AHRQ Patient Safety Network

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The Collection

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Safety Target

•Device-related Complications (85)

•Diagnostic Errors (143)

•Identification Errors (68)

•Discontinuities, Gaps, and Hand-Off Problems (305)

•Fatigue and Sleep Deprivation (71)

•Medication Safety (791)

•Medical Complications (276)

•Nonsurgical Procedural Complications (51)

•Surgical Complications (415)

•Transfusion Complications (13)

•Psychological and Social Complications (95)

Origin/Sponsor

•Africa (4)

•Asia (49)

•Australia and New Zealand (78)

•Central and South America (6)

•Europe (394)

•North America (1859)

Resource Types
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Study

Error Types

•Epidemiology of Errors and Adverse Events (1217)

•Active Errors (364)

•Latent Errors (90)

•Near Miss (58)

Approach to Improving Safety

•Quality Improvement Strategies (463)

•Legal and Policy Approaches (101)

•Error Reporting and Analysis (791)

•Communication Improvement (504)

•Human Factors Engineering (251)

•Teamwork (198)

•Specialization of Care (166)

•Logistical Approaches (198)

•Culture of Safety (209)

•Technologic Approaches (429)

•Education and Training (397)

Clinical Areas

•Allied Health Services (4)

Target Audience

•Health Care Providers (1785)

•Health Care Executives and Administrators (2024)

•Non-Health Care Professionals (836)

•Patients (26)

Setting of Care

•Hospitals (1706)

•Psychiatric Facilities (8)

•Residential Facilities (58)

•Ambulatory Care (249)

•Outpatient Surgery (20)

•Patient Transport (22)

1 - 20 of 2392

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STUDY

Validity of selected patient safety indicators: opportunities and concerns.

Kaafarani HM, Borzecki AM, Itani KM, et al. J Am Coll Surg. 2011; 212:924-934.

STUDY

Effect of a 19-item surgical safety checklist during urgent operations in a global patient population.

Weiser TG, Haynes AB, Dziekan G, et al; Safe Surgery Saves Lives Investigators and Study Group. Ann Surg. 2010;251:976-980.

STUDY

Standardized multidisciplinary protocol improves handover of cardiac surgery patients to the intensive care unit.

Joy BF, Elliott E, Hardy C, Sullivan C, Backer CL, Kane JM. Pediatr Crit Care Med. 2011;12:304-308.

STUDY

An evaluation of information transfer through the continuum of surgical care: a feasibility study.

Nagpal K, Vats A, Ahmed K, Vincent C, Moorthy K. Ann Surg. 2010;252:402-407.

STUDY

Operating room briefings and wrong-site surgery.

Makary MA, Mukherjee A, Sexton BJ, et al. J Am Coll Surg. 2007;204:236-243.

STUDY

Eight-year experience with a neurosurgical checklist.

Lyons MK. Am J Med Qual. 2010;25:285-288.

STUDY

Evaluation of a preoperative team briefing: a new communication routine results in improved clinical practice.

Lingard L, Regehr G, Cartmill C, et al. BMJ Qual Saf. 2011;20:475-482.

STUDY

Communication failure in the operating room.

Halverson AL, Casey JT, Andersson J, et al. Surgery. 2011;49:305-310.

STUDY

Deconstructing intraoperative communication failures.

Hu YY, Arriaga AF, Peyre SE, Corso KA, Roth EM, Greenberg CC. J Surg Res. 2012;177:37-42.

STUDY

Implementation of a surgical comprehensive unit-based safety program to reduce surgical site infections.

Wick EC, Hobson DB, Bennett JL, et al. J Am Coll Surg. 2012;215;193-200.

STUDY

Evaluating an evidence-based bundle for preventing surgical site infection.

Anthony T, Murray BW, Sum-Ping JT, et al. Arch Surg. 2011;146:263-269.

STUDY

Patient characteristics and the occurrence of never events.

Fry DE, Pine M, Jones BL, Meimban RJ. Arch Surg. 2010;145:148-151.

STUDY

The influence of resident involvement on surgical outcomes.

Raval MV, Wang X, Cohen ME, et al. J Am Coll Surg. 2011;212:889-898.

STUDY

Changes in safety attitude and relationship to decreased postoperative morbidity and mortality following implementation of a checklist-based surgical safety intervention.

Haynes AB, Weiser TG, Berry WR, et al; Safe Surgery Saves Lives Study Group. BMJ Qual Saf. 2011;20:102-107.

STUDY

Wrong-site sinus surgery in otolaryngology.

Shah RK, Nussenbaum B, Kienstra M, et al. Otolaryngol Head Neck Surg. 2010;143:37-41.

STUDY

A report card system using error profile analysis and concurrent morbidity and mortality review: surgical outcome analysis, part II.

Antonacci AC, Lam S, Lavarias V, Homel P, Eavey RA. J Surg Res. 2009;153:95-104.

STUDY

Implementation of resident work hour restrictions is associated with a reduction in mortality and provider-related complications on the surgical service: a concurrent analysis of 14,610 patients.

Privette AR, Shackford SR, Osler T, Ratliff J, Sartorelli K, Hebert JC. Ann Surg. 2009;250:316-321.

STUDY

Improving operating room safety.

Hurlbert SN, Garrett J. Patient Saf Surg. 2009;3:25.

STUDY

Nature, causes and consequences of unintended events in surgical units.

van Wagtendonk I, Smits M, Merten H, Heetveld MJ, Wagner C. Br J Surg. 2010;97:1730-1740.

STUDY

How best to measure surgical quality? Comparison of the Agency for Healthcare Research and Quality Patient Safety Indicators (AHRQ-PSI) and the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) postoperative adverse events at a single institution.

Cima RR, Lackore KA, Nehring SA, et al. Surgery. 2011;150:943-949.

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