AHRQ Patient Safety Network

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Safety Target

•Device-related Complications (29)

•Diagnostic Errors (93)

•Identification Errors (31)

•Discontinuities, Gaps, and Hand-Off Problems (128)

•Fatigue and Sleep Deprivation (35)

•Medication Safety (209)

•Medical Complications (106)

•Nonsurgical Procedural Complications (17)

•Surgical Complications (78)

•Transfusion Complications (8)

•Psychological and Social Complications (31)

Origin/Sponsor

•Asia (10)

•Australia and New Zealand (13)

•Central and South America (1)

Resource Types

•Clinical Guideline (1)

•Journal Article (443)

•Legislation/Regulation (11)

•Meeting/Conference (10)

•Newspaper/Magazine Article (182)

•Press Release/Announcement (10)

•Special or Theme Issue (10)

•Tools/Toolkit (21)

•Web Resource (27)

•Grant (2)

Error Types

•Epidemiology of Errors and Adverse Events (164)

•Active Errors (182)

•Latent Errors (91)

•Near Miss (13)

Approach to Improving Safety

•Quality Improvement Strategies (179)

•Legal and Policy Approaches (102)

•Error Reporting and Analysis (240)

•Communication Improvement (230)

•Human Factors Engineering (93)

•Teamwork (35)

•Specialization of Care (57)

•Logistical Approaches (77)

•Culture of Safety (70)

•Technologic Approaches (175)

•Education and Training (195)

Target Audience

•Health Care Providers (595)

•Health Care Executives and Administrators (452)

•Non-Health Care Professionals (265)

•Patients (262)

Setting of Care

•Hospitals (650)

•Psychiatric Facilities (3)

•Residential Facilities (12)

•Ambulatory Care (75)

•Outpatient Surgery (8)

•Patient Transport (1)

1 - 20 of 809

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NEWSPAPER/MAGAZINE ARTICLE

Doctors' smartphones and iPads may be distracting.

Gold J. Kaiser Health News and National Public Radio. March 26, 2012.

COMMENTARY

Appropriate prescribing of medications: an eight-step approach.

Pollock M, Bazaldua OV, Dobbie AE. Am Fam Physician. 2007;75:231-236, 239-240.

COMMENTARY

Doctor, Don't Treat Thyself.

Rosvold EO. AHRQ WebM&M [serial online]. September 2004.

STUDY

A new safety event reporting system improves physician reporting in the surgical intensive care unit.

Schuerer DJ, Nast PA, Harris CB, et al. J Am Coll Surg. 2006;202:881-887.

COMMENTARY

Inappropriate Antibiotic Use.

Babcock HM, Fraser VJ. AHRQ WebM&M [serial online]. June 2003.

COMMENTARY

Crossing the Line.

Feldman JP, Gould MK. AHRQ WebM&M [serial online]. March 2004.

NEWSPAPER/MAGAZINE ARTICLE

Medical errors are hard for doctors to admit, but it's wise to apologize to patients.

Jain M. Washington Post. May 27, 2013.

STUDY

Increasing vigilance on the medical/surgical floor to improve patient safety.

Jacobs JL, Apatov N, Glei M. J Adv Nurs. 2007;57:472-481.

COMMENTARY

Bleeding Risk.

Crowther MA. AHRQ WebM&M [serial online]. July 2003.

COMMENTARY

Poor Prognosis.

Lamont EB. AHRQ WebM&M [serial online]. September 2004.

COMMENTARY

Development of a patient safety web-based education curriculum for physicians, nurses, and patients.

Hendee WR, Keating-Christensen C, Loh YH. J Patient Saf. 2005;1:90-99.

NEWSPAPER/MAGAZINE ARTICLE

Fixing America's hospitals.

Newsweek. October 16, 2006:44-68, 72.

NEWSPAPER/MAGAZINE ARTICLE

Medical malpractice: why is it so hard for doctors to apologize?

Sanghavi D. Boston Globe Magazine. January 27, 2013.

STUDY

Design and implementation of an automated email notification system for results of tests pending at discharge.

Dalal AK, Schnipper JL, Poon EG, et al. J Am Med Inform Assoc. 2012;19:523-538.

STUDY

Evaluating sample medications in primary care: a practice-based research network study.

Hansen LB, Saseen JJ, Westfall JM, et al. Jt Comm J Qual Patient Saf. 2006;32:688-692.

BOOK/REPORT

Breast Cancer Services in Trafford and North Manchester. An Investigation Into The Circumstances Surrounding A Serious Clinical Incident In Symptomatic Breast Services – The Baker Report.

Baker M. Manchester, England: NHS North West; February 2007.

BOOK/REPORT

Consumer Guide to Adverse Health Events.

St. Paul, MN: Minnesota Department of Health; January 2009.

PRESS RELEASE/ANNOUNCEMENT

Important change to heparin container labels to clearly state the total drug strength.

MedWatch Safety Alert. Silver Spring, MD: US Food and Drug Administration; December 6, 2012.

STUDY

Assessing the National Electronic Injury Surveillance System—Cooperative Adverse Drug Event Surveillance Project—six sites, United States, January 1–June 15, 2004.

Centers for Disease and Control Prevention. MMWR Morb Mortal Wkly Rep. 2005;54:380-383.

STUDY

Exploring the role of salient distracting clinical features in the emergence of diagnostic errors and the mechanisms through which reflection counteracts mistakes.

Mamede S, Splinter TAW, van Gog T, Rikers RM, Schmidt HG. BMJ Qual Saf. 2012;21:295-300.

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