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psnet.ahrq.gov/node/47510/psn-pdf
June 30, 2019 - Rethinking high reliability in healthcare: the role of error
management theory towards advancing high reliability
organizing.
June 30, 2019
Guttman O, Keebler JR, Lazzara EH, et al. J Patient Saf Risk Manag. 2019;24:127–133.
https://psnet.ahrq.gov/issue/rethinking-high-reliability-healthcare-role-error-management-…
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psnet.ahrq.gov/node/45453/psn-pdf
November 02, 2016 - Creating highly reliable health care: how reliability-
enhancing work practices affect patient safety in
hospitals.
November 2, 2016
Vogus TJ, Iacobucci D. Creating Highly Reliable Health Care. ILR Review. 2016;69(4).
doi:10.1177/0019793916642759.
https://psnet.ahrq.gov/issue/creating-highly-reliable-health-care-…
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psnet.ahrq.gov/node/45459/psn-pdf
January 03, 2017 - Applying the high reliability health care maturity model to
assess hospital performance: a VA case study.
January 3, 2017
Sullivan JL, Rivard PE, Shin MH, et al. Applying the High Reliability Health Care Maturity Model to Assess
Hospital Performance: A VA Case Study. Jt Comm J Qual Patient Saf. 2016;42(9):389-411.
…
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psnet.ahrq.gov/node/854641/psn-pdf
October 18, 2023 - Ranking of the Rate of State Medical Boards’ Serious
Disciplinary Actions, 2019-2021.
October 18, 2023
Wolfe SW, Oshel RE. Washington, DC: Public Citizen; August 16, 2023.
https://psnet.ahrq.gov/issue/ranking-rate-state-medical-boards-serious-disciplinary-actions-2019-2021
There are recognized systemic w…
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psnet.ahrq.gov/node/867447/psn-pdf
January 08, 2025 - The influence of hospital physician integration on culture
of patient safety.
January 8, 2025
Upadhyay S, Chien L-C. The influence of hospital physician integration on culture of patient safety. J
Patient Saf. 2024;20(8):542-548. doi:10.1097/pts.0000000000001280.
https://psnet.ahrq.gov/issue/influence-hospital-phy…
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psnet.ahrq.gov/node/73622/psn-pdf
August 25, 2021 - The presence and potential impact of psychological
safety in the healthcare setting: an evidence synthesis.
August 25, 2021
Grailey KE, Murray E, Reader T, et al. The presence and potential impact of psychological safety in the
healthcare setting: an evidence synthesis. BMC Health Serv Res. 2021;21(1):773. doi:10.1…
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psnet.ahrq.gov/node/73063/psn-pdf
March 24, 2021 - Clinical data sharing improves quality measurement and
patient safety.
March 24, 2021
D’Amore JD, McCrary LK, Denson J, et al. Clinical data sharing improves quality measurement and patient
safety. J Am Med Inform Assoc. 2021;28(7):1534-1542. doi:10.1093/jamia/ocab039.
https://psnet.ahrq.gov/issue/clinical-data-sh…
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psnet.ahrq.gov/node/35716/psn-pdf
July 10, 2008 - Adherence to black box warnings for prescription
medications in outpatients.
July 10, 2008
Lasser KE, Seger DL, Yu T, et al. Adherence to black box warnings for prescription medications in
outpatients. Arch Intern Med. 2006;166(3):338-44.
https://psnet.ahrq.gov/issue/adherence-black-box-warnings-prescription-medic…
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psnet.ahrq.gov/node/60701/psn-pdf
July 22, 2020 - Prevalence and nature of medication errors and
medication-related harm following discharge from
hospital to community settings: a systematic review.
July 22, 2020
Alqenae FA, Steinke DT, Keers RN. Prevalence and nature of medication errors and medication-related
harm following discharge from hospital to community …
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psnet.ahrq.gov/node/61019/psn-pdf
October 14, 2020 - Clinical deterioration and hospital?acquired
complications in adult patients with isolation precautions
for infection control: a systematic review.
October 14, 2020
Berry D, Wakefield E, Street M, et al. Clinical deterioration and hospital?acquired complications in adult
patients with isolation precautions for inf…
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psnet.ahrq.gov/node/47137/psn-pdf
July 19, 2018 - Physician burnout in the electronic health record era: are
we ignoring the real cause?
July 19, 2018
Downing L, Bates DW, Longhurst CA. Physician Burnout in the Electronic Health Record Era: Are We
Ignoring the Real Cause? Ann Intern Med. 2018;169(1):50-51. doi:10.7326/M18-0139.
https://psnet.ahrq.gov/issue/physic…
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psnet.ahrq.gov/node/47848/psn-pdf
May 08, 2019 - A mixed-method study of practitioners' perspectives on
issues related to EHR medication reconciliation at a
health system.
May 8, 2019
Rangachari P, Dellsperger KC, Fallaw D, et al. A Mixed-Method Study of Practitioners' Perspectives on
Issues Related to EHR Medication Reconciliation at a Health System. Qual Manag…
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psnet.ahrq.gov/node/46453/psn-pdf
October 04, 2017 - Evaluation of patient and family outpatient complaints as
a strategy to prioritize efforts to improve cancer care
delivery.
October 4, 2017
Mack JW, Jacobson J, Frank D, et al. Evaluation of Patient and Family Outpatient Complaints as a
Strategy to Prioritize Efforts to Improve Cancer Care Delivery. Jt Comm J Qual…
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psnet.ahrq.gov/node/74092/psn-pdf
November 17, 2021 - Ensuring medication safety for consumers from ethnic
minority backgrounds: the need to address unconscious
bias within health systems.
November 17, 2021
Chauhan A, Walpola RL. Ensuring medication safety for consumers from ethnic minority backgrounds: the
need to address unconscious bias within health systems. Int …
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psnet.ahrq.gov/node/48138/psn-pdf
July 17, 2019 - Beyond the clinical team: evaluating the human factors-
oriented training of non-clinical professionals working in
healthcare contexts.
July 17, 2019
Lavelle M, Reedy GB, Attoe C, et al. Beyond the clinical team: evaluating the human factors-oriented
training of non-clinical professionals working in healthcare con…
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psnet.ahrq.gov/node/43179/psn-pdf
July 28, 2014 - The effect of the electronic transmission of prescriptions
on dispensing errors and prescription enhancements
made in English community pharmacies: a naturalistic
stepped wedge study.
July 28, 2014
Franklin BD, Reynolds M, Sadler S, et al. The effect of the electronic transmission of prescriptions on
dispensing e…
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psnet.ahrq.gov/node/44592/psn-pdf
December 02, 2015 - Power and conflict: the effect of a superior's interpersonal
behaviour on trainees' ability to challenge authority
during a simulated airway emergency.
December 2, 2015
Friedman Z, Hayter MA, Everett TC, et al. Power and conflict: the effect of a superior's interpersonal
behaviour on trainees' ability to challenge…
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psnet.ahrq.gov/node/44011/psn-pdf
May 06, 2015 - Resident physicians' clinical training and error rate: the
roles of autonomy, consultation, and familiarity with the
literature.
May 6, 2015
Naveh E, Katz-Navon T, Stern Z. Resident physicians' clinical training and error rate: the roles of
autonomy, consultation, and familiarity with the literature. Adv Health Sc…
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psnet.ahrq.gov/node/47109/psn-pdf
June 06, 2018 - Principles of automation for patient safety in intensive
care: learning from aviation.
June 6, 2018
Dominiczak J, Khansa L. Principles of Automation for Patient Safety in Intensive Care: Learning From
Aviation. Jt Comm J Qual Patient Saf. 2018;44(6):366-371. doi:10.1016/j.jcjq.2017.11.008.
https://psnet.ahrq.gov/i…
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psnet.ahrq.gov/node/73591/psn-pdf
August 11, 2021 - Unintended consequences: quantifying the benefits,
iatrogenic harms and downstream cascade costs of
musculoskeletal MRI in UK primary care.
August 11, 2021
Sajid IM, Parkunan A, Frost K. Unintended consequences: quantifying the benefits, iatrogenic harms and
downstream cascade costs of musculoskeletal MRI in UK pr…