AHRQ Patient Safety Network

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Safety Target

•Device-related Complications (53)

•Diagnostic Errors (65)

•Identification Errors (52)

•Discontinuities, Gaps, and Hand-Off Problems (215)

•Fatigue and Sleep Deprivation (63)

•Medication Safety (408)

•Medical Complications (192)

•Nonsurgical Procedural Complications (35)

•Surgical Complications (420)

•Transfusion Complications (8)

•Psychological and Social Complications (142)

Origin/Sponsor

•Africa (2)

•Asia (32)

•Australia and New Zealand (50)

•Central and South America (2)

•Europe (266)

•North America (1473)

Resource Types
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Study

Error Types

•Epidemiology of Errors and Adverse Events (604)

•Active Errors (236)

•Latent Errors (86)

•Near Miss (50)

Approach to Improving Safety

•Quality Improvement Strategies (359)

•Legal and Policy Approaches (73)

•Error Reporting and Analysis (531)

•Communication Improvement (468)

•Human Factors Engineering (185)

•Teamwork (247)

•Specialization of Care (107)

•Logistical Approaches (172)

•Culture of Safety (330)

•Technologic Approaches (248)

•Education and Training (470)

Clinical Areas

•Allied Health Services (6)

•Complementary and Alternative Medicine (1)

Target Audience

•Health Care Providers (1243)

•Health Care Executives and Administrators (1572)

•Non-Health Care Professionals (878)

•Patients (13)

Setting of Care

•Hospitals (1320)

•Psychiatric Facilities (7)

•Residential Facilities (39)

•Ambulatory Care (135)

•Outpatient Surgery (21)

•Patient Transport (16)

1 - 20 of 1821

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STUDY

Does teamwork improve performance in the operating room? A multilevel evaluation.

Weaver SJ, Rosen MA, DiazGranados D, et al. Jt Comm J Qual Patient Saf. 2010;36:133-142.

STUDY

A novel method for reproducibly measuring the effects of interventions to improve emotional climate, indices of team skills and communication, and threat to patient outcome in a high-volume thoracic surgery center.

Nurok M, Lipsitz S, Satwicz P, Kelly A, Frankel A. Arch Surg. 2010;145:489-495.

STUDY

Crew resource management improved perception of patient safety in the operating room.

Gore DC, Powell JM, Baer JG, et al. Am J Med Qual. 2010;25:60-63.

STUDY

Attitudinal changes resulting from repetitive training of operating room personnel using high-fidelity simulation at the point of care.

Paige JT, Kozmenko V, Yang T, et al. Am Surg. 2009;75:584-591.

STUDY

The efficacy of medical team training: improved team performance and decreased operating room delays: a detailed analysis of 4863 cases.

Wolf FA, Way LW, Stewart L. Ann Surg. 2010;252:477-485.

STUDY

Communication failure in the operating room.

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

STUDY

Medical team training and coaching in the veterans health administration; assessment and impact on the first 32 facilities in the programme.

Neily J, Mills PD, Lee P, et al. Qual Saf Health Care. 2010;19:360-364.

STUDY

The effects of aviation-style non-technical skills training on technical performance and outcome in the operating theatre.

McCulloch P, Mishra A, Handa A, Dale T, Hirst G, Catchpole K. Qual Saf Health Care. 2009;18:109-115.

STUDY

Operating room teamwork among physicians and nurses: teamwork in the eye of the beholder.

Makary MA, Sexton JB, Freischlag JA, et al. J Am Coll Surg. 2006;202:746-752.

STUDY

Communication practices on 4 Harvard surgical services: a surgical safety collaborative.

ElBardissi AW, Regenbogen SE, Greenberg CC, et al. Ann Surg. 2009;250:861-865.

STUDY

Surgical team training: the Northwestern Memorial Hospital experience.

Halverson AL, Andersson JL, Anderson K, et al. Arch Surg. 2009;144:107-112.

STUDY

Poor resident–attending intraoperative communication may compromise patient safety.

Belyansky I, Martin TR, Prabhu AS, et al. J Surg Res. 2011;171:386-394.

STUDY

A multidisciplinary team approach to retained foreign objects.

Cima RR, Kollengode A, Storsveen AS, et al. Jt Comm J Qual Patient Saf. 2009;35:123-132.

STUDY

Action research, simulation, team communication, and bringing the tacit into voice. Society for Simulation in Healthcare.

Forsythe L. Simul Healthc. 2009;4:143-148.

STUDY

Use of the Safety Attitudes Questionnaire as a measure in patient safety improvement.

Watts BV, Percarpio K, West P, Mills PD. J Patient Saf. 2010;6:206-209.

STUDY

Can aviation-based team training elicit sustainable behavioral change?

Sax HC, Browne P, Mayewski RJ, et al. Arch Surg. 2009;144:1133-1137.

STUDY

The Oxford NOTECHS System: reliability and validity of a tool for measuring teamwork behaviour in the operating theatre.

Mishra A, Catchpole K, McCulloch P. Qual Saf Health Care. 2009;18:104-108.

STUDY

Improving safety culture on adult medical units through multidisciplinary teamwork and communication interventions: the TOPS Project.

Blegen MA, Sehgal NL, Alldredge BK, Gearhart S, Auerbach AD, Wachter RM. Qual Saf Health Care. 2010;19:346-350.

STUDY

Assessing and improving safety culture throughout an academic medical centre: a prospective cohort study.

Paine LA, Rosenstein BJ, Sexton JB, Kent P, Holzmueller CG, Pronovost PJ. Qual Saf Health Care. 2010;19:547-554.

STUDY

Improving perceptions of teamwork climate with the Veterans Health Administration medical team training program.

Carney BT, West P, Neily JB, Mills PD, Bagian JP. Am J Med Qual. 2011;26:480-484.

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