AHRQ Patient Safety Network

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Safety Target

•Device-related Complications (153)

•Diagnostic Errors (95)

•Identification Errors (96)

•Discontinuities, Gaps, and Hand-Off Problems (431)

•Fatigue and Sleep Deprivation (103)

•Medication Safety (916)

•Medical Complications (466)

•Nonsurgical Procedural Complications (75)

•Surgical Complications (365)

•Transfusion Complications (18)

•Psychological and Social Complications (110)

Origin/Sponsor

•Australia and New Zealand (73)

•Central and South America (1)

•Europe (289)

•North America (2768)

Resource Types

•Audiovisual (38)

•Book/Report (178)

•Clinical Guideline (5)

•Journal Article (2357)

•Legislation/Regulation (43)

•Meeting/Conference (11)

•Newspaper/Magazine Article (432)

•Press Release/Announcement (9)

•Special or Theme Issue (34)

•Tools/Toolkit (44)

•Web Resource (62)

Error Types

•Epidemiology of Errors and Adverse Events (789)

•Active Errors (447)

•Latent Errors (233)

•Near Miss (49)

Approach to Improving Safety

•Quality Improvement Strategies (830)

•Legal and Policy Approaches (334)

•Error Reporting and Analysis (919)

•Communication Improvement (736)

•Human Factors Engineering (403)

•Teamwork (269)

•Specialization of Care (304)

•Logistical Approaches (305)

•Culture of Safety (487)

•Technologic Approaches (649)

•Education and Training (610)

Clinical Areas

•Allied Health Services (4)

•Medicine (2373)

•Nursing (324)

•Pharmacy (360)

Target Audience

•Health Care Providers (2061)

•Health Care Executives and Administrators (2732)

•Non-Health Care Professionals (1213)

•Patients (284)

Setting of Care
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Hospitals

•General Hospitals (853)

•Children’s Hospitals (116)

•Specialty Hospitals (47)

1 - 20 of 3236

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STUDY

Potassium and phosphorus repletion in hospitalized patients: implications for clinical practice and the potential use of healthcare information technology to improve prescribing and patient safety.

Hemstreet BA, Stolpman N, Badesch DB, May SK, McCollum M. Curr Med Res Opin. 2006;22:2449-2455.

STUDY

Drug–drug interactions that should be non-interruptive in order to reduce alert fatigue in electronic health records.

Phansalkar S, van der Sijs H, Tucker AD, et al. J Am Med Inform Assoc. 2013;20:489-493.

COMMENTARY

Preventing medication errors in hospitals through a systems approach and technological innovation: a prescription for 2010.

Crane J, Crane FG. Hosp Top. Fall 2006;84:3-8.

STUDY

The use of patient pictures and verification screens to reduce computerized provider order entry errors.

Hyman D, Laire M, Redmond D, Kaplan DW. Pediatrics. 2012;130:e211-e219.

STUDY

Computerized prescribing alerts and group academic detailing to reduce the use of potentially inappropriate medications in older people.

Simon SR, Smith DH, Feldstein AC, et al. J Am Geriatr Soc. 2006;54:963-968.

NEWSPAPER/MAGAZINE ARTICLE

Piecing together medication administration.

Anderson HJ. Health Data Manage. May 1, 2009;17:22.

STUDY

Design and implementation of an application and associated services to support interdisciplinary medication reconciliation efforts at an integrated healthcare delivery network.

Poon EG, Blumenfeld B, Hamann C, et al. J Am Med Inform Assoc. 2006;13:581-592.

COMMENTARY

Time to sign off on signout.

Stein DM, Stetson PD. Acad Med. 2011;86:804-806.

BOOK/REPORT

Inpatient Computerized Provider Order Entry: Findings from the AHRQ Health IT Portfolio.

Dixon BE, Zafar A, for AHRQ National Resource Center for Health IT. Rockville, MD: Agency for Healthcare Research and Quality; January 2009. AHRQ Publication No. 09-0031-EF.

STUDY

The effect of hospital electronic health record adoption on nurse-assessed quality of care and patient safety.

Kutney-Lee A, Kelly D. J Nurs Adm. 2011;41:466-472.

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.

ORGANIZATIONAL POLICY/GUIDELINES

AORN guidance statement: "do-not-use" abbreviations, acronyms, dosage designations, and symbols.

AORN J. 2006;84:489-492.

STUDY

classic

High rates of adverse drug events in a highly computerized hospital.

Nebeker JR, Hoffman JM, Weir CR, Bennett CL, Hurdle JF. Arch Intern Med. 2005;165:1111-1116.

NEWSPAPER/MAGAZINE ARTICLE

CPOE: it don't come easy.

Anderson HJ. Health Data Manag. January 1, 2009;17:18.

COMMENTARY classic

classic

Healthcare in a land called PeoplePower: nothing about me without me.

Delbanco T, Berwick DM, Boufford JI, et al. Health Expect. 2001;4:144-150.

COMMENTARY

El Camino Hospital: using health information technology to promote patient safety.

Bukunt S, Hunter C, Perkins S, Russell D, Domanico L. Jt Comm J Qual Saf. 2005;31:561-565.

NEWSPAPER/MAGAZINE ARTICLE

Effective use of medication-related decision support in CPOE.

Metzger JB, Welebob E, Turisco F, Classen DC. Patient Saf Qual Healthc. Sept/Oct 2008;5:16-24.

AWARD RECIPIENT

Improving patient safety using interactive, evidence-based decision support tools.

Quinn MM, Mannion J. Jt Comm J Qual Patient Saf. 2005;31:678-683.

NEWSPAPER/MAGAZINE ARTICLE

As industry automates, adverse events continue to haunt caregivers.

Wetzel TG. Health Data Manage. 2011 Feb;19:86, 88, 90 passim.

STUDY

The need for organizational change in patient safety initiatives.

Anderson JG, Ramanujam R, Hensel D, Anderson MM, Sirio CA. Int J Med Inform. 2006;75:809-817.

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