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psnet.ahrq.gov/issue/effect-lean-intervention-improve-safety-processes-and-outcomes-surgical-emergency-unit
January 04, 2010 - Study
Effect of a "Lean" intervention to improve safety processes and outcomes on a surgical emergency unit.
Citation Text:
McCulloch P, Kreckler S, New S, et al. Effect of a "Lean" intervention to improve safety processes and outcomes on a surgical emergency unit. BMJ. 2010;341:c5469.…
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psnet.ahrq.gov/issue/essential-activities-electronic-health-record-safety-qualitative-study
April 29, 2018 - Study
Essential activities for electronic health record safety: a qualitative study.
Citation Text:
Ash JS, Singh H, Wright A, et al. Essential activities for electronic health record safety: A qualitative study. Health Informatics J. 2019:1460458219833109. doi:10.1177/1460458219833109. …
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psnet.ahrq.gov/issue/engineering-safe-landing-engaging-medical-practitioners-systems-approach-patient-safety
July 23, 2008 - Study
Engineering a safe landing: engaging medical practitioners in a systems approach to patient safety.
Citation Text:
Brand C, Ibrahim JE, Bain C, et al. Engineering a safe landing: engaging medical practitioners in a systems approach to patient safety. Intern Med J. 2007;37(5):295-…
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psnet.ahrq.gov/issue/diagnostic-errors-hospitalized-adults-who-died-or-were-transferred-intensive-care
October 13, 2021 - Study
Diagnostic errors in hospitalized adults who died or were transferred to intensive care.
Citation Text:
Diagnostic errors in hospitalized adults who died or were transferred to intensive care. Auerbach AD, Lee TM, Hubbard CC, et al for the UPSIDE Research Group. JAMA Inte…
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psnet.ahrq.gov/issue/effectiveness-root-cause-analysis-what-does-literature-tell-us
February 11, 2013 - Review
The effectiveness of root cause analysis: what does the literature tell us?
Citation Text:
Percarpio KB, Watts V, Weeks WB. The effectiveness of root cause analysis: what does the literature tell us? Jt Comm J Qual Patient Saf. 2008;34(7):391-8.
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psnet.ahrq.gov/issue/exploring-association-between-organizational-safety-climate-failure-rescue-and-mortality
January 26, 2022 - Study
Exploring the association between organizational safety climate, failure to rescue, and mortality in inpatient surgical units.
Citation Text:
Bacon CT, McCoy TP, Henshaw DS. Exploring the Association Between Organizational Safety Climate, Failure to Rescue, and Mortality in Inpatie…
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psnet.ahrq.gov/issue/potentially-inappropriate-medications-large-cohort-patients-geriatric-units-association
April 21, 2021 - Study
Potentially inappropriate medications in a large cohort of patients in geriatric units: association with clinical and functional characteristics.
Citation Text:
Fromm MF, Maas R, Tümena T, et al. Potentially inappropriate medications in a large cohort of patients in geriatric u…
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psnet.ahrq.gov/issue/transform-patient-safety-project-microsystem-approach-improving-outcomes-inpatient-units
February 10, 2012 - Study
The TRANSFORM patient safety project: a microsystem approach to improving outcomes on inpatient units.
Citation Text:
Braddock CH, Szaflarski N, Forsey L, et al. The TRANSFORM Patient Safety Project: a microsystem approach to improving outcomes on inpatient units. J Gen Intern Med.…
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psnet.ahrq.gov/issue/patient-safety-room-horrors-novel-method-assess-medical-students-and-entering-residents
August 14, 2018 - Study
Patient safety room of horrors: a novel method to assess medical students and entering residents' ability to identify hazards of hospitalisation.
Citation Text:
Farnan JM, Gaffney S, Poston JT, et al. Patient safety room of horrors: a novel method to assess medical students and ent…
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psnet.ahrq.gov/issue/professionalism-era-duty-hours-time-shift-change
September 22, 2010 - Commentary
Professionalism in the era of duty hours: time for a shift change?
Citation Text:
Arora V, Farnan JM, Humphrey HJ. Professionalism in the era of duty hours: time for a shift change? JAMA. 2012;308(21):2195-6. doi:10.1001/jama.2012.14584.
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psnet.ahrq.gov/issue/making-healthcare-safer-iii
March 27, 2019 - Book/Report
Making Healthcare Safer III.
Citation Text:
Making Healthcare Safer III. Holmes A, Long A, Wyant B, et al. Rockville, MD: Agency for Healthcare Research and Quality; March 2020. AHRQ Publication No. 20-0029-EF.
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psnet.ahrq.gov/issue/misdiagnosis-mistreatment-and-harm-when-medical-care-ignores-social-forces
November 16, 2022 - Commentary
Emerging Classic
Misdiagnosis, mistreatment, and harm - when medical care ignores social forces.
Citation Text:
Holmes SM, Hansen H, Jenks A, et al. Misdiagnosis, mistreatment, and harm - when medical care ignores social forces. N Engl J Med. 2020;382…
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psnet.ahrq.gov/issue/cler-report-findings-2021-subprotocol-operative-and-procedural-areas
October 18, 2017 - September 1, 2021
Surgical errors happen, but are learners trained to recover from them
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psnet.ahrq.gov/issue/variations-surgical-safety-according-affiliation-status-top-ranked-cancer-hospital
April 24, 2019 - April 19, 2011
The impact of trained assistance on error rates in anaesthesia: a simulation-based
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psnet.ahrq.gov/issue/hybrid-methodology-modeling-risk-adverse-events-complex-health-care-settings
November 11, 2015 - 16, 2022
Comparison of adverse events during procedural sedation between specially trained
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psnet.ahrq.gov/issue/using-preprinted-order-sheet-reduce-prescription-errors-pediatric-emergency-department
March 04, 2011 - 2003
Comparison of adverse events during procedural sedation between specially trained
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psnet.ahrq.gov/issue/teaching-quality-improvement-and-patient-safety-trainees-systematic-review
June 09, 2015 - October 27, 2021
Surgical errors happen, but are learners trained to recover from them
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psnet.ahrq.gov/issue/multidisciplinary-simulation-activity-effectively-prepares-residents-participation-patient
November 30, 2016 - April 29, 2018
Surgical errors happen, but are learners trained to recover from them?
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psnet.ahrq.gov/issue/proportion-errors-medical-prescriptions-and-their-executions-among-hospitalized-children-and
June 15, 2012 - 27, 2011
Comparison of adverse events during procedural sedation between specially trained
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cds.ahrq.gov/sites/default/files/cds/artifact/476/CDS%20Connect%20Pilot%20Site%20Training%20Plan_Final_0.docx
July 23, 2024 - .
· Clinical Champions will be identified in advance of the training but trained with the rest of the