AHRQ Patient Safety Network

The Collection > Quality and Safety Professionals

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Safety Target

•Device-related Complications (98)

•Diagnostic Errors (109)

•Identification Errors (73)

•Discontinuities, Gaps, and Hand-Off Problems (252)

•Fatigue and Sleep Deprivation (35)

•Medication Safety (667)

•Medical Complications (273)

•Nonsurgical Procedural Complications (67)

•Surgical Complications (303)

•Transfusion Complications (11)

•Psychological and Social Complications (55)

Origin/Sponsor

•Africa (2)

•Asia (47)

•Australia and New Zealand (84)

•Central and South America (8)

•Europe (484)

•North America (1417)

Resource Types

•Audiovisual (5)

•Award (5)

•Book/Report (59)

•Clinical Guideline (3)

•Journal Article (1784)

•Legislation/Regulation (19)

•Meeting/Conference (10)

•Newsletter/Journal (2)

•Newspaper/Magazine Article (83)

•Press Release/Announcement (11)

•Special or Theme Issue (24)

•Tools/Toolkit (15)

•Web Resource (37)

•Grant (5)

Error Types

•Epidemiology of Errors and Adverse Events (747)

•Active Errors (405)

•Latent Errors (117)

•Near Miss (49)

Approach to Improving Safety

•Quality Improvement Strategies (530)

•Legal and Policy Approaches (92)

•Error Reporting and Analysis (606)

•Communication Improvement (495)

•Human Factors Engineering (313)

•Teamwork (202)

•Specialization of Care (155)

•Logistical Approaches (129)

•Culture of Safety (244)

•Technologic Approaches (367)

•Education and Training (466)

Clinical Areas

•Allied Health Services (7)

•Complementary and Alternative Medicine (1)

Target Audience
< All

Quality and Safety Professionals

Setting of Care

•Hospitals (1427)

•Psychiatric Facilities (6)

•Residential Facilities (36)

•Ambulatory Care (152)

•Outpatient Surgery (19)

•Patient Transport (15)

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STUDY

Improving teamwork: impact of structured interdisciplinary rounds on a medical teaching unit.

O'Leary KJ, Wayne DB, Haviley C, Slade ME, Lee J, Williams MV. J Gen Intern Med. 2010;25:826-832.

COMMENTARY

Ten years after the IOM report: engaging residents in quality and patient safety by creating a house staff quality council.

Fleischut PM, Evans AS, Nugent WC, et al. Am J Med Qual. 2011;26:89-94.

STUDY

Safety of using a computerized rounding and sign-out system to reduce resident duty hours.

Van Eaton EG, McDonough K, Lober WB, Johnson EA, Pellegrini CA, Horvath KD. Acad Med. 2010;85:1189-1195.

BOOK/REPORT

An In Depth Investigation into Causes of Prescribing Errors by Foundation Trainees in Relation to Their Medical Education—EQUIP Study.

Dornan T, Ashcroft D, Heathfield H, et al. London: General Medical Council; 2009.

STUDY

Structured interdisciplinary rounds in a medical teaching unit: improving patient safety.

O’Leary KJ, Buck R, Fligiel HM, et al. Arch Intern Med. 2011;171:678-684.

STUDY

Uncomfortable prescribing decisions in hospitals: the impact of teamwork.

Lewis PJ, Tully MP. J R Soc Med. 2009;102:481-488.

STUDY

Does the implementation of an electronic prescribing system create unintended medication errors? A study of the sociotechnical context through the analysis of reported medication incidents.

Redwood S, Rajakumar A, Hodson J, Coleman JJ. BMC Med Inform Decis Mak. 2011;11:29.

STUDY

A July spike in fatal medication errors: a possible effect of new medical residents.

Phillips DP, Barker GEC. J Gen Intern Med. 2010;25:774-779.

STUDY

Accuracy of medication documentation in hospital discharge summaries: a retrospective analysis of medication transcription errors in manual and electronic discharge summaries.

Callen J, McIntosh J, Li J. Int J Med Inform. 2010;79:58-64.

STUDY

Fall prevention in acute care hospitals: a randomized trial.

Dykes PC, Carroll DL, Hurley A, et al. JAMA. 2010;304:1912-1918.

STUDY

Medicines reconciliation using a shared electronic health care record.

Moore P, Armitage G, Wright J, Dobrzanski S, Ansari N, Hammond I, Scally A. J Patient Saf. 2011;7:147-153.

STUDY

Using prospective clinical surveillance to identify adverse events in hospital.

Forster AJ, Worthington JR, Hawken S, et al. BMJ Qual Saf. 2011;20:756-763.

STUDY

Errors and omissions in hospital prescriptions: a survey of prescription writing in a hospital.

Calligaris L, Panzera A, Arnoldo L, et al. BMC Clin Pharmacol. 2009;9:9.

REVIEW

Systematic review: association of shift length, protected sleep time, and night float with patient care, residents' health, and education.

Reed DA, Fletcher KE, Arora VM. Ann Intern Med. 2010;153:829-842.

COMMENTARY

An anesthesiology department leads culture change at a hospital system level to improve quality and patient safety.

Fleischut PM, Evans AS, Faggiani SL, Lazar EJ, Kerr GE. Anesthesiol Clin. 2011;29:153-167.

COMMENTARY

Medication reconciliation in a community, nonteaching hospital.

Wortman SB. Am J Health Syst Pharm. 2008;65:2047-2054.

STUDY

Rethinking resident supervision to improve safety: from hierarchical to interprofessional models.

Tamuz M, Giardina TD, Thomas EJ, Menon S, Singh H. J Hosp Med. 2011;6:448-456.

STUDY

Early readmissions to the department of medicine as a screening tool for monitoring quality of care problems.

Balla U, Malnick S, Schattner A. Medicine (Baltimore). 2008;87:294-300.

STUDY

Incidence of potentially avoidable urgent readmissions and their relation to all-cause urgent readmissions.

van Walraven C, Jennings A, Taljaard M, et al. CMAJ. 2011;183:E1067-E1072.

STUDY

Junior doctors' reflections on patient safety.

Ahmed M, Arora S, Carley S, Sevdalis N, Neale G. Postgrad Med J. 2012;88:125-129.

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