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  1. Nature of blame in patient safety incident reports: mixed methods analysis of a national database. | PSNet

    psnet.ahrq.gov/issue/nature-blame-patient-safety-incident-reports-mixed-methods-analysis-national-database
    October 12, 2016 - Study Nature of blame in patient safety incident reports: mixed methods analysis of a national database. Citation Text: Cooper J, Edwards A, Williams H, et al. Nature of Blame in Patient Safety Incident Reports: Mixed Methods Analysis of a National Database. Ann Fam Med. 2017;15(5):455-4…

  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/837709/psn-pdf
    July 20, 2022 - Improving Diagnosis in Medicine Act of 2022. July 20, 2022 117th Cong, 2d Sess (2022) https://psnet.ahrq.gov/issue/improving-diagnosis-medicine-act-2022 Strengthening diagnostic error research and training can lead to sustained diagnostic improvement. Expanding upon legislation introduced in 2020, the “Improving D…

  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/846762/psn-pdf
    March 29, 2023 - Hospital ‘black boxes’ put surgical practices under the microscope. March 29, 2023 Sadick B. Wall Street Journal. March 19, 2023. https://psnet.ahrq.gov/issue/hospital-black-boxes-put-surgical-practices-under-microscope Safety information systems that track action in real time can reveal a trove of data about how …

  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41895/psn-pdf
    December 30, 2014 - Proceedings from the European Handover Research Collaborative. December 30, 2014 Philibert I, Barach P, eds. BMJ Qual Saf. 2012;21(suppl 1):i1-i128. https://psnet.ahrq.gov/issue/proceedings-european-handover-research-collaborative Articles in this supplement highlight findings of a multi-national effort to improve…

  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/60647/psn-pdf
    July 01, 2020 - Beyond the Data: Understanding the Impact of COVID-19 on BAME Groups. July 1, 2020 Public Health England. London, UK: Crown Copyright; 2020. https://psnet.ahrq.gov/issue/beyond-data-understanding-impact-covid-19-bame-groups The COVID-19 pandemic has revealed weaknesses in health care systems worldwide that have af…

  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47763/psn-pdf
    February 13, 2019 - Priorities for pediatric patient safety research. February 13, 2019 Hoffman JM, Keeling NJ, Forrest CB, et al. Priorities for Pediatric Patient Safety Research. Pediatrics. 2019;143(2). doi:10.1542/peds.2018-0496. https://psnet.ahrq.gov/issue/priorities-pediatric-patient-safety-research This study aimed to priorit…

  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/839326/psn-pdf
    November 02, 2022 - Safety considerations for challenges when using smart infusion pumps. November 2, 2022 ISMP Medication Safety Alert! Acute care edition. October 20, 2022;20(21):1-5. https://psnet.ahrq.gov/issue/safety-considerations-challenges-when-using-smart-infusion-pumps Errors due to inadequate information use with intraveno…

  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42313/psn-pdf
    August 24, 2013 - The leader's role in medical device safety. August 24, 2013 Federico F. The leader's role in medical device safety. Healthcare executives must ensure appropriate policies, procedures. Healthcare executive. 2013;28(3):82-5. https://psnet.ahrq.gov/issue/leaders-role-medical-device-safety This article discusses how e…

  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47786/psn-pdf
    June 26, 2019 - Creating a Safe Space: Psychological Health and Safety of Healthcare Workers. June 26, 2019 Canadian Patient Safety Institute: 2019. https://psnet.ahrq.gov/issue/creating-safe-space-psychological-health-and-safety-healthcare-workers Structured approaches to managing negative psychological consequences of medical e…

  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/73170/psn-pdf
    April 21, 2021 - Sentinel Event Alert 63: optimizing smart infusion pump safety with DERS. April 21, 2021 Sentinel Event Alert 63: Optimizing Smart Infusion Pump Safety with DERS. Jt Comm J Qual Patient Saf. 2021;47(6):394-397. doi:10.1016/j.jcjq.2021.03.013. https://psnet.ahrq.gov/issue/sentinel-event-alert-63-optimizing-smart-in…

  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/841785/psn-pdf
    December 21, 2022 - Request for Information: Creating a National Healthcare System Action Alliance to Advance Patient Safety. December 21, 2022 Agency for Healthcare Research and Quality. Fed Register. December 12, 2022;87:76046-76048. https://psnet.ahrq.gov/issue/request-information-creating-national-healthcare-system-action-alliance…

  12. A qualitative study of speaking out about patient safety concerns in intensive care units. | PSNet

    psnet.ahrq.gov/issue/qualitative-study-speaking-out-about-patient-safety-concerns-intensive-care-units
    August 21, 2013 - Study A qualitative study of speaking out about patient safety concerns in intensive care units. Citation Text: Tarrant C, Leslie M, Bion J, et al. A qualitative study of speaking out about patient safety concerns in intensive care units. Soc Sci Med. 2017;193:8-15. doi:10.1016/j.socscim…

  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/847044/psn-pdf
    April 05, 2023 - Perioperative safety determinants in ethnic patient groups. April 5, 2023 Bloo G, Calsbeek H, Westert GP, et al. Perioperative safety determinants in ethnic patient groups. J Patient Saf Risk Manag. 2023;28(1):31-46. doi:10.1177/25160435231151545. https://psnet.ahrq.gov/issue/perioperative-safety-determinants-ethn…

  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45266/psn-pdf
    January 01, 2020 - Learning from lawsuits: using malpractice claims data to develop care transitions planning tools. August 31, 2016 Arbaje AI, Werner NE, Kasda EM, et al. Learning From Lawsuits: Using Malpractice Claims Data to Develop Care Transitions Planning Tools. J Patient Saf. 2020;16(1):52-57. doi:10.1097/pts.000000000000023…

  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/72643/psn-pdf
    January 13, 2021 - Ockenden Report. Emerging Fndings and Recommendations from the Independent Review of Maternity Services at the Shrewsbury and Telford Hospital NHS Trust. January 13, 2021 London UK: Crown Copyright; December 10, 2020. ISBN: 9781528623049.   https://psnet.ahrq.gov/issue/ockenden-report-emerging-fndings-a…

  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42535/psn-pdf
    October 16, 2013 - Implementing an interprofessional patient safety learning initiative: insights from participants, project leads and steering committee members. October 16, 2013 Jeffs L, Abramovich IA, Hayes C, et al. Implementing an interprofessional patient safety learning initiative: insights from participants, project leads an…

  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43831/psn-pdf
    January 21, 2015 - Implementation of standardized dosing units for I.V. medications. January 21, 2015 Jung B, Couldry R, Wilkinson S, et al. Implementation of standardized dosing units for i.v. medications. Am J Health Syst Pharm. 2014;71(24):2153-8. doi:10.2146/ajhp140046. https://psnet.ahrq.gov/issue/implementation-standardized-do…

  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45545/psn-pdf
    October 05, 2016 - How to Improve Electronic Health Record Usability and Patient Safety. October 5, 2016 Philadelphia, PA: Pew Charitable Trusts; September 6, 2016. https://psnet.ahrq.gov/issue/how-improve-electronic-health-record-usability-and-patient-safety The usability of electronic health record (EHR) systems can affect clinici…

  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43882/psn-pdf
    February 18, 2015 - Case Studies in Patient Safety: Foundations for Core Competencies. February 18, 2015 Johnson JK, Haskell HW, Barach PR. Burlington, MA: Jones and Bartlett Learning; 2015. ISBN: 9781449681548. https://psnet.ahrq.gov/issue/case-studies-patient-safety-foundations-core-competencies Patient stories can help illustrate…

  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45811/psn-pdf
    May 08, 2017 - A National Web Conference on Improving Health IT Safety Through the Use of Natural Language Processing to Improve Accuracy of EHR Documentation. May 8, 2017 Agency for Healthcare Research and Quality. February 7, 2017. https://psnet.ahrq.gov/issue/national-web-conference-improving-health-it-safety-through-use-natu…
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