AHRQ Patient Safety Network

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Safety Target

•Device-related Complications (4)

•Diagnostic Errors (25)

•Identification Errors (11)

•Discontinuities, Gaps, and Hand-Off Problems (33)

•Fatigue and Sleep Deprivation (3)

•Medication Safety (44)

•Medical Complications (13)

•Nonsurgical Procedural Complications (2)

•Surgical Complications (15)

•Transfusion Complications (2)

•Psychological and Social Complications (10)

Origin/Sponsor
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Agency for Healthcare Research and Quality (AHRQ)

Resource Types

•Audiovisual (1)

•Book/Report (9)

•Journal Article (114)

•Meeting/Conference (3)

•Newspaper/Magazine Article (2)

•Press Release/Announcement (1)

•Special or Theme Issue (1)

•Tools/Toolkit (5)

•Web Resource (3)

Error Types

•Epidemiology of Errors and Adverse Events (12)

•Active Errors (65)

•Latent Errors (61)

•Near Miss (10)

Approach to Improving Safety

•Quality Improvement Strategies (45)

•Legal and Policy Approaches (9)

•Error Reporting and Analysis (30)

•Communication Improvement (56)

•Human Factors Engineering (28)

•Teamwork (12)

•Specialization of Care (12)

•Logistical Approaches (22)

•Culture of Safety (18)

•Technologic Approaches (50)

•Education and Training (40)

Clinical Areas

•Allied Health Services (1)

•Medicine (97)

•Nursing (34)

•Pharmacy (9)

Target Audience

•Health Care Providers (129)

•Health Care Executives and Administrators (66)

•Non-Health Care Professionals (61)

•Patients (5)

Setting of Care

•Hospitals (85)

•Residential Facilities (11)

•Ambulatory Care (21)

•Outpatient Surgery (1)

1 - 20 of 139

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COMMENTARY

Too Tight Control.

Rubin HR, Fajtova VT. AHRQ WebM&M [serial online]. May 2004.

COMMENTARY

On O.R. Off?

Leonard M. AHRQ WebM&M [serial online]. March 2005.

COMMENTARY

Gaba DM. AHRQ WebM&M [serial online]. October 2004.

COMMENTARY

Around the Block.

Minichiello T. AHRQ WebM&M [serial online]. March 2005.

COMMENTARY

Medication Overdose.

Kaushal R. AHRQ WebM&M [serial online]. April 2003.

STUDY

The effect of automated alerts on provider ordering behavior in an outpatient setting.

Steele AW, Eisert S, Witter J, et al. PLoS Medicine. 2005;2:e255.

COMMENTARY

Moved Too Soon.

Lindenauer P. AHRQ WebM&M [serial online]. October 2004.

STUDY

Computerized physician order entry with clinical decision support in the long-term care setting: insights from the Baycrest Centre for Geriatric Care.

Rochon PA, Field TS, Bates DW, et al. J Am Geriatr Soc. 2005;53:1780-1789.

COMMENTARY

Another Fall.

Bogardus ST Jr. AHRQ WebM&M [serial online]. April 2003.

STUDY

Indication-based prescribing prevents wrong-patient medication errors in computerized provider order entry (CPOE).

Galanter W, Falck S, Burns M, Laragh M, Lambert BL. J Am Med Inform Assoc. 2013;20:477-481.

STUDY

classic

Mixed results in the safety performance of computerized physician order entry.

Metzger J, Welebob E, Bates DW, Lipsitz S, Classen DC. Health Aff (Millwood). 2010;29:655-663.

STUDY

Improving acceptance of computerized prescribing alerts in ambulatory care.

Shah NR, Seger AC, Seger DL, et al. J Am Med Inform Assoc. 2006;13:5-11.

STUDY

classic

Role of computerized physician order entry systems in facilitating medication errors.

Koppel R, Metlay JP, Cohen A, et al. JAMA. 2005;293:1197-1203.

COMMENTARY

Bleeding Risk.

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

BOOK/REPORT classic

classic

Keeping Patients Safe: Transforming the Work Environment of Nurses.

Committee on the Work Environment for Nurses and Patient Safety, Board on Health Care Services, Page A, ed. Washington, DC: National Academies Press; 2004.

COMMENTARY

Electronic Err.

Tang PC. AHRQ WebM&M [serial online]. October 2004.

STUDY

Implementing a commercial rule base as a medication order safety net.

Reichley RM, Seaton TL, Resetar E, et al. J Am Med Inform Assoc. 2005;12:383-389.

COMMENTARY

The 2-Week Itch.

Cohen MR. AHRQ WebM&M [serial online]. April 2003.

MULTI-USE WEBSITE

Simulation Training for Rapid Assessment & Improved Teamwork (STRAIT) Project.

Center for Perioperative Research in Quality, Vanderbilt University.

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.

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