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psnet.ahrq.gov/node/46048/psn-pdf
July 05, 2017 - Association between elements of electronic health record
systems and the weekend effect in urgent general
surgery.
July 5, 2017
Kothari A, Brownlee SA, Blackwell RH, et al. Association Between Elements of Electronic Health Record
Systems and the Weekend Effect in Urgent General Surgery. JAMA Surg. 2017;152(6):602-…
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psnet.ahrq.gov/node/42989/psn-pdf
May 28, 2014 - Interactive questioning in critical care during handovers:
a transcript analysis of communication behaviours by
physicians, nurses and nurse practitioners.
May 28, 2014
Rayo MF, Mount-Campbell AF, O'Brien JM, et al. Interactive questioning in critical care during handovers: a
transcript analysis of communication b…
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psnet.ahrq.gov/node/45090/psn-pdf
July 01, 2016 - Association between the Centers for Medicare and
Medicaid Services hospital star rating and patient
outcomes.
July 1, 2016
Wang DE, Tsugawa Y, Figueroa JF, et al. Association Between the Centers for Medicare and Medicaid
Services Hospital Star Rating and Patient Outcomes. JAMA Intern Med. 2016;176(6):848-50.
doi:…
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psnet.ahrq.gov/node/45733/psn-pdf
December 07, 2016 - Global patient outcomes after elective surgery:
prospective cohort study in 27 low-, middle- and high-
income countries.
December 7, 2016
group ISOS. Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle-
and high-income countries. Br J Anaesth. 2016;117(5):601-609. doi:10.109…
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psnet.ahrq.gov/node/73061/psn-pdf
March 24, 2021 - Timeout procedure in paediatric surgery: effective tool or
lip service? A randomised prospective observational
study.
March 24, 2021
Muensterer OJ, Kreutz H, Poplawski A, et al. Timeout procedure in paediatric surgery: effective tool or lip
service? A randomised prospective observational study. BMJ Qual Saf. 2021;…
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psnet.ahrq.gov/node/44523/psn-pdf
January 01, 2016 - Electronic health record-based triggers to detect adverse
events after outpatient orthopaedic surgery.
December 16, 2015
Menendez ME, Janssen SJ, Ring D. Electronic health record-based triggers to detect adverse events after
outpatient orthopaedic surgery. BMJ Qual Saf. 2016;25(1):25-30. doi:10.1136/bmjqs-2015-0043…
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psnet.ahrq.gov/node/34874/psn-pdf
February 25, 2009 - Intensive care unit nurse staffing and the risk for
complications after abdominal aortic surgery.
February 25, 2009
Pronovost PJ, Dang D, Dorman T, et al. Intensive care unit nurse staffing and the risk for complications
after abdominal aortic surgery. Eff Clin Pract. 2001;4(5):199-206.
https://psnet.ahrq.gov/issu…
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psnet.ahrq.gov/node/47941/psn-pdf
January 01, 2020 - Usability and feasibility of consumer-facing technology to
reduce unsafe medication use by older adults.
May 22, 2019
Holden RJ, Campbell NL, Abebe E, et al. Usability and feasibility of consumer-facing technology to reduce
unsafe medication use by older adults. Res Social Adm Pharm. 2020;16(1):54-61.
doi:10.1016/…
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psnet.ahrq.gov/node/47969/psn-pdf
June 12, 2019 - Opioid medication discontinuation and risk of adverse
opioid-related health care events.
June 12, 2019
Mark TL, Parish W. Opioid medication discontinuation and risk of adverse opioid-related health care
events. J Subst Abuse Treat. 2019;103:58-63. doi:10.1016/j.jsat.2019.05.001.
https://psnet.ahrq.gov/issue/opioid…
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psnet.ahrq.gov/node/44430/psn-pdf
October 28, 2015 - The role of dynamic trade-offs in creating safety—a
qualitative study of handover across care boundaries in
emergency care.
October 28, 2015
Sujan M, Spurgeon P, Cooke M. The role of dynamic trade-offs in creating safety—A qualitative study of
handover across care boundaries in emergency care. Reliab Eng Syst Saf.…
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psnet.ahrq.gov/node/46844/psn-pdf
March 07, 2018 - Learning collaboratives: insights and a new taxonomy
from AHRQ's two decades of experience.
March 7, 2018
Nix M, McNamara P, Genevro J, et al. Learning Collaboratives: Insights And A New Taxonomy From
AHRQ's Two Decades Of Experience. Health Aff (Millwood). 2018;37(2):205-212.
doi:10.1377/hlthaff.2017.1144.
https…
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psnet.ahrq.gov/node/46544/psn-pdf
September 12, 2018 - Interventions to improve follow-up of laboratory test
results pending at discharge: a systematic review.
September 12, 2018
Whitehead NS, Williams L, Meleth S, et al. Interventions to Improve Follow-Up of Laboratory Test Results
Pending at Discharge: A Systematic Review. J Hosp Med. 2018. doi:10.12788/jhm.2944.
ht…
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psnet.ahrq.gov/node/44756/psn-pdf
September 12, 2016 - Importance of teamwork, communication and culture on
failure-to-rescue in the elderly.
September 12, 2016
Ghaferi AA, Dimick JB. Importance of teamwork, communication and culture on failure-to-rescue in the
elderly. Br J Surg. 2016;103(2):e47-51. doi:10.1002/bjs.10031.
https://psnet.ahrq.gov/issue/importance-teamw…
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psnet.ahrq.gov/node/853611/psn-pdf
September 20, 2023 - Preventing potential patient harm through clinical content
interventions during oncology clinical trial
implementation.
September 20, 2023
Loo VC, Kim S, Johnson LM, et al. Preventing potential patient harm through clinical content interventions
during oncology clinical trial implementation. J Patient Saf. 2023;19…
-
psnet.ahrq.gov/node/46412/psn-pdf
October 11, 2017 - Team-based care: the changing face of cardiothoracic
surgery.
October 11, 2017
Crawford TC, Conte J, Sanchez JA. Team-Based Care: The Changing Face of Cardiothoracic Surgery.
Surg Clin North Am. 2017;97(4):801-810. doi:10.1016/j.suc.2017.03.003.
https://psnet.ahrq.gov/issue/team-based-care-changing-face-cardiothor…
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psnet.ahrq.gov/node/74066/psn-pdf
November 10, 2021 - Lessons Learned? Building a Culture of Patient Safety
Within the Veterans Health Administration.
November 10, 2021
US House of Representatives Committee on Veterans' Affairs Subcommittee on Health. 117th
Cong. 1st Sess (2021).
https://psnet.ahrq.gov/issue/lessons-learned-building-culture-patient-safety-withi…
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psnet.ahrq.gov/node/73610/psn-pdf
January 01, 2022 - Patient factors and hospital outcomes associated with
atypical presentation in hospitalized older adults with
COVID-19 during the first surge of the pandemic.
August 18, 2021
Marziliano A, Burns E, Chauhan L, et al. Patient factors and hospital outcomes associated with atypical
presentation in hospitalized older a…
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psnet.ahrq.gov/node/49593/psn-pdf
October 01, 2009 - Who Nose Where the Airway Is?
October 1, 2009
Lee CR. Who Nose Where the Airway Is? PSNet [internet]. 2009.
https://psnet.ahrq.gov/web-mm/who-nose-where-airway
The Case
A 70-year-old man with peripheral vascular disease was brought to the operating room to undergo vascular
bypass surgery on his right upper extrem…
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psnet.ahrq.gov/node/49562/psn-pdf
May 01, 2008 - The Inside of a Time Out
May 1, 2008
Feldman DL. The Inside of a Time Out. PSNet [internet]. 2008.
https://psnet.ahrq.gov/web-mm/inside-time-out
The Case
A 65-year-old man was scheduled for an elective endovascular repair of an abdominal aortic aneurysm.
The patient had an allergy to "IV contrast dye" that was no…
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psnet.ahrq.gov/node/865373/psn-pdf
March 27, 2024 - It’s fine if it suggests the wrong
movie for me, but what if it gets it wrong when it comes to my healthcare