AHRQ Patient Safety Network

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The Collection

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Safety Target

•Device-related Complications (41)

•Diagnostic Errors (45)

•Identification Errors (38)

•Discontinuities, Gaps, and Hand-Off Problems (124)

•Fatigue and Sleep Deprivation (49)

•Medication Safety (313)

•Medical Complications (107)

•Nonsurgical Procedural Complications (26)

•Surgical Complications (407)

•Transfusion Complications (5)

•Psychological and Social Complications (59)

Origin/Sponsor

•Africa (1)

•Asia (37)

•Australia and New Zealand (56)

•Central and South America (4)

•Europe (267)

•North America (904)

Resource Types
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Study

Error Types

•Epidemiology of Errors and Adverse Events (440)

•Active Errors (165)

•Latent Errors (55)

•Near Miss (32)

Approach to Improving Safety

•Quality Improvement Strategies (243)

•Legal and Policy Approaches (52)

•Error Reporting and Analysis (423)

•Communication Improvement (272)

•Human Factors Engineering (162)

•Teamwork (156)

•Specialization of Care (61)

•Logistical Approaches (115)

•Culture of Safety (235)

•Technologic Approaches (166)

•Education and Training (265)

Clinical Areas

•Allied Health Services (2)

•Complementary and Alternative Medicine (1)

•Medicine (991)

•Nursing (209)

•Pharmacy (57)

Target Audience

•Health Care Providers (1000)

•Health Care Executives and Administrators (1110)

•Non-Health Care Professionals (434)

•Patients (24)

Setting of Care

•Hospitals (957)

•Psychiatric Facilities (7)

•Residential Facilities (23)

•Ambulatory Care (72)

•Outpatient Surgery (15)

•Patient Transport (9)

1 - 20 of 1282

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STUDY

Bridging the communication gap in the operating room with medical team training.

Awad SS, Fagan SP, Bellows C, et al. Am J Surg. 2005;190:770-774.

STUDY

Representative case series from public hospital admissions 1998 II: surgical adverse events.

Briant R, Morton J, Lay-Yee R, Davis P, Ali W. N Z Med J. 2005;118:U1591.

STUDY

Getting teams to talk: development and pilot implementation of a checklist to promote interprofessional communication in the OR.

Lingard L, Espin S, Rubin B, et al. Qual Saf Health Care. 2005;14:340-346.

STUDY

'Skating on thin ice?' Consultant surgeon's contemporary experience of adverse surgical events.

Skevington SM, Langdon JE, Giddins G. Psychol Health Med. 2012;17:1-16.

STUDY

Mapping changes in surgical mortality over 9 years by peer review audit.

Thompson AM, Ashraf Z, Burton H, Stonebridge PA. Br J Surg. 2005;92:1449-1452.

STUDY

Wrong-side/wrong-site, wrong-procedure, and wrong-patient adverse events: are they preventable?

Seiden SC, Barach P. Arch Surg. 2006;141:931-939.

STUDY

From the flight deck to the operating room: an initial pilot study of the feasibility and potential impact of true interdisciplinary team training using high-fidelity simulation.

Paige J, Kozmenko V, Morgan B, et al. J Surg Educ. 2007;64:369-377.

STUDY

Error, stress, and teamwork in medicine and aviation: cross sectional surveys.

Sexton JB, Thomas EJ, Helmreich RL. BMJ. 2000;320:745-749.

STUDY

Teamwork in the operating theatre: cohesion or confusion?

Undre S, Sevdalis N, Healey AN, Darzi A, Vincent CA. J Eval Clin Pract. 2006;12:182-189.

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

Observational assessment of surgical teamwork: a feasibility study.

Undre S, Healey AN, Darzi A, Vincent CA. World J Surg. 2006;30:1774-1783.

STUDY

Prevention of medical accidents caused by defective surgical instruments.

Yasuhara H, Fukatsu K, Komatsu T, Obayashi T, Saito Y, Uetera Y. Surgery. 2012;151:153-161.

STUDY

Communication failures in the operating room: an observational classification of recurrent types and effects.

Lingard L, Espin S, Whyte S, et al. Qual Saf Health Care. 2004;13:330-334.

STUDY

Effects of the introduction of the WHO "Surgical Safety Checklist" on in-hospital mortality: a cohort study.

van Klei WA, Hoff RG, van Aarnhem EE, et al. Ann Surg. 2012;255:44-49.

STUDY

Time of day effects on the incidence of anesthetic adverse events.

Wright MC, Phillips-Bute B, Mark JB, et al. Qual Saf Health Care. 2006;15:258-263.

STUDY

Rules and guidelines in clinical practice: a qualitative study in operating theatres of doctors' and nurses' views.

McDonald R, Waring J, Harrison S, Walshe K, Boaden R. Qual Saf Health Care. 2005;14:290-294.

STUDY

Thirty-day outcomes support implementation of a surgical safety checklist.

Bliss LA, Ross-Richardson CB, Sanzari LJ, et al. J Am Coll Surg. 2012;215:766-776.

STUDY

The implementation of a perioperative checklist increases patients' perioperative safety and staff satisfaction.

Böhmer AB, Wappler F, Tinschmann T, et al. Acta Anaesthesiol Scand. 2012;56:332-338.

STUDY

Medical error identification, disclosure, and reporting: do emergency medicine provider groups differ?

Hobgood C, Weiner B, Tamayo-Sarver JH. Acad Emerg Med. 2006;13:443-451.

STUDY

Risk-adjusted morbidity in teaching hospitals correlates with reported levels of communication and collaboration on surgical teams but not with scale measures of teamwork climate, safety climate, or working conditions.

Davenport DL, Henderson WG, Mosca CL, Khuri SF, Mentzer RM Jr. J Am Coll Surg. 2007;205:778-784.

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