-checklists-check
    September 13, 2010 - Commentary Are you using checklists? Check! Citation Text: McNellis B, AAPA QCC of the. Are you using checklists? Check!. JAAPA. 2010;23(7):24-6, 31. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId RIS Down…

  14. Safe medication prescribing and monitoring in the outpatient setting. | PSNet

    psnet.ahrq.gov/issue/safe-medication-prescribing-and-monitoring-outpatient-setting
    January 06, 2018 - Commentary Safe medication prescribing and monitoring in the outpatient setting. Citation Text: Shojania KG. Safe medication prescribing and monitoring in the outpatient setting. Can Med Assoc J. 2006;174(9). doi:10.1503/cmaj.050984. Copy Citation Format: DOI Google Schol…

  15. Reducing cognitive errors in dermatology: can anything be done? | PSNet

    psnet.ahrq.gov/issue/reducing-cognitive-errors-dermatology-can-anything-be-done
    September 29, 2010 - Commentary Reducing cognitive errors in dermatology: can anything be done? Citation Text: Dunbar M, Helms SE, Brodell RT. Reducing cognitive errors in dermatology: can anything be done? J Am Acad Dermatol. 2013;69(5):810-813. doi:10.1016/j.jaad.2013.07.008. Copy Citation Format: …

  16. Resident and Family Engagement: What is my role as a leader? (pdf file)

    www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/quality-resources/tools/cauti-ltc/modules/resources/tools/engage/rfe-role-leader.pdf
    March 01, 2017 - Resident and Family Engagement: What is my role as a leader? • Resident and family engagement is one component of person-centered care, a philosophy that recognizes residents as individuals and as partners. • Effective resident and family partnerships are demonstrated by including the residents and family a…

  17. New Covid boosters look a lot like the old ones. Doctors worry that could lead to errors. | PSNet

    psnet.ahrq.gov/issue/new-covid-boosters-look-lot-old-ones-doctors-worry-could-lead-errors
    April 26, 2023 - Newspaper/Magazine Article New Covid boosters look a lot like the old ones. Doctors worry that could lead to errors. Citation Text: New Covid boosters look a lot like the old ones. Doctors worry that could lead to errors. Lovelace Jr, B. NBC News. September 7, 2022. Copy Citation …

  18. How a major public hospital is protecting doctors by silencing the patients who accuse them. | PSNet

    psnet.ahrq.gov/issue/how-major-public-hospital-protecting-doctors-silencing-patients-who-accuse-them
    January 24, 2024 - Newspaper/Magazine Article How a major public hospital is protecting doctors by silencing the patients who accuse them. Citation Text: How a major public hospital is protecting doctors by silencing the patients who accuse them. Kamb L. NBC News. June 14, 2024, Copy Citation …

  19. Guidelines in practice: medication safety. | PSNet

    psnet.ahrq.gov/issue/guidelines-practice-medication-safety
    June 26, 2019 - Commentary Guidelines in practice: medication safety. Citation Text: Speth J. Guidelines in practice: medication safety. AORN J. 2023;118(6):380-389. doi:10.1002/aorn.14034. Copy Citation Format: DOI Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId…

  20. Health literacy and communication quality in health care organizations. | PSNet

    psnet.ahrq.gov/issue/health-literacy-and-communication-quality-health-care-organizations
    November 26, 2014 - Study Health literacy and communication quality in health care organizations. Citation Text: Wynia M, Osborn CY. Health literacy and communication quality in health care organizations. J Health Commun. 2010;15 Suppl 2:102-15. doi:10.1080/10810730.2010.499981. Copy Citation Format…
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