AHRQ Patient Safety Network

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The Collection

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Safety Target

•Device-related Complications (22)

•Diagnostic Errors (53)

•Identification Errors (29)

•Discontinuities, Gaps, and Hand-Off Problems (107)

•Fatigue and Sleep Deprivation (49)

•Medication Safety (158)

•Medical Complications (49)

•Nonsurgical Procedural Complications (20)

•Surgical Complications (396)

•Transfusion Complications (3)

•Psychological and Social Complications (44)

Origin/Sponsor

•Africa (1)

•Asia (11)

•Australia and New Zealand (15)

•Europe (131)

•North America (757)

Resource Types
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Study

Error Types

•Epidemiology of Errors and Adverse Events (306)

•Active Errors (103)

•Latent Errors (40)

•Near Miss (17)

Approach to Improving Safety

•Quality Improvement Strategies (146)

•Legal and Policy Approaches (42)

•Error Reporting and Analysis (260)

•Communication Improvement (212)

•Human Factors Engineering (112)

•Teamwork (158)

•Specialization of Care (43)

•Logistical Approaches (91)

•Culture of Safety (86)

•Technologic Approaches (112)

•Education and Training (257)

Clinical Areas

•Allied Health Services (1)

•Medicine (778)

•Nursing (51)

•Pharmacy (38)

Target Audience

•Health Care Providers (772)

•Health Care Executives and Administrators (659)

•Non-Health Care Professionals (348)

•Patients (11)

Setting of Care

•Hospitals (672)

•Psychiatric Facilities (1)

•Residential Facilities (5)

•Ambulatory Care (56)

•Outpatient Surgery (17)

•Patient Transport (5)

1 - 20 of 915

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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

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

Communication failure in the operating room.

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

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

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 surgical simulation curriculum for senior medical students based on TeamSTEPPS.

Meier AH, Boehler ML, McDowell CM, et al. Arch Surg. 2012;147:761-766.

STUDY

An observational analysis of surgical team compliance with perioperative safety practices after crew resource management training.

France DJ, Leming-Lee S, Jackson T, Feistritzer NR, Higgins MS. Am J Surg. 2008;195:546-553.

STUDY

The relationship of the emotional climate of work and threat to patient outcome in a high-volume thoracic surgery operating room team.

Nurok M, Evans LA, Lipsitz S, Satwicz P, Kelly A, Frankel A. BMJ Qual Saf. 2011;20:237-242.

STUDY

Surgical team training: the Northwestern Memorial Hospital experience.

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

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

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

Expanded surgical time out: a key to real-time data collection and quality improvement.

Altpeter T, Luckhardt K, Lewis JN, Harken AH, Polk HC Jr. J Am Coll Surg. 2007;204:527-532.

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

Surgical confusions in ophthalmology.

Simon JW, Ngo Y, Khan S, Strogatz D. Arch Ophthalmol. 2007;125:1515-1522.

STUDY

Effect of short-term pretrial practice on surgical proficiency in simulated environments: a randomized trial of the "preoperative warm-up" effect.

Kahol K, Satava RM, Ferrara J, Smith ML. J Am Coll Surg. 2009;208:255-268.

STUDY

Improving patient safety by identifying latent failures in successful operations.

Catchpole KR, Giddings AE, Wilkinson M, Hirst G, Dale T, de Leval MR. Surgery. 2007;142:102-110.

STUDY

Training operating room teams in damage control surgery for trauma: a followup study of the Norwegian model.

Hansen KS, Uggen PE, Brattebø G, Wisborg T. J Am Coll Surg. 2007;205:712-716.

STUDY

Risks of complications by attending physicians after performing nighttime procedures.

Rothschild JM, Keohane CA, Rogers S, et al. JAMA. 2009;302:1565-1572.

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

High-fidelity, simulation-based, interdisciplinary operating room team training at the point of care.

Paige JT, Kozmenko V, Yang T, et al. Surgery. 2009;145:138-146.

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