AHRQ Patient Safety Network

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Safety Target

•Device-related Complications (11)

•Diagnostic Errors (21)

•Identification Errors (6)

•Discontinuities, Gaps, and Hand-Off Problems (29)

•Fatigue and Sleep Deprivation (19)

•Medication Safety (90)

•Medical Complications (66)

•Nonsurgical Procedural Complications (6)

•Surgical Complications (52)

•Transfusion Complications (1)

•Psychological and Social Complications (15)

Origin/Sponsor

•Africa (3)

•Asia (2)

•Australia and New Zealand (15)

•Central and South America (2)

Resource Types

•Journal Article (292)

•Legislation/Regulation (21)

•Meeting/Conference (12)

•Newsletter/Journal (4)

•Newspaper/Magazine Article (74)

•Press Release/Announcement (3)

•Special or Theme Issue (10)

•Tools/Toolkit (5)

•Web Resource (21)

•Grant (5)

Error Types

•Epidemiology of Errors and Adverse Events (84)

•Active Errors (32)

•Latent Errors (38)

•Near Miss (6)

Approach to Improving Safety

•Quality Improvement Strategies (150)

•Legal and Policy Approaches (299)

•Error Reporting and Analysis (255)

•Communication Improvement (74)

•Human Factors Engineering (32)

•Teamwork (28)

•Specialization of Care (11)

•Logistical Approaches (33)

•Culture of Safety (91)

•Technologic Approaches (80)

•Education and Training (85)

Clinical Areas

•Allied Health Services (1)

•Medicine (239)

•Nursing (8)

•Pharmacy (34)

Target Audience
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Policy Makers

Setting of Care

•Hospitals (227)

•Psychiatric Facilities (3)

•Residential Facilities (12)

•Ambulatory Care (44)

•Outpatient Surgery (11)

•Patient Transport (1)

1 - 20 of 556

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BOOK/REPORT

Safety First: Top of Your Board's Agenda: 100 Day Challenge Survey Report.

The Patients Association. Harrow, Middlesex, UK: The Patients Association; June 2009.

COMMENTARY

Medication errors in family practice, in hospitals and after discharge from the hospital: an ethical analysis.

Clark PA. J Law Med Ethics. 2004;32:349-357.

STUDY

Racial disparities in the frequency of patient safety events: results from the National Medicare Patient Safety Monitoring System.

Metersky ML, Hunt DR, Kliman R, et al. Med Care. 2011;49:504-510.

BOOK/REPORT

Patient Safety: HHS Has Taken Steps to Address Unsafe Injection Practices, but More Action Is Needed.

Kohn LT. Washington, DC: United States Government Accountability Office; July 2012. Publication GAO-12-712.

STUDY

Perceptions of standards-based electronic prescribing systems as implemented in outpatient primary care: a physician survey.

Wang CJ, Patel MH, Schueth AJ, et al. J Am Med Inform Assoc. 2009;16:493-502.

BOOK/REPORT

Improving America's Hospitals: The Joint Commission's Annual Report on Quality and Safety 2012.

Oakbrook Terrace, IL: The Joint Commission; September 2012.

REVIEW

Meta-analysis: effect of interactive communication between collaborating primary care physicians and specialists.

Foy R, Hempel S, Rubenstein L, et al. Ann Intern Med. 2010;152:247-258.

NEWSPAPER/MAGAZINE ARTICLE

Medical errors still claiming many lives.

Weise E. USA Today. May 18, 2005.

COMMENTARY

Residents' duty hours—toward an empirical narrative.

Rosenbaum L, Lamas D. N Engl J Med. 2012;367:2044-2049.

BOOK/REPORT

IBEAS: A Pioneer Study on Patient Safety in Latin America: Towards Safer Hospital Care.

Geneva, Switzerland: World Health Organization; 2011.

BOOK/REPORT

Tennessee Center for Patient Safety Annual Report 2010.

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

STUDY

Thirty-day, all-cause readmissions for elderly patients who have an injury-related inpatient stay.

Spector WD, Mutter R, Owens P, Limcangco R. Med Care. 2012;50:863-869.

COMMENTARY classic

Accidental deaths, saved lives, and improved quality.

Brennan TA, Gawande A, Thomas E, Studdert D. N Engl J Med. 2005;353:1405-1409.

STUDY

Venous thromboembolism after trauma: a never event?

Thorson CM, Ryan ML, Van Haren RM, et al. Crit Care Med. 2012;40:2967-2973.

BOOK/REPORT

Hospital Reporting Program.

Portland, OR: Oregon Patient Safety Commission.

BOOK/REPORT

Improving America's Hospitals: The Joint Commission's Annual Report on Quality and Safety 2009.

Oakbrook Terrace, IL: The Joint Commission; January 2010.

STUDY

Effect of a protected sleep period on hours slept during extended overnight in-hospital duty hours among medical interns: a randomized trial.

Volpp KG, Shea JA, Small DS, et al. JAMA. 2012;308:2208-2217.

STUDY

Use of board certification and recertification of pediatricians in health plan credentialing policies.

Freed GL, Singer D, Lakhani I, Wheeler JRC, Stockman JA III; Research Advisory Committee of the American Board of Pediatrics. JAMA. 2006;295:913-918.

STUDY

Paid malpractice claims for adverse events in inpatient and outpatient settings.

Bishop TF, Ryan AK, Casalino LP. JAMA. 2011;305:2427-2431.

STUDY

National survey on the effect of oncology drug shortages on cancer care.

McBride A, Holle LM, Westendorf C, et al. Am J Health Syst Pharm. 2013;70:609-617.

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