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psnet.ahrq.gov/issue/there-evidence-better-health-care-cancer-patients-after-second-opinion-systematic-review
May 03, 2023 - Review
Is there evidence for a better health care for cancer patients after a second opinion? A systematic review.
Citation Text:
Ruetters D, Keinki C, Schroth S, et al. Is there evidence for a better health care for cancer patients after a second opinion? A systematic review. J Cancer …
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psnet.ahrq.gov/issue/program-director-perceptions-surgical-resident-training-and-patient-care-under-flexible-duty
November 18, 2016 - Study
Program director perceptions of surgical resident training and patient care under flexible duty hour requirements.
Citation Text:
Saadat L, Dahlke AR, Rajaram R, et al. Program Director Perceptions of Surgical Resident Training and Patient Care under Flexible Duty Hour Requirements…
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psnet.ahrq.gov/issue/diagnostic-error-emergency-department-follow-patients-minor-trauma-outpatient-clinic
November 15, 2023 - Study
Diagnostic error in the emergency department: follow up of patients with minor trauma in the outpatient clinic.
Citation Text:
Moonen P-J, Mercelina L, Boer W, et al. Diagnostic error in the Emergency Department: follow up of patients with minor trauma in the outpatient clinic. Sca…
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psnet.ahrq.gov/issue/preventing-medication-errors-long-term-care-results-and-evaluation-large-scale-web-based
June 15, 2011 - Study
Preventing medication errors in long-term care: results and evaluation of a large scale web-based error reporting system.
Citation Text:
Pierson S, Hansen RA, Greene SB, et al. Preventing medication errors in long-term care: results and evaluation of a large scale web-based error…
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psnet.ahrq.gov/issue/deficits-communication-and-information-transfer-between-hospital-based-and-primary-care
January 25, 2017 - Review
Classic
Deficits in communication and information transfer between hospital-based and primary care physicians: implications for patient safety and continuity of care.
Citation Text:
Kripalani S, LeFevre F, Phillips CO, et al. Deficits in communication a…
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psnet.ahrq.gov/issue/drug-drug-interactions-should-be-non-interruptive-order-reduce-alert-fatigue-electronic
December 31, 2014 - Study
Drug–drug interactions that should be non-interruptive in order to reduce alert fatigue in electronic health records.
Citation Text:
Phansalkar S, van der Sijs H, Tucker AD, et al. Drug-drug interactions that should be non-interruptive in order to reduce alert fatigue in electronic…
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psnet.ahrq.gov/issue/initiative-reduce-insulin-related-adverse-drug-events-childrens-hospital
March 24, 2021 - Study
An initiative to reduce insulin-related adverse drug events in a children's hospital.
Citation Text:
Lawson SA, Hornung LN, Lawrence M, et al. An initiative to reduce insulin-related adverse drug events in a children's hospital. Pediatrics. 2022;149(1):e2020004937. doi:10.1542/peds…
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psnet.ahrq.gov/issue/obtaining-best-possible-medication-history-hospital-admission-description-pharmacy-technician
October 31, 2023 - Study
Obtaining the best possible medication history at hospital admission: description of a pharmacy technician-driven program to identify medication discrepancies.
Citation Text:
Kabir R, Liaw S, Cerise J, et al. Obtaining the best possible medication history at hospital admission: des…
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psnet.ahrq.gov/issue/video-based-communication-assessment-physician-error-disclosure-skills-crowdsourced-laypeople
August 21, 2024 - Study
Video-based communication assessment of physician error disclosure skills by crowdsourced laypeople and patient advocates who experienced medical harm: reliability assessment with generalizability theory.
Citation Text:
White AA, King AM, D’Addario AE, et al. Video-based communicat…
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psnet.ahrq.gov/issue/failures-respectful-care-critically-ill-patients
December 19, 2018 - Study
Failures in the respectful care of critically ill patients.
Citation Text:
Law AC, Roche S, Reichheld A, et al. Failures in the Respectful Care of Critically Ill Patients. Jt Comm J Qual Patient Saf. 2019;45(4):276-284. doi:10.1016/j.jcjq.2018.05.008.
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psnet.ahrq.gov/issue/using-health-care-failure-mode-and-effect-analysis-va-national-center-patient-safetys
January 17, 2012 - Study
Classic
Using Health Care Failure Mode and Effect Analysis: the VA National Center for Patient Safety's prospective risk analysis system.
Citation Text:
DeRosier JM, Stalhandske E, Bagian JP, et al. Using health care Failure Mode and Effect Analysis: the V…
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psnet.ahrq.gov/issue/use-structured-approach-and-virtual-simulation-practice-improve-diagnostic-reasoning
December 15, 2021 - Study
Use of a structured approach and virtual simulation practice to improve diagnostic reasoning.
Citation Text:
Dekhtyar M, Park YS, Kalinyak J, et al. Use of a structured approach and virtual simulation practice to improve diagnostic reasoning. Diagnosis (Berl). 2022;9(1):69-76. doi:…
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psnet.ahrq.gov/issue/medication-discrepancies-resident-sign-outs-and-their-potential-harm
March 28, 2011 - Study
Medication discrepancies in resident sign-outs and their potential to harm.
Citation Text:
Arora V, Kao J, Lovinger D, et al. Medication discrepancies in resident sign-outs and their potential to harm. J Gen Intern Med. 2007;22(12):1751-5.
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psnet.ahrq.gov/issue/effects-i-pass-nursing-handoff-bundle-communication-quality-and-workflow
November 12, 2014 - Study
Effects of the I-PASS nursing handoff bundle on communication quality and workflow.
Citation Text:
Starmer AJ, Schnock KO, Lyons A, et al. Effects of the I-PASS Nursing Handoff Bundle on communication quality and workflow. BMJ Qual Saf. 2017;26(12):949-957. doi:10.1136/bmjqs-2016-0…
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psnet.ahrq.gov/issue/go-between-study-simulation-study-comparing-traffic-lights-and-sbar-tools-means-communication
March 01, 2023 - Study
The 'go-between' study: a simulation study comparing the 'Traffic Lights' and 'SBAR' tools as a means of communication between anaesthetic staff.
Citation Text:
MacDougall-Davis SR, Kettley L, Cook TM. The 'go-between' study: a simulation study comparing the 'Traffic Lights' and 'S…
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psnet.ahrq.gov/issue/patient-handoffs-and-multi-specialty-trainee-perspectives-across-institution-informing
February 23, 2022 - Study
Patient handoffs and multi-specialty trainee perspectives across an institution: informing recommendations for health systems and an expanded conceptual framework for handoffs.
Citation Text:
Williams SR, Sebok-Syer SS, Caretta-Weyer H, et al. Patient handoffs and multi-specialty t…
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psnet.ahrq.gov/issue/inadequate-hand-communication
April 02, 2015 - Sentinel Event Alerts
Inadequate hand-off communication.
Citation Text:
Inadequate hand-off communication. Sentinel event alert. 2017;58(58):1-6.
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psnet.ahrq.gov/issue/descriptive-study-morbidity-and-mortality-conferences-and-their-conformity-medical-incident
September 28, 2010 - Study
A descriptive study of morbidity and mortality conferences and their conformity to medical incident analysis models: results of the morbidity and mortality conference improvement study, phase 1.
Citation Text:
Aboumatar HJ, Blackledge CG, Dickson C, et al. A descriptive study of …
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psnet.ahrq.gov/issue/impact-interoperability-smart-infusion-pumps-and-electronic-medical-record-critical-care
August 25, 2021 - Study
Impact of interoperability of smart infusion pumps and an electronic medical record in critical care.
Citation Text:
Joseph R, Lee SW, Anderson SV, et al. Impact of interoperability of smart infusion pumps and an electronic medical record in critical care. Am J Health-System Pharm.…
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psnet.ahrq.gov/issue/racial-disparities-frequency-patient-safety-events-results-national-medicare-patient-safety
December 18, 2014 - Study
Racial disparities in the frequency of patient safety events: results from the National Medicare Patient Safety Monitoring System.
Citation Text:
Metersky M, Hunt D, Kliman R, et al. Racial disparities in the frequency of patient safety events: results from the National Medicare …