AHRQ Patient Safety Network

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Safety Target

•Device-related Complications (166)

•Diagnostic Errors (157)

•Identification Errors (103)

•Discontinuities, Gaps, and Hand-Off Problems (455)

•Fatigue and Sleep Deprivation (107)

•Medication Safety (1060)

•Medical Complications (524)

•Nonsurgical Procedural Complications (88)

•Surgical Complications (351)

•Transfusion Complications (19)

•Psychological and Social Complications (138)

Origin/Sponsor
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United States of America

•United States Federal Government (313)

•State Governments and Agencies (56)

Resource Types

•Audiovisual (58)

•Bibliography (3)

•Book/Report (281)

•Clinical Guideline (9)

•Journal Article (2620)

•Legislation/Regulation (62)

•Meeting/Conference (36)

•Newsletter/Journal (12)

•Newspaper/Magazine Article (551)

•Press Release/Announcement (30)

•Special or Theme Issue (60)

•Tools/Toolkit (80)

•Web Resource (129)

Error Types

•Epidemiology of Errors and Adverse Events (747)

•Active Errors (500)

•Latent Errors (249)

•Near Miss (60)

Approach to Improving Safety

•Quality Improvement Strategies (1007)

•Legal and Policy Approaches (504)

•Error Reporting and Analysis (1075)

•Communication Improvement (935)

•Human Factors Engineering (452)

•Teamwork (310)

•Specialization of Care (306)

•Logistical Approaches (315)

•Culture of Safety (605)

•Technologic Approaches (715)

•Education and Training (751)

Clinical Areas

•Allied Health Services (9)

•Dentistry (2)

•Medicine (2526)

•Nursing (270)

•Pharmacy (409)

Target Audience

•Health Care Providers (2838)

•Health Care Executives and Administrators (3078)

•Non-Health Care Professionals (1534)

•Patients (400)

Setting of Care

•Hospitals (2672)

•Psychiatric Facilities (14)

•Residential Facilities (66)

•Ambulatory Care (371)

•Outpatient Surgery (40)

•Patient Transport (21)

1 - 20 of 3989

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STUDY

The association between night or weekend admission and hospitalization-relevant patient outcomes.

Khanna R, Wachsberg K, Marouni A, Feinglass J, Williams MV, Wayne DB. J Hosp Med. 2011;6:10-14.

BOOK/REPORT

Health Care Leader Action Guide to Reduce Avoidable Readmissions.

Osei-Anto A, Joshi M, Audet AJ, Berman A, Jencks SF. New York, NY: The Commonwealth Fund, The John Hartford Foundation, Health Research and Educational Trust; January 25, 2010.

COMMENTARY

Early warning systems: the next level of rapid response.

Duncan KD, McMullan C, Mills BM. Nursing. 2012;42:38-44.

STUDY

Impact of a statewide intensive care unit quality improvement initiative on hospital mortality and length of stay: retrospective comparative analysis.

Lipitz-Snyderman A, Steinwachs D, Needham DM, Colantuoni E, Morlock LL, Pronovost PJ. BMJ. 2011;342:d219.

AWARD RECIPIENT

Announcing 2009 Leapfrog top hospitals.

Washington, DC: Leapfrog Group; December 4, 2009.

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

A reengineered hospital discharge program to decrease rehospitalization: a randomized trial.

Jack BW, Chetty VK, Anthony D, et al. Ann Intern Med. 2009;150:178-187.

BOOK/REPORT

Health Care Leaders Action Guide: Hospital Strategies for Reducing Preventable Mortality.

Chicago, IL: Health Research & Educational Trust; March 2011.

MEASUREMENT TOOL/INDICATOR

2011 ISMP Medication Safety Self Assessment for Hospitals.

Horsham, PA: Institute for Safe Medication Practices; April 2011.

STUDY

The impact of resident duty hour reform on hospital readmission rates among Medicare beneficiaries.

Press MJ, Silber JH, Rosen AK, et al. J Gen Intern Med. 2011;26:405-411.

REVIEW

Interdisciplinary teamwork in hospitals: a review and practical recommendations for improvement.

O'Leary KJ, Sehgal NL, Terrell G, Williams MV; High Performance Teams and the Hospital of the Future Project Team. J Hosp Med. 2011 Oct 31; [Epub ahead of print].

STUDY

A review of verbal order policies in acute care hospitals.

Wakefield DS, Wakefield BJ, Despins L, et al. Jt Comm J Qual Patient Saf. 2012;38:24-33.

NEWSPAPER/MAGAZINE ARTICLE

Have you M.E.T. the future of better patient safety?

Larson L. Trustee. September 2005;58:6-10.

NEWSPAPER/MAGAZINE ARTICLE

Hospitals boost patients' power as advisers.

Landro L. Wall Street Journal. August 8, 2007:D1.

BOOK/REPORT

Tennessee Center for Patient Safety Annual Report 2010.

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

REVIEW

classic

"July Effect": impact of the academic year-end changeover on patient outcomes. A systematic review.

Young JQ, Ranji SR, Wachter RM, Lee CM, Niehaus B, Auerbach AD. Ann Intern Med. 2011;155:309-315.

COMMENTARY

Learning accountability for patient outcomes.

Pronovost PJ. JAMA. 2010;304:204-205.

BOOK/REPORT

Hospital Reporting Program.

Portland, OR: Oregon Patient Safety Commission.

NEWSPAPER/MAGAZINE ARTICLE

How has the current economy affected patient safety?

ISMP Medication Safety Alert! Acute Care Edition. September 10, 2009;14:1-2.

STUDY

classic

The relationship between patients' perception of care and measures of hospital quality and safety.

Isaac T, Zaslavsky AM, Cleary PD, Landon BE. Health Serv Res. 2010;45:1024-1040.

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