AHRQ Patient Safety Network

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Safety Target

•Device-related Complications (129)

•Diagnostic Errors (101)

•Identification Errors (71)

•Discontinuities, Gaps, and Hand-Off Problems (433)

•Fatigue and Sleep Deprivation (98)

•Medication Safety (901)

•Medical Complications (428)

•Nonsurgical Procedural Complications (49)

•Surgical Complications (206)

•Transfusion Complications (16)

•Psychological and Social Complications (125)

Origin/Sponsor

•Africa (2)

•Asia (29)

•Australia and New Zealand (57)

•Europe (277)

•North America (2977)

Resource Types

•Clinical Guideline (4)

•Journal Article (2265)

•Legislation/Regulation (43)

•Meeting/Conference (22)

•Newsletter/Journal (5)

•Newspaper/Magazine Article (486)

•Press Release/Announcement (11)

•Special or Theme Issue (53)

•Tools/Toolkit (55)

•Web Resource (76)

•Grant (7)

Error Types

•Epidemiology of Errors and Adverse Events (648)

•Active Errors (352)

•Latent Errors (222)

•Near Miss (43)

Approach to Improving Safety

•Quality Improvement Strategies (889)

•Legal and Policy Approaches (461)

•Error Reporting and Analysis (967)

•Communication Improvement (775)

•Human Factors Engineering (344)

•Teamwork (235)

•Specialization of Care (260)

•Logistical Approaches (278)

•Culture of Safety (595)

•Technologic Approaches (619)

•Education and Training (612)

Clinical Areas

•Allied Health Services (7)

•Medicine (2214)

•Nursing (241)

•Pharmacy (372)

Target Audience

•Health Care Providers (2053)

•Health Care Executives and Administrators (2772)

•Non-Health Care Professionals (1352)

•Patients (336)

Setting of Care

•Hospitals (2629)

•Psychiatric Facilities (12)

•Residential Facilities (45)

•Ambulatory Care (285)

•Outpatient Surgery (27)

•Patient Transport (9)

1 - 20 of 3369

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NEWSPAPER/MAGAZINE ARTICLE

The importance of failing forward. All of us will fail and make mistakes, but how can they benefit us and our organizations?

Hofmann PB. Healthc Exec. 2012 May-Jun;27:64,66-67.

STUDY

Description and evaluation of adaptations to the Global Trigger Tool to enhance value to adverse event reduction efforts.

Kennerly DA, Saldaña M, Kudyakov R, da Graca B, Nicewander D, Compton J. J Patient Saf. 2013 Jan 30; [Epub ahead of print].

COMMENTARY

The Safe Tables Collaborative: a statewide experience.

Wagner CA, Cecchettini D, Fletcher J. Jt Comm J Qual Patient Saf. 2011;37:206-210.

MEETING/CONFERENCE PROCEEDINGS

Patient Safety as an Exercise in Behavioral Change.

Leape LL. Social and Behavioral Sciences in Action. Washington, DC: National Research Council of the National Academies. September 24, 2012.

NEWSPAPER/MAGAZINE ARTICLE

Could it happen here? Learning from other organizations' safety errors.

Conway J. Healthc Exec. November/December 2008;23:64-67.

COMMENTARY

The competitive imperative of learning.

Edmondson AC. Harv Bus Rev. 2008;86:60-67, 160.

NEWSPAPER/MAGAZINE ARTICLE

Tapping front-line knowledge: identifying problems as they occur helps enhance patient safety.

Luther K, Resar RK. Healthc Exec. Jan/Feb 2013;28:84-87.

BOOK/REPORT

Hospital Reporting Program.

Portland, OR: Oregon Patient Safety Commission.

NEWSPAPER/MAGAZINE ARTICLE

The pursuit of perfection: hospitals take heightened actions to reduce adverse events.

May EL. Healthc Exec. 2012;27:26-28,30-33.

COMMENTARY

Assessing hospital safety on nights and weekends: the SWAN tool.

Shulkin DJ. J Patient Saf. 2009;5:75-78.

COMMENTARY

Minnesota Hospital Association Statewide Project: SAFE from FALLS.

Apold J, Quigley PA. J Nurs Care Qual. 2012;27:299-306.

COMMENTARY

Revisiting duty-hour limits — IOM recommendations for patient safety and resident education.

Iglehart JK. N Engl J Med. 2008;359:2633-2635.

STUDY

'Global Trigger Tool' shows that adverse events in hospitals may be ten times greater than previously measured.

Classen DC, Resar R, Griffin F, et al. Health Aff (Millwood). 2011;30:581-589.

STUDY

Patient safety climate in hospitals: act locally on variation across units.

Campbell EG, Singer S, Kitch BT, Iezzoni LI, Meyer GS. Jt Comm J Qual Patient Saf. 2010;36:319-326.

MEETING/CONFERENCE PROCEEDINGS

The 2012 Fifth International High Reliability Conference Proceedings.

Oakbrook Terrace, IL: Joint Commission; May 21–23, 2012.

STUDY

A reengineered hospital discharge program to decrease rehospitalization: a randomized trial.

Jack BW, Chetty VK, Anthony D, et al. Ann Intern Med. 2009;150:178-187.

BOOK/REPORT

Improving America's Hospitals: The Joint Commission's Annual Report on Quality and Safety 2009.

Oakbrook Terrace, IL: The Joint Commission; January 2010.

NEWSPAPER/MAGAZINE ARTICLE

The role of the chief executive officer in maximizing patient safety.

Shorr AS. Healthc Exec. March-April 2007;22:19, 21-22, 24, 26.

COMMENTARY

Duty hour reform in a shifting medical landscape.

Jena AB, Prasad V. J Gen Intern Med. 2013 Apr 9; [Epub ahead of print].

NEWSPAPER/MAGAZINE ARTICLE

How has the current economy affected patient safety?

ISMP Medication Safety Alert! Acute Care Edition. September 10, 2009;14:1-2.

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