AHRQ Patient Safety Network

The Collection > Communication between Providers

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Safety Target

•Device-related Complications (20)

•Diagnostic Errors (45)

•Identification Errors (57)

•Discontinuities, Gaps, and Hand-Off Problems (374)

•Fatigue and Sleep Deprivation (9)

•Medication Safety (215)

•Medical Complications (43)

•Nonsurgical Procedural Complications (9)

•Surgical Complications (191)

•Transfusion Complications (2)

•Psychological and Social Complications (48)

Origin/Sponsor

•Asia (9)

•Australia and New Zealand (18)

Resource Types

•Clinical Guideline (1)

•Journal Article (658)

•Legislation/Regulation (14)

•Meeting/Conference (2)

•Newspaper/Magazine Article (106)

•Special or Theme Issue (10)

•Tools/Toolkit (11)

•Web Resource (7)

•Grant (1)

Error Types

•Epidemiology of Errors and Adverse Events (135)

•Active Errors (166)

•Latent Errors (73)

•Near Miss (13)

Approach to Improving Safety
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Communication between Providers

•Read Back Protocols (81)

•Structured Hand-offs (139)

•SBAR (23)

•Medication Reconciliation (106)

Clinical Areas

•Allied Health Services (3)

Target Audience

•Health Care Providers (666)

•Health Care Executives and Administrators (613)

•Non-Health Care Professionals (264)

•Patients (47)

Setting of Care

•Hospitals (622)

•Psychiatric Facilities (2)

•Residential Facilities (20)

•Ambulatory Care (81)

•Outpatient Surgery (8)

•Patient Transport (14)

1 - 20 of 838

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IMAGE/POSTER

Distributing Cognition: ICU Handoffs Conform to Grice's Maxims.

Brandwijk M, Nemeth C, O'Conner M, Kahana M, Cook RI. Departments of Pediatrics and Anesthesia and Critical Care: Chicago, IL: University of Chicago.

STUDY

In search of common ground in handoff documentation in an intensive care unit.

Collins SA, Mamykina L, Jordan D, et al. J Biomed Inform. 2012;45:307-315.

COMMENTARY

Right? Left? Neither!

Howell EA, Chassin MR. AHRQ WebM&M [serial online]. May 2006.

STUDY

What is the patient really taking? Discrepancies between surgery and anesthesiology preoperative medication histories.

Burda SA, Hobson D, Pronovost PJ. Qual Saf Health Care. 2005;14:414-416.

COMMENTARY

Deciphering the Code

Goldstein MK. AHRQ WebM&M [serial online]. Febuary 2006.

REVIEW

Communication devices in the operating room.

Ruskin KJ. Curr Opin Anaesthesiol. 2006;19:655-659.

STUDY

An observational study of changes to long-term medication after admission to an intensive care unit.

Campbell AJ, Bloomfield R, Noble DW. Anaesthesia. 2006;61:1087-1092.

STUDY

Bridging gaps in handoffs: a continuity of care based approach.

Abraham J, Kannampallil TG, Patel VL. J Biomed Inform. 2012;45:240-254.

ORGANIZATIONAL POLICY/GUIDELINES

Statement on the prevention of retained foreign bodies after surgery.

Bulletin of the American College of Surgeons; October 2005.

STUDY

"It's not our ass": medical resident sense-making regarding lawsuits.

Noland C, Carl WJ. Health Commun. 2006;20:81-89.

STUDY

Unplanned transfers to a medical intensive care unit: causes and relationship to preventable errors in care.

Bapoje SR, Gaudiani JL, Narayanan V, Albert RK. J Hosp Med. 2011;6:68-72.

COMMENTARY

A nurse-led approach to developing and implementing a collaborative count policy.

Norton EK, Micheli AJ, Gedney J, Felkerson TM. AORN J. 2012;95:222-227.

STUDY

Failure to notify reportable test results: significance in medical malpractice.

Gale BD, Bissett-Siegel DP, Davidson SJ, Juran DC. J Am Coll Radiol. 2011;8:776-779.

STUDY

Standardized multidisciplinary protocol improves handover of cardiac surgery patients to the intensive care unit.

Joy BF, Elliott E, Hardy C, Sullivan C, Backer CL, Kane JM. Pediatr Crit Care Med. 2011;12:304-308.

STUDY

Healthy work environments, nurse-physician communication, and patients' outcomes.

Manojlovich M, DeCicco B. Am J Crit Care. 2007;16:536-543.

STUDY

Discharge rounds in the 80-hour workweek: importance of the trauma nurse practitioner.

Haan JM, Dutton RP, Willis M, Leone S, Kramer ME, Scalea TM. J Trauma. 2007;63:339-343.

STUDY

Customer focused incident monitoring in anaesthesia.

Khan FA, Khimani S. Anaesthesia. 2007;62:586-590.

COMMENTARY

Handovers from the OR to the ICU.

Bonifacio AS, Segall N, Barbeito A, Taekman J, Schroeder R, Mark JB. Int Anesthesiol Clin. 2013;51:43-61.

STUDY

Pilot implementation of a perioperative protocol to guide operating room-to-intensive care unit patient handoffs.

Petrovic MA, Aboumatar H, Baumgartner WA, et al. J Cardiothorac Vasc Anesth. 2012;26:11-16.

REVIEW

Can we make postoperative patient handovers safer? A systematic review of the literature.

Segall N, Bonifacio AS, Schroeder RA, et al; Durham VA Patient Safety Center of Inquiry. Anesth Analg. 2012;115:102-115.

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