AHRQ Patient Safety Network

PATIENT SAFETY PRIMERS
Safety Culture

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Safety Culture: High-reliability organizations consistently minimize adverse events despite carrying out intrinsically hazardous work... Read Full Glossary Entry >

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Safety Target

•Device-related Complications (32)

•Diagnostic Errors (19)

•Identification Errors (16)

•Discontinuities, Gaps, and Hand-Off Problems (49)

•Fatigue and Sleep Deprivation (7)

•Medication Safety (150)

•Medical Complications (111)

•Nonsurgical Procedural Complications (21)

•Surgical Complications (93)

•Transfusion Complications (3)

•Psychological and Social Complications (42)

Origin/Sponsor

•Africa (1)

•Asia (8)

•Australia and New Zealand (20)

•Central and South America (2)

Resource Types

•Clinical Guideline (1)

•Journal Article (622)

•Legislation/Regulation (12)

•Meeting/Conference (18)

•Newspaper/Magazine Article (97)

•Press Release/Announcement (4)

•Special or Theme Issue (37)

•Tools/Toolkit (19)

•Web Resource (30)

•Grant (7)

Error Types

•Epidemiology of Errors and Adverse Events (95)

•Active Errors (66)

•Latent Errors (71)

•Near Miss (15)

Approach to Improving Safety
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Culture of Safety

•Learning Organization (57)

•Red Rules (2)

•Institutional Patient Safety Plan (28)

•Just Culture (26)

Clinical Areas

•Allied Health Services (4)

Target Audience

•Health Care Providers (591)

•Health Care Executives and Administrators (847)

•Non-Health Care Professionals (444)

•Patients (59)

Setting of Care

•Hospitals (579)

•Psychiatric Facilities (4)

•Residential Facilities (27)

•Ambulatory Care (63)

•Outpatient Surgery (5)

•Patient Transport (7)

1 - 20 of 987

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AWARD RECIPIENT

Improving patient safety using interactive, evidence-based decision support tools.

Quinn MM, Mannion J. Jt Comm J Qual Patient Saf. 2005;31:678-683.

NEWSPAPER/MAGAZINE ARTICLE

Get me out alive.

Feldman R. The Washington Post. May 2, 2006:HE01.

AWARD RECIPIENT

2005 Quest for Quality Prize.

Runy LA. Hosp Health Netw. September 2005;79:67-75.

AWARD RECIPIENT

2006 Quest for Quality Prize.

Runy LA. Hosp Health Netw. September 2006.

NEWSPAPER/MAGAZINE ARTICLE

Pediatric safety.

Runy LA. Hosp Health Netw. May 2009.

NEWSPAPER/MAGAZINE ARTICLE

Saving lives: hospitals have signed on to a six-part plan to avoid a multitude of unnecessary deaths.

Comarow A. US News & World Report. July 18, 2005;139:74,76,79.

NEWSPAPER/MAGAZINE ARTICLE

How we cut drug errors.

Nicol N, Huminski L. Mod Healthc. August 28, 2006;36:38.

BOOK/REPORT

State of Healthcare 2006.

The Healthcare Commission. London, England: Commission for Healthcare Audit and Inspection; 2006. ISBN: 1845621182.

STUDY

A multidisciplinary approach to reduce central line–associated bloodstream infections.

McMullan C, Propper G, Schuhmacher C, et al. Jt Comm J Qual Patient Saf. 2013;39:61-69.

GRANT RECIPIENT

The MacArthur Fellows Program: Michael Cohen.

The John D. and Catherine T. MacArthur Foundation. September 20, 2005.

BOOK/REPORT classic

Safe Patients, Smart Hospitals: How One Doctor's Checklist Can Help Us Change Health Care from the Inside Out.

Pronovost P, Vohr E. New York, NY: Hudson Street Press; 2010. ISBN: 9781594630644.

AUDIOVISUAL

Eye to eye: Donald Berwick.

"Eye to Eye with Katie Couric." CBS News Video. February 6, 2007.

COMMENTARY

Disruptive clinician behavior: a persistent threat to patient safety.

Porto G, Lauve R. Patient Safety Qual Healthc. July/August 2006;3:16-24.

BOOK/REPORT classic

Josie's Story.

King S. New York, NY: Atlantic Monthly Press; 2009. ISBN: 9780802119209.

AUDIOVISUAL

Good News: How Hospitals Heal Themselves [documentary].

Washington, DC: CCM, Inc.; 2006. Crawford-Mason C (producer), Dobyns L (reporter); Management Wisdom Video Series.

STUDY

Variations in surgical outcomes associated with hospital compliance with safety practices.

Brooke BS, Dominici F, Pronovost PJ, Makary MA, Schneider E, Pawlik TM. Surgery. 2012;151:651-659.

COMMENTARY

Integrating CUSP and TRIP to improve patient safety.

Romig M, Goeschel C, Pronovost P, Berenholtz SM. Hosp Pract (Minneap). 2010;38:114-121.

BOOK/REPORT

Patient-Centered Care Improvement Guide.

Frampton S, Guastello S, Brady C, et al. Derby, CT: Planetree; Camden, ME: Picker Institute; 2008.

SPECIAL OR THEME ISSUE

Quality of Anesthesia Care.

Neuman MD, Martinez EA, eds. Anesthesiol Clin. 2011;29:1-178.

SPECIAL OR THEME ISSUE

Patient Safety.

Matlow A, Laxer RM, eds. Pediatr Clin North Am. 2006;53:1053-1267.

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