AHRQ Patient Safety Network

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Safety Target

•Device-related Complications (62)

•Diagnostic Errors (252)

•Identification Errors (65)

•Discontinuities, Gaps, and Hand-Off Problems (243)

•Fatigue and Sleep Deprivation (28)

•Medication Safety (356)

•Medical Complications (167)

•Nonsurgical Procedural Complications (34)

•Surgical Complications (280)

•Transfusion Complications (6)

•Psychological and Social Complications (266)

Origin/Sponsor

•Asia (11)

•Australia and New Zealand (31)

•Central and South America (1)

•Europe (113)

•North America (1729)

Resource Types

•Audiovisual (69)

•Award (10)

•Book/Report (115)

•Clinical Guideline (1)

•Journal Article (1100)

•Legislation/Regulation (15)

•Meeting/Conference (11)

•Newsletter/Journal (3)

•Newspaper/Magazine Article (458)

•Press Release/Announcement (4)

•Special or Theme Issue (33)

•Tools/Toolkit (32)

•Web Resource (51)

•Grant (3)

Error Types

•Epidemiology of Errors and Adverse Events (221)

•Active Errors (408)

•Latent Errors (127)

•Near Miss (24)

Approach to Improving Safety

•Quality Improvement Strategies (398)

•Legal and Policy Approaches (289)

•Error Reporting and Analysis (491)

•Communication Improvement (796)

•Human Factors Engineering (200)

•Teamwork (441)

•Specialization of Care (105)

•Logistical Approaches (126)

•Culture of Safety (336)

•Technologic Approaches (224)

•Education and Training (456)

Clinical Areas

•Allied Health Services (8)

Target Audience

•Health Care Providers (1165)

•Health Care Executives and Administrators (1171)

•Non-Health Care Professionals (906)

•Patients (601)

Setting of Care

•Hospitals (1122)

•Psychiatric Facilities (8)

•Residential Facilities (19)

•Ambulatory Care (164)

•Outpatient Surgery (16)

•Patient Transport (13)

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COMMENTARY

Do Not Disturb!

Duffy FD, Cassel CK. AHRQ WebM&M [serial online]. October 2007.

NEWSPAPER/MAGAZINE ARTICLE

Anger management courses are a new tool for dealing with out-of-control doctors.

Boodman SG. Washington Post. March 4, 2013.

COMMENTARY

"Managing up" can improve teamwork in the OR.

Smith SL. AORN J. 2010;91:576-582.

STUDY

Incidence and impact of physician and nurse disruptive behaviors in the emergency department.

Rosenstein AH, Naylor B. J Emerg Med. 2012;43:139-148.

STUDY

Professionalism: a necessary ingredient in a culture of safety.

DuPree E, Anderson R, McEvoy MD, Brodman M. Jt Comm J Qual Patient Saf. 2011;37:447-455.

STUDY

Interprofessional conflict and medical errors: results of a national multi-specialty survey of hospital residents in the US.

Baldwin DC Jr, Daugherty SR. J Interprof Care. 2008;22:573-586.

STUDY

Managing disruptive behaviors in the health care setting: focus on obstetrics services.

Rosenstein AH. Am J Obstet Gynecol. 2011;204:187-192.

COMMENTARY

The quality and economic impact of disruptive behaviors on clinical outcomes of patient care.

Rosenstein AH. Am J Med Qual. 2011;26:372-379.

BOOK/REPORT

Defusing Disruptive Behavior. A Workbook for Health Care Leaders.

Oakbrook, IL: Joint Commission Resources; 2007. ISBN: 9781599400846.

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.

SPECIAL OR THEME ISSUE

2009 Doctor-Nurse Behavior Survey.

Physician Exec. Nov-Dec 2009;5-22.

STUDY

Physicians' needs in coping with emotional stressors: the case for peer support.

Hu YY, Fix ML, Hevelone ND, et al. Arch Surg. 2012;147:212-217.

STUDY

Predictors of likelihood of speaking up about safety concerns in labour and delivery.

Lyndon A, Sexton JB, Simpson KR, Rosenstein A, Lee KA, Wachter RM. BMJ Qual Saf. 2012;21;791-799.

REVIEW

Intimidation: a concept analysis.

Lamontagne C. Nurs Forum. 2010;45:54-65.

STUDY

The Schwartz Center Rounds: evaluation of an interdisciplinary approach to enhancing patient-centered communication, teamwork, and provider support.

Lown BA, Manning CF. Acad Med. 2010;85:1073-1081.

NEWSPAPER/MAGAZINE ARTICLE

Arrogant, abusive and disruptive — and a doctor.

Tarkan L. New York Times. December 1, 2008;Science Desk:1.

AUDIOVISUAL

Interview with Jerome Groopman.

"The Colbert Report." Comedy Central. March 19, 2007.

STUDY

Health care workers as second victims of medical errors.

Edrees HH, Paine LA, Feroli ER, Wu AW. Pol Arch Med Wewn. 2011;121:101-108.

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.

COMMENTARY

How to Identify and Manage Problem Behaviors.

Rosenstein AH, O'Daniel M. AHRQ WebM&M [serial online]. December 2009.

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