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  1. Microsoft PowerPoint - FINAL SLIDES Sept_Spotlight Case_When the Lytes Go Out_SLIDES_08.25.2020-revised.pptx (pdf file)

    psnet.ahrq.gov/sites/default/files/2020-09/final_slides_sept_spotlight_case_when_the_lytes_go_out_slides_08.25.2020-revised.pdf
    January 01, 2020 - Change Needed (2) • Protocol-based electrolyte depletion can reduce the time from when an abnormal lab test

  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/866621/psn-pdf
    August 28, 2024 - exploring protocols for communication channels between clinicians in order to design, develop, and test

  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49590/psn-pdf
    January 01, 2010 - nursing inexperience, a transition between day and night teams, and maybe even a suboptimal critical test

  4. In Conversation With… Tejal K. Gandhi, MD, MPH | PSNet

    psnet.ahrq.gov/perspective/conversation-tejal-k-gandhi-md-mph
    February 26, 2025 - about making sure that we are doing things like reducing readmissions, complications, and following test … If a patient receives a test result or a radiology report with something concerning and they see that

  5. Fatigue and risk: are train drivers safer than doctors? | PSNet

    psnet.ahrq.gov/issue/fatigue-and-risk-are-train-drivers-safer-doctors
    September 03, 2016 - June 18, 2008 Errors test openness at Beth Israel Deaconess.

  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/857060/psn-pdf
    November 27, 2023 - the learner showing the instructor what they know generally through a graded written assignment or test

  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/865373/psn-pdf
    March 27, 2024 - For instance, how they move after surgery or how they complete a digital clock drawing test. … Cate Price and a number of others on an AI analysis of the digital clock drawing test.1 In just a couple

  8. The PSNet Collection | PSNet

    psnet.ahrq.gov/psnet-collection
    January 15, 2024 - Diagnostic Errors (1592) Clinical Misdiagnosis (516) Diagnostic Test … Diagnostic Errors (1592) Clinical Misdiagnosis (516) Diagnostic Test

  9. Spotlight

    psnet.ahrq.gov/sites/default/files/2024-12/spotlight_case_csf_leak_after_elective_spine_surgery_slides_-_final.pptx
    January 01, 2024 - Less than 1 mL is needed to test for its presence. … 22 Intraoperative Management – Sutures (2) After completing a primary closure, the surgeon should test

  10. In Conversation with…Vineet Arora, MD, MA | PSNet

    psnet.ahrq.gov/perspective/conversation-withvineet-arora-md-ma
    March 01, 2011 - and condition, as well as what tasks need to be performed (e.g., following up on a pending laboratory test

  11. In Conversation with Timothy Vogus about High Reliability Organization (HRO) Principles and Patient Safety | PSNet

    psnet.ahrq.gov/perspective/conversation-timothy-vogus-about-high-reliability-organization-hro-principles-and
    February 26, 2025 - COVID was a useful test case because all the “non-essential” people were sent home—the chaplains, the … Children's Hospitals' Solutions for Patient Safety network, researchers assessed survey results to test

  12. High Reliability Organization (HRO) Principles and Patient Safety | PSNet

    psnet.ahrq.gov/perspective/high-reliability-organization-hro-principles-and-patient-safety
    February 26, 2025 - Children's Hospitals' Solutions for Patient Safety network, researchers assessed survey results to test … COVID was a useful test case because all the “non-essential” people were sent home—the chaplains, the

  13. The PSNet Collection | PSNet

    psnet.ahrq.gov/psnet-collection?search=%7B%22Topic%22%3A%22COVID-19%22%7D&f%5B0%5D=clinical_area%3A5356
    October 27, 2021 - All Content Search Apply Advanced Search Search Tips Save Subscribe to this search Download citations Selection All results on this page Selection Format RIS Download All Content …

  14. Periodic Issue | PSNet

    psnet.ahrq.gov/periodic-issue/periodic-issue-345
    May 16, 2022 - June 8, 2022 Weekly Issue PSNet highlights the latest patient safety literature, news, and expert commentary, including Weekly Updates, WebM&M, and Perspectives on Safety. The current issue highlights what's new this week in patient safety literature, news, conferences, reports, a…

  15. Long-term care healthcare-associated iInfections in 2022: an analysis of 20,216 reports. | PSNet

    psnet.ahrq.gov/issue/long-term-care-healthcare-associated-iinfections-2022-analysis-20216-reports
    May 19, 2021 - Study Long-term care healthcare-associated iInfections in 2022: an analysis of 20,216 reports. Citation Text: Kepner S, Bingman C, Jones RM. Long-term care healthcare-associated iInfections in 2022: an analysis of 20,216 reports. Patient Saf. 2023;5(2):20-31. doi:10.33940/001c.74494. C…

  16. The safety of inpatient pediatrics: preventing medical errors and injuries among hospitalized children. | PSNet

    psnet.ahrq.gov/issue/safety-inpatient-pediatrics-preventing-medical-errors-and-injuries-among-hospitalized
    November 16, 2022 - Four-year impact of an alert notification system on closed-loop communication of critical test

  17. The nature of surgical error: a cautionary tale and a call to reason. | PSNet

    psnet.ahrq.gov/issue/nature-surgical-error-cautionary-tale-and-call-reason
    September 12, 2007 - Commentary The nature of surgical error: a cautionary tale and a call to reason. Citation Text: Satava RM. The nature of surgical error: a cautionary tale and a call to reason. Surg Endosc. 2005;19(8):1014-6. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3 X…

  18. Misgivings. | PSNet

    psnet.ahrq.gov/issue/misgivings
    March 17, 2021 - December 23, 2020 Commissioning simulations to test new healthcare facilities: a proactive

  19. Periodic Issue | PSNet

    psnet.ahrq.gov/periodic-issue/weekly-resource-0
    October 30, 2024 - October 23, 2024 Weekly Issue PSNet highlights the latest patient safety literature, news, and expert commentary, including Weekly Updates, WebM&M, and Perspectives on Safety. The current issue highlights what's new this week in patient safety literature, news, conferences, report…

  20. Periodic Issue | PSNet

    psnet.ahrq.gov/periodic-issue/periodic-issue-426
    February 28, 2024 - Several days into the hospital stay, acetylcholine receptor antibody test results returned markedly elevated
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