AHRQ Patient Safety Network

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Safety Target

•Device-related Complications (156)

•Diagnostic Errors (133)

•Identification Errors (90)

•Discontinuities, Gaps, and Hand-Off Problems (427)

•Fatigue and Sleep Deprivation (109)

•Medication Safety (1008)

•Medical Complications (462)

•Nonsurgical Procedural Complications (71)

•Surgical Complications (304)

•Transfusion Complications (21)

•Psychological and Social Complications (190)

Origin/Sponsor

•Africa (3)

•Asia (44)

•Australia and New Zealand (80)

•Central and South America (3)

•Europe (317)

•North America (3632)

Resource Types

•Clinical Guideline (5)

•Journal Article (2780)

•Legislation/Regulation (52)

•Meeting/Conference (44)

•Newsletter/Journal (10)

•Newspaper/Magazine Article (552)

•Press Release/Announcement (23)

•Special or Theme Issue (89)

•Tools/Toolkit (68)

•Web Resource (115)

•Grant (11)

Error Types

•Epidemiology of Errors and Adverse Events (683)

•Active Errors (426)

•Latent Errors (282)

•Near Miss (59)

Approach to Improving Safety

•Quality Improvement Strategies (1226)

•Legal and Policy Approaches (540)

•Error Reporting and Analysis (1204)

•Communication Improvement (905)

•Human Factors Engineering (428)

•Teamwork (374)

•Specialization of Care (274)

•Logistical Approaches (327)

•Culture of Safety (994)

•Technologic Approaches (656)

•Education and Training (842)

Clinical Areas

•Allied Health Services (16)

Target Audience

•Health Care Providers (2578)

•Health Care Executives and Administrators (3394)

•Non-Health Care Professionals (1800)

•Patients (378)

Setting of Care

•Hospitals (2790)

•Psychiatric Facilities (14)

•Residential Facilities (74)

•Ambulatory Care (269)

•Outpatient Surgery (37)

•Patient Transport (17)

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COMMENTARY

The Role of the Patient in Improving Patient Safety

Gibson R. AHRQ WebM&M [serial online]. March 2007.

COMMENTARY

Patient safety rounds: description of an inexpensive but important strategy to improve the safety culture.

Campbell DA Jr, Thompson M. Am J Med Qual. 2007;22:26-33.

STUDY

Examination of how a survey can spur culture changes using a quality improvement approach: a region-wide approach to determining a patient safety culture.

Pringle J, Weber RJ, Rice K, Kirisci L, Sirio C. Am J Med Qual. 2009; 24:374-384.

STUDY

The impact of safety organizing, trusted leadership, and care pathways on reported medication errors in hospital nursing units.

Vogus TJ, Sutcliffe KM. Med Care. 2007;45:997-1002.

STUDY

Evaluation of organizational culture among different levels of healthcare staff participating in the Institute for Healthcare Improvement's 100,000 Lives Campaign.

Sinkowitz-Cochran RL, Garcia-Williams A, Hackbarth AD, et al. Infect Control Hosp Epidemiol. 2012;33:135-143.

BOOK/REPORT

Through the Eyes of the Workforce: Creating Joy, Meaning, and Safer Health Care.

Roundtable on Joy and Meaning in Work and Workforce Safety, The Lucian Leape Institute. Boston, MA: National Patient Safety Foundation; 2013.

STUDY

The Safety Organizing Scale: development and validation of a behavioral measure of safety culture in hospital nursing units.

Vogus TJ, Sutcliffe KM. Med Care. 2007;45:46-54.

STUDY

Identifying organizational cultures that promote patient safety.

Singer SJ, Falwell A, Gaba DM, et al. Health Care Manage Rev. 2009;34:300-311.

BOOK/REPORT

Improving the Reliability of Health Care.

Nolan T, Resar R, Haraden C, Griffin FA. Boston, MA: Institute for Healthcare Improvement; 2004.

COMMENTARY

Developing a medication patient safety program — infrastructure and strategy.

Mark SM, Weber RJ. Hosp Pharm. 2007;42:149-156.

NEWSPAPER/MAGAZINE ARTICLE

Fixing America's hospitals.

Newsweek. October 16, 2006:44-68, 72.

STUDY

Organizational culture, critical success factors, and the reduction of hospital errors.

Stock GN, McFadden KL, Gowen III, CR. Int J Prod Econ. 2007;106:368–392.

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.

SPECIAL OR THEME ISSUE

Improving the Health Care Work Environment.

Jt Comm J Qual Patient Saf. November 2007;33(suppl 1):3-84.

MULTI-USE WEBSITE

BOOSTing Care Transitions Resource Room.

Project BOOST (Better Outcomes for Older adults through Safe Transitions), Society of Hospital Medicine.

BOOK/REPORT

Tennessee Center for Patient Safety Annual Report 2010.

Nashville, TN: Tennessee Center for Patient Safety; August 2011.

BOOK/REPORT

Taking the Lead in Patient Safety: How Healthcare Leaders Influence Behavior and Create Culture.

Krause TR, Hidley J. Hoboken, NJ: Wiley; 2008. ISBN: 9780470225394.

SPECIAL OR THEME ISSUE

Interprofessional Approaches to Patient Safety.

J Interprof Care. 2006;20:455-571.

MEETING/CONFERENCE PROCEEDINGS

The 2012 Fifth International High Reliability Conference Proceedings.

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

COMMENTARY

Journey to no preventable risk: The Baylor Health Care System patient safety experience.

Kennerly D, Richter KM, Good V, Compton J, Ballard DJ. Am J Med Qual. 2011;26:43-52.

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