AHRQ Patient Safety Network

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Safety Target

•Device-related Complications (1)

•Diagnostic Errors (5)

•Identification Errors (1)

•Discontinuities, Gaps, and Hand-Off Problems (4)

•Medication Safety (10)

•Medical Complications (3)

•Nonsurgical Procedural Complications (1)

•Surgical Complications (1)

•Psychological and Social Complications (1)

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•Newspaper/Magazine Article (5)

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•Epidemiology of Errors and Adverse Events (7)

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•Latent Errors (2)

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Approach to Improving Safety

•Quality Improvement Strategies (9)

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Setting of Care
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Psychiatric Facilities

1 - 20 of 34

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BOOK/REPORT

Adverse Health Events in Minnesota: Ninth Annual Public Report.

St. Paul, MN: Minnesota Department of Health; January 2013.

STUDY

Identifying and reducing medication errors in psychiatry: creating a culture of safety through the use of an adverse event reporting mechanism.

Jayaram G, Doyle D, Steinwachs D, Samuels J. J Psychiatr Pract. 2011;17:81–88.

REVIEW

Patient safety in psychiatric inpatient care: a literature review.

Kanerva A, Lammintakanen J, Kivinen T. J Psychiatr Ment Health Nurs. 2012 Jul 8; [Epub ahead of print].

STUDY

Supporting a psychiatric hospital culture of safety.

Mahoney JS, Ellis TE, Garland G, Palyo N, Greene PK. J Am Psychiatr Nurses Assoc. 2012;18:299-306.

NEWSPAPER/MAGAZINE ARTICLE

Hospital mistakes kept secret.

Judd A. The Atlanta Journal-Constitution. November 20, 2011.

STUDY

Using root cause analysis to reduce falls with injury in the psychiatric unit.

Lee A, Mills PD, Watts BV. Gen Hosp Psychiatry. 2012;34:304-311.

STUDY

What near misses tell us about risk and safety in mental health care.

Jeffs L, Rose D, Macrae C, Maione M, Macmillan KM. J Psychiatr Ment Health Nurs. 2012;19:430-437.

STUDY

Identifying the 'right patient': nurse and consumer perspectives on verifying patient identity during medication administration.

Kelly T, Roper C, Elsom S, Gaskin C. Int J Ment Health Nurs. 2011;20:371-379.

BOOK/REPORT

Improving Communication During Transitions of Care.

Oakbrook Terrace, IL: Joint Commission Resources; 2010. ISBN: 9781599404097.

STUDY

Emerging issues and challenges for improving patient safety in mental health: a qualitative analysis of expert perspectives.

Brickell TA, McLean C. J Patient Saf. 2011;7:39-44.

NEWSPAPER/MAGAZINE ARTICLE

Approved: no new National Patient Safety Goals, only minor revisions for 2011.

Jt Comm Perspect. August 2010;30:6-7.

STUDY

Toward understanding errors in inpatient psychiatry: a qualitative inquiry.

Cullen SW, Nath SB, Marcus SC. Psychiatr Q. 2010;81:197-205.

NEWSPAPER/MAGAZINE ARTICLE

Hospital infections hard to gauge.

Hamill SD. Pittsburgh Post-Gazette. April 18, 2010:A1.

NEWSPAPER/MAGAZINE ARTICLE

Learning from the best.

Grantham D. Behav Healthc. April 2010;30:22-24.

STUDY

Applying Toyota Production System principles to a psychiatric hospital: making transfers safer and more timely.

Young JQ, Wachter RM. Jt Comm J Qual Patient Saf. 2009;35:439-448.

BOOK/REPORT

Safety in Doses.

London, UK: National Patient Safety Agency; 2009. ISBN: 9781906624088.

NEWSPAPER/MAGAZINE ARTICLE

Approved: 2010 National Patient Safety Goals.

Jt Comm Perspect. October 2009;29:1, 20-31.

COMMENTARY

Global priorities for patient safety research.

Bates DW, Larizgoitia I, Prasopa-Plaizier N, Jha AK; Research Priority Setting Working Group of the WHO World Alliance for Patient Safety. BMJ. 2009;338:b1775.

STUDY

Making patients safer: nurses' responses to patient safety alerts.

Lankshear A, Lowson K, Harden J, Lowson P, Saxby RC. J Adv Nurs. 2008;63:567-575.

STUDY

Diagnostic errors and temporal stability in bipolar disorder.

López J, Baca E, Botillo C, et al. Actas Esp Psiquiatr. 2008;36:205-209.

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