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421. Shared understanding of resilient practices in the context of inpatient suicide prevention: a narrative synthesis. | PSNet
     psnet.ahrq.gov/issue/shared-understanding-resilient-practices-context-inpatient-suicide-prevention-narrative
     December 23, 2020 - Study Shared understanding of resilient practices in the context of inpatient suicide … Differences in medication reconciliation interventions between six hospitals: a mixed method study … 2022 The role of feedback in emergency ambulance services: a qualitative interview study … A qualitative study of interprofessional dissonance in hospital infection prevention and control. … emotions experienced by healthcare staff following medication administration errors: a descriptive study

422. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/851189/psn-pdf
     July 05, 2023 - So many ways to be wrong: completeness and accuracy in a prospective study of OR-to-ICU handoff standardization … So many ways to be wrong: completeness and accuracy in a prospective study of OR-to-ICU handoff standardization … https://psnet.ahrq.gov/issue/so-many-ways-be-wrong-completeness-and-accuracy-prospective-study-or- icu-handoff … This article describes the impact of the Handoffs and Transitions in Critical Care (HATRICC) study on … Omissions, mortality, and length of intensive care unit (ICU) stay were reported in a 2019 study.

423. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/847543/psn-pdf
     April 12, 2023 - What works in medication reconciliation: an on-treatment and site analysis of the MARQUIS2 study. … What works in medication reconciliation: an on-treatment and site analysis of the MARQUIS2 study. … ://psnet.ahrq.gov/issue/what-works-medication-reconciliation-treatment-and-site-analysis-marquis2- study … The MARQUIS2 study examined whether system- and patient-level interventions plus physician mentors can … This analysis based on patient exposure in the MARQUIS2 study found that patient receipt of a best possible

424. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/836923/psn-pdf
     April 13, 2022 - An e-Delphi study to obtain expert consensus on the level of risk associated with preventable e-prescribing … Delphi study to obtain expert consensus on the level of risk associated with preventable e? … https://psnet.ahrq.gov/issue/e-delphi-study-obtain-expert-consensus-level-risk-associated-preventable-e … This study developed a similar simulation tool for use in the UK. … Study participants rated 178 clinical scenarios for likelihood of occurrence, level of associated harm

425. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/843054/psn-pdf
     January 25, 2023 - Exploring nursing-sensitive events in home healthcare: a national multicenter cohort study using a trigger … Exploring nursing-sensitive events in home healthcare: a national multicenter cohort study using a trigger … psnet.ahrq.gov/issue/exploring-nursing-sensitive-events-home-healthcare-national-multicenter- cohort-study-using … In this retrospective study of 600 patient records from ten Swedish home healthcare organizations, researchers … psnet.ahrq.gov/issue/exploring-nursing-sensitive-events-home-healthcare-national-multicenter-cohort-study-using

426. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/74260/psn-pdf
     January 19, 2022 - What counts as a voiceable concern in decisions about speaking out in hospitals: a qualitative study … What counts as a voiceable concern in decisions about speaking out in hospitals: a qualitative study … psnet.ahrq.gov/issue/what-counts-voiceable-concern-decisions-about-speaking-out-hospitals- qualitative-study … In this study of 165 frontline and senior leader participants, deciding to report a safety event (referred … psnet.ahrq.gov/issue/what-counts-voiceable-concern-decisions-about-speaking-out-hospitals-qualitative-study

427. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/47791/psn-pdf
     March 20, 2019 - Essential activities for electronic health record safety: a qualitative study. … Essential activities for electronic health record safety: A qualitative study. … https://psnet.ahrq.gov/issue/essential-activities-electronic-health-record-safety-qualitative-study … This direct observation and interview study examined safety activities associated with electronic health … https://psnet.ahrq.gov/issue/essential-activities-electronic-health-record-safety-qualitative-study https

428. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/45106/psn-pdf
     August 16, 2017 - The 'go-between' study: a simulation study comparing the 'Traffic Lights' and 'SBAR' tools as a means … The 'go-between' study: a simulation study comparing the 'Traffic Lights' and 'SBAR' tools as a means … https://psnet.ahrq.gov/issue/go-between-study-simulation-study-comparing-traffic-lights-and-sbar-tools … https://psnet.ahrq.gov/issue/go-between-study-simulation-study-comparing-traffic-lights-and-sbar-tools-means-communication … https://psnet.ahrq.gov/issue/go-between-study-simulation-study-comparing-traffic-lights-and-sbar-tools-means-communication

429. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/36807/psn-pdf
     October 25, 2013 - HealthGrades Quality Study: Fourth Annual Patient Safety in American Hospitals Study. … https://psnet.ahrq.gov/issue/healthgrades-quality-study-fourth-annual-patient-safety-american-hospitals-study … https://psnet.ahrq.gov/issue/healthgrades-quality-study-fourth-annual-patient-safety-american-hospitals-study … psnet.ahrq.gov/issue/patient-safety-indicators-overview https://psnet.ahrq.gov/issue/healthgrades-quality-study-second-annual-patient-safety-american-hospitals-study … https://psnet.ahrq.gov/issue/healthgrades-quality-study-third-annual-patient-safety-american-hospitals-study

430. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/37458/psn-pdf
     June 07, 2008 - The National Emergency Department Safety Study: study rationale and design. … The National Emergency Department Safety Study: Study Rationale and Design. … https://psnet.ahrq.gov/issue/national-emergency-department-safety-study-study-rationale-and-design The … authors describe the process used to implement a national epidemiological study of medical error in … https://psnet.ahrq.gov/issue/national-emergency-department-safety-study-study-rationale-and-design

431. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/46014/psn-pdf
     April 05, 2017 - Immersive high fidelity simulation of critically ill patients to study cognitive errors: a pilot study … Immersive high fidelity simulation of critically ill patients to study cognitive errors: a pilot study … - pilot-study Cognitive bias can lead to diagnostic error. … https://psnet.ahrq.gov/issue/immersive-high-fidelity-simulation-critically-ill-patients-study-cognitive-errors-pilot-study … https://psnet.ahrq.gov/issue/immersive-high-fidelity-simulation-critically-ill-patients-study-cognitive-errors-pilot-study

432. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/34641/psn-pdf
     March 03, 2011 - Study of the deaths associated with anesthesia and surgery: based on a study of 599, 548 anesthesias … A study of the deaths associated with anesthesia and surgery: based on a study of 599, 548 anesthesias … https://psnet.ahrq.gov/issue/study-deaths-associated-anesthesia-and-surgery-based-study-599-548- anesthesias-ten … https://psnet.ahrq.gov/issue/study-deaths-associated-anesthesia-and-surgery-based-study-599-548-anesthesias-ten … https://psnet.ahrq.gov/issue/study-deaths-associated-anesthesia-and-surgery-based-study-599-548-anesthesias-ten

433. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/37700/psn-pdf
     October 25, 2013 - HealthGrades Quality Study: Fifth Annual Patient Safety in American Hospitals Study. … https://psnet.ahrq.gov/issue/healthgrades-quality-study-fifth-annual-patient-safety-american-hospitals-study … The limitations of using PSIs as a performance measure have been discussed in a prior study and AHRQ … https://psnet.ahrq.gov/issue/healthgrades-quality-study-fifth-annual-patient-safety-american-hospitals-study … https://psnet.ahrq.gov/issue/healthgrades-quality-study-fourth-annual-patient-safety-american-hospitals-study

434. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/36334/psn-pdf
     October 26, 2010 - Missed and delayed diagnoses in the emergency department: a study of closed malpractice claims from … Missed and delayed diagnoses in the emergency department: a study of closed malpractice claims from … -4-liability This study addressing the causes of missed and delayed diagnoses in emergency department … patients used similar methodology as a companion study of error in the ambulatory setting and a prior … study of surgical patients. 

435. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/35855/psn-pdf
     October 25, 2013 - HealthGrades Quality Study: Third Annual Patient Safety in American Hospitals Study. … https://psnet.ahrq.gov/issue/healthgrades-quality-study-third-annual-patient-safety-american-hospitals … https://psnet.ahrq.gov/issue/healthgrades-quality-study-third-annual-patient-safety-american-hospitals-study … https://psnet.ahrq.gov/issue/healthgrades-quality-study-third-annual-patient-safety-american-hospitals-study … psnet.ahrq.gov/issue/patient-safety-indicators-overview https://psnet.ahrq.gov/issue/healthgrades-quality-study-second-annual-patient-safety-american-hospitals-study

436. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/38259/psn-pdf
     December 03, 2008 - Incidence of adverse events related to health care in Spain: results of the Spanish National Study of … Incidence of adverse events related to health care in Spain: results of the Spanish National Study of … /psnet.ahrq.gov/issue/incidence-adverse-events-related-health-care-spain-results-spanish-national- study-adverse … This retrospective cohort study analyzed inpatient cases associated with adverse events (AEs) and found … Canada and Australia but are higher than those reported in the highly regarded Harvard Medical Practice Study

437. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/35006/psn-pdf
     October 25, 2013 - HealthGrades Quality Study: Second Annual Patient Safety in American Hospitals Study. … https://psnet.ahrq.gov/issue/healthgrades-quality-study-second-annual-patient-safety-american-hospitals … - study The first version of this now annual report on the safety of hospitalized Medicare patients … https://psnet.ahrq.gov/issue/healthgrades-quality-study-second-annual-patient-safety-american-hospitals-study … https://psnet.ahrq.gov/issue/healthgrades-quality-study-second-annual-patient-safety-american-hospitals-study

438. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/44045/psn-pdf
     December 04, 2015 - Residents' reluctance to challenge negative hierarchy in the operating room: a qualitative study. … Residents' reluctance to challenge negative hierarchy in the operating room: a qualitative study. … psnet.ahrq.gov/issue/residents-reluctance-challenge-negative-hierarchy-operating-room-qualitative- study … In this simulation study, most anesthesiology residents acceded to an attending physician's order to … This study is reminiscent of one of the earliest studies of the impact of hierarchies on patient safety

439. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/37114/psn-pdf
     October 04, 2011 - 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. … 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. … Despite their ubiquity, a prior study of internal medicine and surgery conferences found that errors

440. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/37738/psn-pdf
     January 10, 2017 - Recruitment of hospitals for a safety climate study: facilitators and barriers. … Recruitment of hospitals for a safety climate study: facilitators and barriers. … https://psnet.ahrq.gov/issue/recruitment-hospitals-safety-climate-study-facilitators-and-barriers A … In this study, the authors of the original study report on the difficulties they faced in recruiting … hospitals to participate in the survey, and how recruitment difficulties could have biased the study