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psnet.ahrq.gov/issue/creating-safer-health-care-system-finding-constraint
February 24, 2011 - Commentary
Creating a safer health care system: finding the constraint.
Citation Text:
Pauker SG, Zane EM, Salem D. Creating a safer health care system: finding the constraint. JAMA. 2005;294(22):2906-8.
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psnet.ahrq.gov/issue/recommendations-improve-usability-drug-drug-interaction-clinical-decision-support-alerts
February 14, 2024 - Commentary
Recommendations to improve the usability of drug–drug interaction clinical decision support alerts.
Citation Text:
Payne TH, Hines LE, Chan RC, et al. Recommendations to improve the usability of drug-drug interaction clinical decision support alerts. J Am Med Inform Assoc. 201…
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psnet.ahrq.gov/issue/work-hour-restrictions-ethical-dilemma-residents
April 24, 2018 - Study
Work-hour restrictions as an ethical dilemma for residents.
Citation Text:
Carpenter RO, Austin MT, Tarpley JL, et al. Work-hour restrictions as an ethical dilemma for residents. Am J Surg. 2006;191(4):527-32.
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psnet.ahrq.gov/issue/intensive-care-unit-nurse-staffing-and-risk-complications-after-abdominal-aortic-surgery
December 02, 2020 - Study
Classic
Intensive care unit nurse staffing and the risk for complications after abdominal aortic surgery.
Citation Text:
Pronovost PJ, Dang D, Dorman T, et al. Intensive care unit nurse staffing and the risk for complications after abdominal aortic surge…
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psnet.ahrq.gov/issue/improving-safety-evaluating-impact-supply-chain-and-drug-shortages-health-systems
November 04, 2020 - Commentary
Improving safety by evaluating the impact of the supply chain and drug shortages on health-systems.
Citation Text:
Patel V, Cieslak K, Hertig JB. Improving safety by evaluating the impact of the supply chain and drug shortages on health-systems. Hosp Pharm. 2023;58(2):120-124.…
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psnet.ahrq.gov/issue/im-concerned-multi-site-assessment-emergency-medicine-resident-speaking-behaviors
December 02, 2020 - Study
“I’m concerned”: a multi-site assessment of emergency medicine resident speaking up behaviors.
Citation Text:
Feldman N, Volz N, Snow T, et al. “I’m concerned”: A multi-site assessment of emergency medicine resident speaking up behaviors. J Patient Saf Risk Manag. 2022;27(5):229-23…
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digital.ahrq.gov/health-it-tools-and-resources/workflow-assessment-health-it-toolkit/research/mollon-b-et-al-2009
January 01, 2009 - Mollon B et al. 2009 "Features predicting the success of computerized decision support for prescribing: a systematic review of randomized controlled trials."
Reference
Mollon B, Chong JJR, Holbrook AM, et al. Features predicting the success of computerized decision support for prescribing: a systemati…
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psnet.ahrq.gov/issue/competencies-improving-diagnosis-interprofessional-framework-education-and-training-health
September 12, 2018 - Study
Competencies for improving diagnosis: an interprofessional framework for education and training in health care.
Citation Text:
Olson A, Rencic J, Cosby K, et al. Competencies for improving diagnosis: an interprofessional framework for education and training in health care. Diagnosi…
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digital.ahrq.gov/health-it-tools-and-resources/workflow-assessment-health-it-toolkit/research/ventres-w-et-al-2005
January 01, 2005 - Ventres W et al. 2005 "Clinician style and examination room computers: a video ethnography."
Reference
Ventres W, Kooienga S, Marlin R, et al. Clinician style and examination room computers: a video ethnography. Fam Med 2005;37(4):276-281.
[Link]
Abstract
"Background and Objectives: The use …
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psnet.ahrq.gov/issue/impact-laws-aimed-healthcare-associated-infection-reduction-qualitative-study
December 23, 2020 - Study
Impact of laws aimed at healthcare-associated infection reduction: a qualitative study.
Citation Text:
Stone PW, Pogorzelska-Maziarz M, Reagan J, et al. Impact of laws aimed at healthcare-associated infection reduction: a qualitative study. BMJ Qual Saf. 2015;24(10):637-44. doi:10.…
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psnet.ahrq.gov/issue/value-learning-near-misses-improve-patient-safety-scoping-review
April 27, 2022 - Review
The value of learning from near misses to improve patient safety: a scoping review.
Citation Text:
Woodier N, Burnett C, Moppett I. The value of learning from near misses to improve patient safety: a scoping review. J Patient Saf. 2022;19(1):42-47. doi:10.1097/pts.0000000000001078…
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psnet.ahrq.gov/issue/problem-root-cause-analysis
August 28, 2024 - Commentary
The problem with root cause analysis.
Citation Text:
Peerally MF, Carr S, Waring J, et al. The problem with root cause analysis. BMJ Qual Saf. 2017;26(5):417-422. doi:10.1136/bmjqs-2016-005511.
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psnet.ahrq.gov/issue/potential-improved-teamwork-reduce-medical-errors-emergency-department
July 07, 2021 - Review
Classic
The potential for improved teamwork to reduce medical errors in the emergency department.
Citation Text:
Risser DT, Rice MM, Salisbury ML, et al. The potential for improved teamwork to reduce medical errors in the emergency department. Ann Emerg M…
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psnet.ahrq.gov/issue/systematic-review-failures-handoff-communication-during-intrahospital-transfers
November 03, 2015 - Review
A systematic review of failures in handoff communication during intrahospital transfers.
Citation Text:
Ong M-S, Coiera E. A systematic review of failures in handoff communication during intrahospital transfers. Jt Comm J Qual Patient Saf. 2011;37(6):274-284.
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psnet.ahrq.gov/issue/deficiencies-facility-leaders-response-critical-surgical-events-michael-e-debakey-va-medical
November 29, 2023 - Book/Report
Deficiencies in Facility Leaders' Response to Critical Surgical Events at the Michael E. DeBakey VA Medical Center in Houston, Texas.
Citation Text:
Deficiencies in Facility Leaders' Response to Critical Surgical Events at the Michael E. DeBakey VA Medical Center in Houston, …
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digital.ahrq.gov/ahrq-funded-projects/health-information-technology-ambulatory-care-settings-effects-quality-and-disparities
January 01, 2023 - Health Information Technology in Ambulatory Care Settings: Effects on Quality and Disparities
Project Final Report ( PDF , 106.85 KB) Disclaimer
Disclaimer
The findings and conclusions in this document are those of the author(s), who are responsible for its content, and do not …
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psnet.ahrq.gov/issue/incidence-patterns-and-prevention-wrong-site-surgery
September 30, 2010 - Study
Classic
Incidence, patterns, and prevention of wrong-site surgery.
Citation Text:
Kwaan MR, Studdert DM, Zinner MJ, et al. Incidence, patterns, and prevention of wrong-site surgery. Arch Surg. 2006;141(4):353-358.
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digital.ahrq.gov/health-it-tools-and-resources/workflow-assessment-health-it-toolkit/research/berlin-et-al-2006
January 01, 2006 - Berlin A et al. 2006 "A taxonomic description of computer-based clinical decision support systems."
Reference
Berlin A, Sorani M, Sim I. A taxonomic description of computer-based clinical decision support systems. J Biomed Inf 2006;39(6):656-667.
Abstract
"Objective. Computer-based clinical de…
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psnet.ahrq.gov/issue/using-targeted-solutions-tool-improve-hand-hygiene-compliance-associated-decreased-health
August 18, 2021 - Study
Using the Targeted Solutions Tool to improve hand hygiene compliance is associated with decreased health care–associated infections.
Citation Text:
Shabot M, Chassin MR, France A-C, et al. Using the Targeted Solutions Tool® to Improve Hand Hygiene Compliance Is Associated with Decr…
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psnet.ahrq.gov/issue/beyond-burnout-physician-wellness-hierarchy-designed-prioritize-interventions-systems-level
July 19, 2023 - Review
Beyond burnout: a physician wellness hierarchy designed to prioritize interventions at the systems level.
Citation Text:
Shapiro DE, Duquette C, Abbott LM, et al. Beyond Burnout: A Physician Wellness Hierarchy Designed to Prioritize Interventions at the Systems Level. Am J Med. 20…