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psnet.ahrq.gov/node/39440/psn-pdf
September 19, 2016 - Toward understanding errors in inpatient psychiatry: a
qualitative inquiry.
September 19, 2016
Cullen SW, Nath SB, Marcus SC. Toward understanding errors in inpatient psychiatry: a qualitative inquiry.
Psychiatr Q. 2010;81(3):197-205. doi:10.1007/s11126-010-9129-z.
https://psnet.ahrq.gov/issue/toward-understanding…
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psnet.ahrq.gov/node/37920/psn-pdf
May 24, 2015 - Functional health literacy and understanding of
medications at discharge.
May 24, 2015
Maniaci MJ, Heckman MG, Dawson NL. Functional health literacy and understanding of medications at
discharge. Mayo Clin Proc. 2008;83(5):554-8. doi:10.4065/83.5.554.
https://psnet.ahrq.gov/issue/functional-health-literacy-and-und…
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psnet.ahrq.gov/node/39486/psn-pdf
May 05, 2010 - Understanding handling of drug safety alerts: a
simulation study.
May 5, 2010
van der Sijs H, van Gelder T, Vulto A, et al. Understanding handling of drug safety alerts: a simulation
study. Int J Med Inform. 2010;79(5). doi:10.1016/j.ijmedinf.2010.01.008.
https://psnet.ahrq.gov/issue/understanding-handling-drug-sa…
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psnet.ahrq.gov/node/44312/psn-pdf
November 06, 2015 - Beyond the team: understanding interprofessional work
in two North American ICUs.
November 6, 2015
Alexanian JA, Kitto S, Rak KJ, et al. Beyond the Team: Understanding Interprofessional Work in Two North
American ICUs. Crit Care Med. 2015;43(9):1880-6. doi:10.1097/CCM.0000000000001136.
https://psnet.ahrq.gov/issue…
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psnet.ahrq.gov/node/40852/psn-pdf
January 19, 2012 - Understanding how rapid response systems may improve
safety for the acutely ill patient: learning from the
frontline.
January 19, 2012
Mackintosh N, Rainey H, Sandall J. Understanding how rapid response systems may improve safety for the
acutely ill patient: learning from the frontline. BMJ Qual Saf. 2012;21(2):13…
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psnet.ahrq.gov/node/42925/psn-pdf
February 05, 2014 - Understanding the Role of Facility Design in the
Acquisition and Prevention of Healthcare-Associated
Infections.
February 5, 2014
Hamilton DK, Stichler JF, eds. HERD. 2013;7(suppl):1-154.
https://psnet.ahrq.gov/issue/understanding-role-facility-design-acquisition-and-prevention-healthcare-
associated
Articles in…
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psnet.ahrq.gov/node/34708/psn-pdf
February 18, 2011 - Understanding and responding to adverse events.
February 18, 2011
Vincent CA. Understanding and Responding to Adverse Events. New Engl J Med. 2003;348(11):1051-
1056. doi:10.1056/nejmhpr020760.
https://psnet.ahrq.gov/issue/understanding-and-responding-adverse-events
In this article, Vincent describes the investiga…
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psnet.ahrq.gov/node/46174/psn-pdf
August 30, 2017 - Inpatients notes: sensemaking—fostering a shared
understanding in clinical teams.
August 30, 2017
Leykum LK, O'Leary KJ. Web Exclusives. Annals for Hospitalists Inpatient Notes - Sensemaking-Fostering
a Shared Understanding in Clinical Teams. Ann Intern Med. 2017;167(4):HO2-HO3. doi:10.7326/M17-
1829.
https://psn…
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psnet.ahrq.gov/node/43008/psn-pdf
November 21, 2014 - Understanding safety culture in long-term care: a case
study.
November 21, 2014
Halligan MH, Zecevic A, Kothari AR, et al. Understanding safety culture in long-term care: a case study. J
Patient Saf. 2014;10(4):192-201. doi:10.1097/PTS.0b013e31829d4ae7.
https://psnet.ahrq.gov/issue/understanding-safety-culture-lon…
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psnet.ahrq.gov/node/46401/psn-pdf
September 13, 2017 - Understanding middle managers' influence in
implementing patient safety culture.
September 13, 2017
Gutberg J, Berta W. Understanding middle managers' influence in implementing patient safety culture.
BMC Health Serv Res. 2017;17(1):582. doi:10.1186/s12913-017-2533-4.
https://psnet.ahrq.gov/issue/understanding-mid…
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psnet.ahrq.gov/node/41535/psn-pdf
December 31, 2014 - Understanding and preventing wrong-patient electronic
orders: a randomized controlled trial.
December 31, 2014
Adelman JS, Kalkut GE, Schechter CB, et al. Understanding and preventing wrong-patient electronic
orders: a randomized controlled trial. J Am Med Inform Assoc. 2013;20(2):305-310. doi:10.1136/amiajnl-
201…
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psnet.ahrq.gov/node/43791/psn-pdf
December 17, 2014 - Facilitating Patient Understanding of Discharge
Instructions: Workshop Summary.
December 17, 2014
Alper J, Hernandez LM; Roundtable on Health Literacy, Board on Population Health and Public Health
Practice, Institute of Medicine. Washington, DC: National Academies Press; December 2014. ISBN:
9780309307383.
https:…
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psnet.ahrq.gov/node/44344/psn-pdf
July 22, 2015 - Making healthcare safer by understanding, designing and
buying better IT.
July 22, 2015
Thimbleby H, Lewis A, Williams J. Making healthcare safer by understanding, designing and buying better
IT. Clin Med (Lond). 2015;15(3):258-62. doi:10.7861/clinmedicine.15-3-258.
https://psnet.ahrq.gov/issue/making-healthcare-s…
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psnet.ahrq.gov/node/43200/psn-pdf
May 21, 2014 - How Does Hospital Quality Management Drive Quality?
Results From the "Deepening Our Understanding of
Quality Improvement (DUQuE)" Project.
May 21, 2014
Schneider EC, ed. Int J Qual Healthc. 2014;26(suppl 1):1-115.
https://psnet.ahrq.gov/issue/how-does-hospital-quality-management-drive-quality-results-deepening-our…
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psnet.ahrq.gov/node/42354/psn-pdf
January 01, 2014 - Understanding differences in electronic health record
(EHR) use: linking individual physicians' perceptions of
uncertainty and EHR use patterns in ambulatory care.
December 18, 2013
Lanham HJ, Sittig DF, Leykum LK, et al. Understanding differences in electronic health record (EHR) use:
linking individual physician…
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psnet.ahrq.gov/node/37400/psn-pdf
June 30, 2011 - Errors in cancer diagnosis: current understanding and
future directions.
June 30, 2011
Singh H, Sethi S, Raber M, et al. Errors in cancer diagnosis: current understanding and future directions. J
Clin Oncol. 2007;25(31):5009-18.
https://psnet.ahrq.gov/issue/errors-cancer-diagnosis-current-understanding-and-future-…
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psnet.ahrq.gov/node/47254/psn-pdf
September 19, 2018 - Understanding the knowledge gaps in whistleblowing and
speaking up in health care: narrative reviews of the
research literature and formal inquiries, a legal analysis
and stakeholder interviews.
September 19, 2018
Mannion R, Blenkinsopp J, Powell M, et al. Southampton (UK): NIHR Journals Library; August 2018.…
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psnet.ahrq.gov/node/42797/psn-pdf
June 10, 2018 - Understanding and managing IV container overfill.
June 10, 2018
ISMP Medication Safety Alert! Acute care edition. November 14, 2013;18:1-4.
https://psnet.ahrq.gov/issue/understanding-and-managing-iv-container-overfill
This newsletter article reports on concerns associated with chemotherapy preparations due to varia…
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psnet.ahrq.gov/node/40572/psn-pdf
June 27, 2018 - Understanding care transitions as a patient safety issue.
June 27, 2018
Butterfield S; Stegel C; Glock S; Tartaglia D.
https://psnet.ahrq.gov/issue/understanding-care-transitions-patient-safety-issue
This article describes a regional collaborative to enhance care transitions of Medicare beneficiaries by
improving …
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psnet.ahrq.gov/node/45338/psn-pdf
July 20, 2016 - Understanding models of error and how they apply in
clinical practice.
July 20, 2016
Garfield S, Franklin BD. Pharm J. June 14, 2016.
https://psnet.ahrq.gov/issue/understanding-models-error-and-how-they-apply-clinical-practice
Human error and fallibility are a part of health care delivery that can be exacerbated b…