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psnet.ahrq.gov/issue/implementing-patient-safety-addressing-culture-conditions-and-values-help-people-work-safely
October 18, 2017 - Book/Report
Implementing Patient Safety: Addressing Culture, Conditions and Values to Help People Work Safely.
Citation Text:
Implementing Patient Safety: Addressing Culture, Conditions and Values to Help People Work Safely. Woodward, S. 1st ed. New York, NY: Taylor & Francis Group; Sept…
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psnet.ahrq.gov/issue/national-action-alliance-advance-patient-safety-webinar-series
April 01, 2024 - Webinar
National Action Alliance to Advance Patient and Workforce Safety Webinar Series.
Citation Text:
National Action Alliance to Advance Patient and Workforce Safety Webinar Series. US Department of Health and Human Services. 2023-2025.
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psnet.ahrq.gov/issue/hsib-maternity-investigation-programme-year-review-202122-summary-highlights-themes-and
September 14, 2022 - Book/Report
HSIB Maternity Investigation Programme Year in Review 2021/22. Summary of Highlights, Themes and Future Work.
Citation Text:
HSIB Maternity Investigation Programme Year in Review 2021/22. Summary of Highlights, Themes and Future Work. Farnborough, UK: Healthcare Safety Invest…
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psnet.ahrq.gov/issue/first-do-no-harm-improving-health-quality-and-patient-safety
September 28, 2010 - Congressional Testimony
First, Do No Harm: Improving Health Quality and Patient Safety.
Citation Text:
First, Do No Harm: Improving Health Quality and Patient Safety. Full Committee Hearing. US Senate Committee on Health, Education, Labor and Pensions (May 5, 2011)
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psnet.ahrq.gov/primer/high-reliability
January 29, 2020 - High Reliability
Citation Text:
High Reliability. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2019.
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psnet.ahrq.gov/node/866587/psn-pdf
January 01, 2025 - Professionalising patient safety? Findings from a mixed-
methods formative evaluation of the patient safety
specialist role in the English National Health Service.
August 28, 2024
Martin G, Pralat R, Waring J, et al. Professionalising patient safety? Findings from a mixed-methods
formative evaluation of the patien…
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psnet.ahrq.gov/perspective/conversation-lawrence-smith-md
February 01, 2012 - Recently, the ACGME has been working with residency training programs to propose milestones for tracking
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psnet.ahrq.gov/perspective/conversation-sigall-k-bell-md
February 26, 2025 - I started working with Patient and Family Advisory Councils (PFACs), clinicians, and health care systems
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psnet.ahrq.gov/node/33866/psn-pdf
September 01, 2018 - I started working with Patient and Family Advisory Councils
(PFACs), clinicians, and health care systems
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psnet.ahrq.gov/perspective/conversation-ashish-k-jha-md-mph
May 01, 2013 - theory would be that we don't really understand the link between processes and outcomes and we are working
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psnet.ahrq.gov/issue/learning-diagnostic-errors-improve-patient-safety-when-gps-work-or-alongside-emergency
December 15, 2021 - Study
Learning from diagnostic errors to improve patient safety when GPs work in or alongside emergency departments: incorporating realist methodology into patient safety incident report analysis.
Citation Text:
Cooper A, Carson-Stevens A, Cooke M, et al. Learning from diagnostic errors …
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psnet.ahrq.gov/web-mm/primary-workaround-secondary-complication
January 24, 2018 - Primary Workaround, Secondary Complication
Citation Text:
Debono D, Levett-Jones T. Primary Workaround, Secondary Complication. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2018.
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psnet.ahrq.gov/node/73156/psn-pdf
April 21, 2021 - Increasing naloxone prescribing in the emergency
department through education and electronic medical
record work-aids.
April 21, 2021
Funke M, Kaplan MC, Glover H, et al. Increasing naloxone prescribing in the emergency department
through education and electronic medical record work-aids. Jt Comm J Qual Patient Sa…
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psnet.ahrq.gov/node/40422/psn-pdf
December 21, 2014 - Persistent next-day effects of excessive alcohol
consumption on laparoscopic surgical performance.
December 21, 2014
Gallagher AG, Boyle E, Toner P, et al. Persistent next-day effects of excessive alcohol consumption on
laparoscopic surgical performance. Arch Surg. 2011;146(4):419-26. doi:10.1001/archsurg.2011.67.
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psnet.ahrq.gov/node/837297/psn-pdf
June 01, 2022 - Checklists to reduce diagnostic error: a systematic review
of the literature using a human factors framework.
June 1, 2022
Al-Khafaji J, Townshend RF, Townsend W, et al. Checklists to reduce diagnostic error: a systematic review
of the literature using a human factors framework. BMJ Open. 2022;12(4):e058219. doi:10…
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psnet.ahrq.gov/issue/interruptions-and-medication-errors-part-i
January 03, 2017 - Commentary
Interruptions and medication errors: part I.
Citation Text:
Flanders S, Clark AP. Interruptions and medication errors: part I. Clin Nurse Spec. 2010;24(6):281-5. doi:10.1097/NUR.0b013e3181faf78b.
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psnet.ahrq.gov/issue/unreported-errors-intensive-care-unit-case-study-way-we-work
December 12, 2012 - Commentary
Unreported errors in the intensive care unit: a case study of the way we work.
Citation Text:
Henneman EA. Unreported errors in the intensive care unit: a case study of the way we work. Crit Care Nurse. 2007;27(5):27-34; quiz 35.
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psnet.ahrq.gov/issue/factors-associated-misdiagnosis-acute-stroke-young-adults
January 15, 2014 - Study
Factors associated with misdiagnosis of acute stroke in young adults.
Citation Text:
Kuruvilla A, Bhattacharya P, Rajamani K, et al. Factors associated with misdiagnosis of acute stroke in young adults. J Stroke Cerebrovasc Dis. 2011;20(6):523-7. doi:10.1016/j.jstrokecerebrovasdi…
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psnet.ahrq.gov/issue/night-and-day-shedding-light-hours-care
September 28, 2010 - Commentary
Like night and day — shedding light on off-hours care.
Citation Text:
Shulkin DJ. Like night and day--shedding light on off-hours care. N Engl J Med. 2008;358(20):2091-3. doi:10.1056/NEJMp0707144.
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psnet.ahrq.gov/issue/audibility-patient-clinical-alarms-hospital-nursing-personnel
November 15, 2023 - Study
Audibility of patient clinical alarms to hospital nursing personnel.
Citation Text:
Sobieraj J, Ortega C, West I, et al. Audibility of patient clinical alarms to hospital nursing personnel. Mil Med. 2006;171(4):306-10.
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