AHRQ Patient Safety Network

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Safety Target

•Device-related Complications (50)

•Diagnostic Errors (39)

•Identification Errors (25)

•Discontinuities, Gaps, and Hand-Off Problems (237)

•Fatigue and Sleep Deprivation (34)

•Medication Safety (344)

•Medical Complications (226)

•Nonsurgical Procedural Complications (16)

•Surgical Complications (68)

•Transfusion Complications (9)

•Psychological and Social Complications (59)

Origin/Sponsor

•Australia and New Zealand (40)

•Europe (215)

•North America (1132)

Resource Types

•Audiovisual (20)

•Book/Report (109)

•Clinical Guideline (1)

•Journal Article (1013)

•Legislation/Regulation (11)

•Meeting/Conference (6)

•Newspaper/Magazine Article (173)

•Press Release/Announcement (2)

•Special or Theme Issue (11)

•Tools/Toolkit (22)

•Web Resource (27)

Error Types

•Epidemiology of Errors and Adverse Events (378)

•Active Errors (156)

•Latent Errors (95)

•Near Miss (19)

Approach to Improving Safety

•Quality Improvement Strategies (351)

•Legal and Policy Approaches (164)

•Error Reporting and Analysis (401)

•Communication Improvement (366)

•Human Factors Engineering (138)

•Teamwork (92)

•Specialization of Care (100)

•Logistical Approaches (113)

•Culture of Safety (239)

•Technologic Approaches (244)

•Education and Training (246)

Clinical Areas
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General Internal Medicine

Target Audience

•Health Care Providers (781)

•Health Care Executives and Administrators (1113)

•Non-Health Care Professionals (546)

•Patients (123)

Setting of Care

•Hospitals (1255)

•Psychiatric Facilities (5)

•Residential Facilities (9)

•Ambulatory Care (145)

•Outpatient Surgery (4)

•Patient Transport (2)

1 - 20 of 1403

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STUDY

Association of a clinical knowledge support system with improved patient safety, reduced complications and shorter length of stay among Medicare beneficiaries in acute care hospitals in the United States.

Bonis PA, Pickens GT, Rind DM, Foster DA. Int J Med Inform. 2008;77:745-753.

NEWSPAPER/MAGAZINE ARTICLE

Effective use of medication-related decision support in CPOE.

Metzger JB, Welebob E, Turisco F, Classen DC. Patient Saf Qual Healthc. Sept/Oct 2008;5:16-24.

NEWSPAPER/MAGAZINE ARTICLE

Piecing together medication administration.

Anderson HJ. Health Data Manage. May 1, 2009;17:22.

NEWSPAPER/MAGAZINE ARTICLE

CPOE: it don't come easy.

Anderson HJ. Health Data Manag. January 1, 2009;17:18.

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.

NEWSPAPER/MAGAZINE ARTICLE

Using clinical decision support to improve medication reconciliation.

Moore G. Patient Saf Qual Healthc. November/December 2006;3:28-30, 32-33.

COMMENTARY

Time to sign off on signout.

Stein DM, Stetson PD. Acad Med. 2011;86:804-806.

BOOK/REPORT

Inpatient Computerized Provider Order Entry: Findings from the AHRQ Health IT Portfolio.

Dixon BE, Zafar A, for AHRQ National Resource Center for Health IT. Rockville, MD: Agency for Healthcare Research and Quality; January 2009. AHRQ Publication No. 09-0031-EF.

NEWSPAPER/MAGAZINE ARTICLE

Safety in numbers? Try connectivity.

Dyell D. Patient Saf Qual Healthc. January/February 2012;9:34-37.

STUDY

Systematically improving physician assignment during in-hospital transitions of care by enhancing a preexisting hospital electronic health record.

Zsenits B, Polashenski WA, Sterns RH, Brown DR IV, Moheet A. J Hosp Med. 2009;4:308-312.

STUDY

Predictive combinations of monitor alarms preceding in-hospital code blue events.

Hu X, Sapo M, Nenov V, et al. J Biomed Inform. 2012;45:913-921.

NEWSPAPER/MAGAZINE ARTICLE

For all the right reasons.

Hagland M. Healthc Informatics. 2009;26:40-44.

STUDY

Concept and development of a discharge alert filter for abnormal laboratory values coupled with computerized provider order entry: a tool for quality improvement and hospital risk management.

Mathew G, Kho A, Dexter P, et al. J Patient Saf. 2012;8:69-75.

NEWSPAPER/MAGAZINE ARTICLE

Computer viruses are "rampant" on medical devices in hospitals.

Talbot D. MIT Technology Review. October 17, 2012.

STUDY

Using computerized provider order entry and clinical decision support to improve referring physicians' implementation of consultants' medical recommendations.

Were MC, Abernathy G, Hui SL, Kempf C, Weiner M. J Am Med Inform Assoc. 2009;16:196-202.

MEASUREMENT TOOL/INDICATOR

Medication Safety Self Assessment for Automated Dispensing Cabinets.

Horsham, PA: Institute for Safe Medication Practices; 2009.

COMMENTARY

Making inpatient medication reconciliation patient centered, clinically relevant and implementable: a consensus statement on key principles and necessary first steps.

Greenwald JL, Halasyamani L, Greene J, et al. J Hosp Med. 2010;5:477-485.

STUDY

Relationship between medication event rates and the Leapfrog computerized physician order entry evaluation tool.

Leung AA, Keohane C, Lipsitz S, et al. J Am Med Inform Assoc. 2013 Apr 18; [Epub ahead of print].

STUDY

Smartphone use during inpatient attending rounds: prevalence, patterns and potential for distraction.

Katz-Sidlow RJ, Ludwig A, Miller S, Sidlow R. J Hosp Med. 2012;7:595-599.

NEWSPAPER/MAGAZINE ARTICLE

As industry automates, adverse events continue to haunt caregivers.

Wetzel TG. Health Data Manage. 2011 Feb;19:86, 88, 90 passim.

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