AHRQ Patient Safety Network

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Safety Target

•Device-related Complications (188)

•Diagnostic Errors (252)

•Identification Errors (141)

•Discontinuities, Gaps, and Hand-Off Problems (473)

•Fatigue and Sleep Deprivation (189)

•Medication Safety (1251)

•Medical Complications (441)

•Nonsurgical Procedural Complications (104)

•Surgical Complications (820)

•Transfusion Complications (19)

•Psychological and Social Complications (159)

Origin/Sponsor

•Africa (3)

•Asia (62)

•Australia and New Zealand (108)

•Central and South America (9)

•Europe (529)

•North America (3652)

Resource Types

•Audiovisual (32)

•Award (9)

•Book/Report (153)

•Clinical Guideline (10)

•Journal Article (3581)

•Legislation/Regulation (51)

•Meeting/Conference (15)

•Newsletter/Journal (10)

•Newspaper/Magazine Article (374)

•Press Release/Announcement (20)

•Special or Theme Issue (55)

•Tools/Toolkit (44)

•Web Resource (72)

•Grant (4)

Error Types

•Epidemiology of Errors and Adverse Events (1446)

•Active Errors (677)

•Latent Errors (233)

•Near Miss (81)

Approach to Improving Safety

•Quality Improvement Strategies (946)

•Legal and Policy Approaches (334)

•Error Reporting and Analysis (1355)

•Communication Improvement (976)

•Human Factors Engineering (555)

•Teamwork (397)

•Specialization of Care (238)

•Logistical Approaches (397)

•Culture of Safety (471)

•Technologic Approaches (711)

•Education and Training (1018)

Clinical Areas

•Allied Health Services (11)

•Complementary and Alternative Medicine (1)

Target Audience

•Health Care Providers (3175)

•Health Care Executives and Administrators (3524)

•Non-Health Care Professionals (1678)

•Patients (236)

Setting of Care

•Hospitals (2752)

•Psychiatric Facilities (11)

•Residential Facilities (70)

•Ambulatory Care (358)

•Outpatient Surgery (56)

•Patient Transport (34)

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STUDY

The effects of work-hour limitations on resident well-being, patient care, and education in an internal medicine residency program.

Goitein L, Shanafelt TD, Wipf JE, Slatore CG, Back AL. Arch Intern Med. 2005;165:2601-2606.

STUDY

Complying with ACGME resident duty hours restrictions: restructuring the 80-hour workweek to enhance education and patient safety at Texas A&M/Scott & White Memorial Hospital.

Ogden PE, Sibbitt S, Howell M, et al. Acad Med. 2006;81:1026-1031.

STUDY

Effects of duty hour restrictions on core competencies, education, quality of life, and burnout among general surgery interns.

Antiel RM, Reed DA, Van Arendonk JK, et al. JAMA Surg. 2013;148:448-455.

STUDY

The impact of the 80-hour resident workweek on surgical residents and attending surgeons.

Hutter MM, Kellogg KC, Ferguson CM, Abbott WM, Warshaw AL. Ann Surg. 2006;243:864-871; discussion 871-875.

STUDY

Implementation of resident work hour restrictions is associated with a reduction in mortality and provider-related complications on the surgical service: a concurrent analysis of 14,610 patients.

Privette AR, Shackford SR, Osler T, Ratliff J, Sartorelli K, Hebert JC. Ann Surg. 2009;250:316-321.

NEWSPAPER/MAGAZINE ARTICLE

A case that shook medicine.

Lerner BH. The Washington Post. November 28, 2006:HE01.

BOOK/REPORT

Annual Benchmarking Report: Malpractice Risks in Surgery.

Cambridge, MA: CRICO/RMF Strategies; 2010.

MULTI-USE WEBSITE

Accreditation Council for Graduate Medical Education.

COMMENTARY

The 80-hour duty week: rationale, early attitudes, and future questions.

Friedlaender GE. Clin Orthop Relat Res. 2006;449:138-142.

STUDY

Work-hour restrictions as an ethical dilemma for residents.

Carpenter RO, Austin MT, Tarpley JL, Griffin MR, Lomis KD. Amer J Surg. 2006;191:527-532.

STUDY

Patterns of communication breakdowns resulting in injury to surgical patients.

Greenberg CC, Regenbogen SE, Studdert DM, et al. J Am Coll Surg. 2007;204:533-540.

COMMENTARY

The 80-hour work week: why safer patient care will mean more health care is provided by physician extenders.

McLean TR. J Leg Med. 2005;26:339-384.

STUDY

Perceived impact of duty hours limits on the fragmentation of patient care: results from an academic health center.

Keating RJ, LaRusso NF, Kolars JC. Am J Med. 2005;118:788-793.

STUDY

Resident attitudes regarding the impact of the 80–duty-hours work standards.

Zonia SC, LaBaere RJ, Stommel M, Tomaszewski DD. J Am Osteopath Assoc. 2005;105:307-313.

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.

NEWSPAPER/MAGAZINE ARTICLE

Safety in ASCs: putting patients first.

Dix K. Today's Surgicenter. December 1, 2006.

STUDY

Impact of resident participation in surgical operations on postoperative outcomes: National Surgical Quality Improvement Program.

Kiran RP, Ahmed Ali U, Coffey JC, Vogel JD, Pokala N, Fazio VW. Ann Surg. 2012;256:469-475.

STUDY

Persistent noncompliance with the work-hour regulation.

Tabrizian P, Rajhbeharrysingh U, Khaitov S, Divino CM. Arch Surg. 2011;146:175-178.

STUDY

The American College of Surgeons' closed claims study: new insights for improving care.

Griffen FD, Stephens LS, Alexander JB, et al. J Am Coll Surg. 2007;204:561-569.

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.

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