AHRQ Patient Safety Network

The Collection > Facility and Group Administrators

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Safety Target

•Device-related Complications (11)

•Diagnostic Errors (22)

•Identification Errors (10)

•Discontinuities, Gaps, and Hand-Off Problems (82)

•Fatigue and Sleep Deprivation (28)

•Medication Safety (129)

•Medical Complications (19)

•Nonsurgical Procedural Complications (1)

•Surgical Complications (34)

•Transfusion Complications (1)

•Psychological and Social Complications (16)

Origin/Sponsor

•Asia (7)

•Australia and New Zealand (12)

Resource Types

•Clinical Guideline (1)

•Journal Article (309)

•Legislation/Regulation (4)

•Meeting/Conference (2)

•Newspaper/Magazine Article (26)

•Press Release/Announcement (2)

•Special or Theme Issue (3)

•Tools/Toolkit (6)

•Web Resource (2)

Error Types

•Epidemiology of Errors and Adverse Events (86)

•Active Errors (47)

•Latent Errors (45)

•Near Miss (11)

Approach to Improving Safety

•Quality Improvement Strategies (99)

•Legal and Policy Approaches (37)

•Error Reporting and Analysis (115)

•Communication Improvement (104)

•Human Factors Engineering (34)

•Teamwork (27)

•Specialization of Care (22)

•Logistical Approaches (60)

•Culture of Safety (51)

•Technologic Approaches (106)

•Education and Training (63)

Clinical Areas

•Allied Health Services (1)

•Medicine (246)

•Nursing (41)

•Pharmacy (19)

Target Audience
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Facility and Group Administrators

Setting of Care

•Hospitals (193)

•Psychiatric Facilities (2)

•Residential Facilities (27)

•Ambulatory Care (54)

•Outpatient Surgery (6)

•Patient Transport (5)

1 - 20 of 373

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COMMENTARY

Electronic Err.

Tang PC. AHRQ WebM&M [serial online]. October 2004.

STUDY

Communication in critical care environments: mobile telephones improve patient care.

Soto RG, Chu LF, Goldman JM, Rampil IJ, Ruskin KJ. Anesth Analg. 2006;102:535-541.

STUDY

Interruptive communication patterns in the intensive care unit ward round.

Alvarez G, Coiera E. Int J Med Inform. 2005;74:791-796.

REVIEW

Failure mode and effects analysis application to critical care medicine.

Duwe B, Fuchs BD, Hansen-Flaschen J. Crit Care Clin. 2005;21:21-30, vii.

STUDY

Faculty member review and feedback using a sign-out checklist: improving intern written sign-out.

Bump GM, Bost JE, Buranosky R, Elnicki M. Acad Med. 2012;87;1125-1131.

STUDY

Development of the ICU safety reporting system.

Wu AW, Holzmueller CG, Lubomski LH, et al. J Patient Saf. 2005;1:23-32.

REVIEW

Coordinating care across diseases, settings, and clinicians: a key role for the generalist in practice.

Stille CJ, Jerant A, Bell D, Meltzer D, Elmore JG. Ann Intern Med. 2005;142:700-708.

COMMENTARY

Discharge Against Medical Advice.

Hwang SW. WebM&M [serial online]. May 2005.

STUDY

Risky procedures by nurses in hospitals: problems and (contemplated) refusals of orders by physicians, and views of physicians and nurses: a questionnaire survey.

de Bie J, Cuperus-Bosma JM, van der Jagt MAB, Gevers JKM, van der Wal G. Int J Nurs Stud. 2005;42:637-648.

COMMENTARY

Delay in Initiating Antibiotics Leads to Fatal Error.

Bellini LM. AHRQ WebM&M [serial online]. February 2004.

COMMENTARY

System errors in intrapartum electronic fetal monitoring: a case review.

Miller LA. J Midwifery Womens Health. 2005;50:507-516.

STUDY

Using a computerized sign-out system to improve physician–nurse communication.

Sidlow R, Katz-Sidlow RJ. Jt Comm J Qual Patient Saf. 2006;32:32-36.

COMMENTARY

Triage Time Bomb.

Washington DL. AHRQ WebM&M [serial online]. January 2004.

COMMENTARY

An Outpatient “Zebra”

Berkowitz L. AHRQ WebM&M [serial online]. January 2006.

STUDY

Risk of medication errors at hospital discharge and barriers to problem resolution.

Enguidanos SM, Brumley RD. Home Health Care Serv Q. 2005;24:123-135.

STUDY

Design and implementation of an ICU incident registry.

van der Veer S, Cornet R, de Jonge E. Int J Med Inform. 2007;76:103-108.

STUDY

Implementing and validating a comprehensive unit-based safety program.

Pronovost P, Weast B, Rosenstein B. J Patient Saf. 2005;1:33-40.

COMMENTARY

Teamwork and team training in the ICU: where do the similarities with aviation end?

Reader TW, Cuthbertson BH. Crit Care. 2011;15:313.

STUDY

Surgical skill is predicted by the ability to detect errors.

Bann S, Khan M, Datta V, Darzi A. Am J Surg. 2005;189:412-415.

STUDY

Discontinuity of chronic medications in patients discharged from the intensive care unit.

Bell CM, Rahimi-Darabad P, Orner AI. J Gen Intern Med. 2006;21:937-941.

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