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psnet.ahrq.gov/issue/qualitative-content-analysis-retained-surgical-items-learning-root-cause-analysis
December 06, 2023 - Study
A qualitative content analysis of retained surgical items: learning from root cause analysis investigations.
Citation Text:
Hibbert PD, Thomas MJW, Deakin A, et al. A qualitative content analysis of retained surgical items: learning from root cause analysis investigations. Int J Qu…
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psnet.ahrq.gov/issue/patient-and-consumer-safety-risks-when-using-conversational-assistants-medical-information
December 15, 2021 - Study
Patient and consumer safety risks when using conversational assistants for medical information: an observational study of Siri, Alexa, and Google Assistant.
Citation Text:
Bickmore TW, Trinh H, Olafsson S, et al. Patient and consumer safety risks when using conversational assistant…
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psnet.ahrq.gov/issue/health-outcomes-deprescribing-interventions-among-older-residents-nursing-homes-systematic
March 01, 2023 - Review
Health outcomes of deprescribing interventions among older residents in nursing homes: a systematic review and meta-analysis.
Citation Text:
Kua C-H, Mak VSL, Lee SWH. Health Outcomes of Deprescribing Interventions Among Older Residents in Nursing Homes: A Systematic Review and Me…
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www.ahrq.gov/news/newsroom/case-studies/201714.html
September 01, 2019 - Medication Therapy Tools Help Pharmacists Educate Patients, Improve Adherence and Safety
Search All Impact Case Studies
November 2017
AHRQ’s Health Literacy Tools for Providers of Medication Therapy Management make it easier for pharmacists to help patients understand and correctly manage their medication…
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psnet.ahrq.gov/issue/applicability-healthcare-failure-mode-and-effects-analysis-healthcare-epidemiology-evaluation
October 19, 2022 - Study
Applicability of Healthcare Failure Mode and Effects Analysis to healthcare epidemiology: evaluation of the sterilization and use of surgical instruments.
Citation Text:
Weinstein RA, Linkin DR, Sausman C, et al. Applicability of Healthcare Failure Mode and Effects Analysis to Heal…
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psnet.ahrq.gov/issue/does-one-size-fit-all-developing-evaluation-strategy-assess-large-language-models-patient
December 07, 2022 - Study
Does one size fit all? Developing an evaluation strategy to assess large language models for patient safety event report analysis.
Citation Text:
Fong A, Adams KT, Boxley C, et al. Does one size fit all? Developing an evaluation strategy to assess large language models for patient …
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psnet.ahrq.gov/issue/effect-visitation-restrictions-ed-error
July 01, 2016 - Study
The effect of visitation restrictions on ED error.
Citation Text:
Marks CM, Wolfe RE, Grossman SA. The effect of visitation restrictions on ED error. Intern Emerg Med. 2024;19(5):1425-1430. doi:10.1007/s11739-024-03537-3.
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psnet.ahrq.gov/issue/assessing-stops-framework-coping-intraoperative-errors-evidence-efficacy-hints-hubris-and
June 14, 2023 - Study
Assessing the STOPS framework for coping with intraoperative errors: evidence of efficacy, hints of hubris, and a bridge to abridging burnout.
Citation Text:
D'Angelo JD, Rivera M, Rasmussen TE, et al. Assessing the stops framework for coping with intraoperative errors: evidence of…
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psnet.ahrq.gov/issue/measuring-impact-ai-diagnosis-hospitalized-patients-randomized-clinical-vignette-survey-study
December 20, 2020 - Study
Measuring the impact of AI in the diagnosis of hospitalized patients: a randomized clinical vignette survey study.
Citation Text:
Jabbour S, Fouhey D, Shepard S, et al. Measuring the impact of AI in the diagnosis of hospitalized patients: a randomized clinical vignette survey study…
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psnet.ahrq.gov/issue/evaluation-natural-language-processing-approach-identify-diagnostic-errors-and-analysis
October 30, 2024 - Study
Evaluation of a natural language processing approach to identify diagnostic errors and analysis of safety learning system case review data: retrospective cohort study.
Citation Text:
Tabaie A, Tran A, Calabria T, et al. Evaluation of a natural language processing approach to identi…
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psnet.ahrq.gov/issue/multimodal-system-designed-reduce-errors-recording-and-administration-drugs-anaesthesia
September 26, 2012 - Study
Multimodal system designed to reduce errors in recording and administration of drugs in anaesthesia: prospective randomised clinical evaluation.
Citation Text:
Merry A, Webster CS, Hannam J, et al. Multimodal system designed to reduce errors in recording and administration of drugs…
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psnet.ahrq.gov/issue/duplicate-medication-order-errors-safety-gaps-and-recommendations-improvement
March 22, 2023 - Study
Duplicate medication order errors: safety gaps and recommendations for improvement.
Citation Text:
Bocknek L, Kim T, Spaar P, et al. Duplicate medication order errors: safety gaps and recommendations for improvement. Patient Safety. 2022;4(3):39-47. doi:10.33940/data/2022.9.6.
Co…
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psnet.ahrq.gov/issue/engaging-ethnic-minority-consumers-improve-safety-cancer-services-national-stakeholder
September 15, 2021 - Study
Engaging with ethnic minority consumers to improve safety in cancer services: a national stakeholder analysis.
Citation Text:
Joseph K, Newman B, Manias E, et al. Engaging with ethnic minority consumers to improve safety in cancer services: a national stakeholder analysis. Patient …
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psnet.ahrq.gov/issue/free-text-computerized-provider-order-entry-orders-used-workaround-communicating-medication
July 29, 2020 - Study
Free-text computerized provider order entry orders used as workaround for communicating medication information.
Citation Text:
Kandaswamy S, Grimes J, Hoffman D, et al. Free-text computerized provider order entry orders used as workaround for communicating medication information. J…
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psnet.ahrq.gov/issue/malpractice-cases-breast-surgery-assessment-litigation-involving-surgeons
August 04, 2021 - Study
Malpractice cases in breast surgery: an assessment of litigation involving surgeons.
Citation Text:
Fan B, Pardo J, Yu-Moe CW, et al. Malpractice cases in breast surgery: an assessment of litigation involving surgeons. Ann Surg Oncol. 2021;28(13):8109-8115. doi:10.1245/s10434-021-1…
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psnet.ahrq.gov/issue/implementation-participatory-organizational-change-long-term-care-improve-safety
February 01, 2012 - Study
Implementation of participatory organizational change in long term care to improve safety.
Citation Text:
Van Eerd D, D'Elia T, Ferron EM, et al. Implementation of participatory organizational change in long term care to improve safety. J Safety Res. 2021;78:9-18. doi:10.1016/j.jsr…
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psnet.ahrq.gov/issue/taking-heat-or-taking-temperature-qualitative-study-large-scale-exercise-seeking-measure
November 02, 2016 - Study
Classic
Taking the heat or taking the temperature? A qualitative study of a large-scale exercise in seeking to measure for improvement, not blame.
Citation Text:
Armstrong N, Brewster L, Tarrant C, et al. Taking the heat or taking the temperature? A qualit…
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psnet.ahrq.gov/node/41683/psn-pdf
September 19, 2012 - Techniques to improve patient safety in hospitals: what
nurse administrators need to know.
September 19, 2012
Fagan MJ. Techniques to improve patient safety in hospitals: what nurse administrators need to know. J
Nurs Adm. 2012;42(9):426-430. doi:10.1097/NNA.0b013e3182664df5.
https://psnet.ahrq.gov/issue/technique…
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psnet.ahrq.gov/node/38698/psn-pdf
June 10, 2009 - Towards a framework to select techniques for error
prediction: supporting novice users in the healthcare
sector.
June 10, 2009
Lyons M. Towards a framework to select techniques for error prediction: supporting novice users in the
healthcare sector. Appl Ergon. 2009;40(3):379-95. doi:10.1016/j.apergo.2008.11.004.
…
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psnet.ahrq.gov/node/46304/psn-pdf
November 01, 2017 - Comparative performance of pediatric weight estimation
techniques: a human factor errors analysis.
November 1, 2017
Abdel-Rahman SM, Jacobsen R, Watts JL, et al. Comparative performance of pediatric weight estimation
techniques: a human factor errors analysis. Pediatr Emerg Care. 2015;33(8):548-552.
doi:10.1097/pe…