The AHRQ PSNet Collection comprises an extensive selection of resources relevant to the patient safety community. These resources come in a variety of formats, including literature, research, tools, and Web sites. Resources are identified using the National Library of Medicine’s Medline database, various news and content aggregators, and the expertise of the AHRQ PSNet editorial and technical teams.
Patient safety has been described as an unmet need in physician training. This special issue covers areas of focus for a patient safety curriculum drawn from experience in the German medical education system. Topics covered include human error, blame, and responsibility. Articles also review the epidemiology of common problems such as medication safety, organizational contributors to failure, and diagnostic error.
Boonyasai RT, Ijagbemi OM, Pham JC, et al. Rockville, MD: Agency for Healthcare Research and Quality; December 2014. AHRQ Publication No. 14(15)-0067-EF.
This report analyzes the literature discussing emergency department discharge processes and highlights elements of high-quality discharges and risk factors for suboptimal discharges. The in-depth review summarizes interventions currently implemented to augment discharge procedures, care coordination, and the identification of patients more susceptible to poor discharge.
… disclosure . … J Public Health Res. 2013;2:e22-e33. … AW … DJ … G … KM … O … S … PR … JT … I … MC … H … JC … T … PJ … JR … J … BH … JV … AF … E … T … Wu … Boyle … Wallace … Mazor … Guillod … … … Pronovost … Clarke … Carthey … Spitzberg … Petrocelli … Hannawa … Kelley … Manser … AWWu … DJ Boyle … G Wallace … KM …
Plebani M, ed. Clinica Chimica Acta. 2009;404(1):1-86.
… 2009;404(1):1-86. … O' Kane M; Da Rin G … LL … L … C … AW … A … G … F … M … LH … IM … MT … G … O … M … MM … S … M … R … E … P … ML … C … L … Leape … McCay … Lemer … Wu … Ghirardini … Murolo … Palumbo … Plebani … Hilborne … … … Ponzetti … Sciacovelli … LL Leape … L McCay … C Lemer … AWWu … A Ghirardini … G Murolo … F Palumbo … M Plebani … LH …
Skapik JL; Pronovost PJ; Miller MR; Thompson DA; Wu AW.
The Intensive Care Unit Safety Reporting System (ICUSRS) is a model incident reporting system that has been used to analyze and improve safety for ICU patients in prior research. This study used ICUSRS data to characterize the types of adverse events suffered by pediatric and neonatal ICU patients. In contrast to a prior study, the most common types of errors involved medications and procedural complications. The authors discuss methods, such as checklists, that could be used to address the safety issues identified in this study.
… may lead to data-generated improvements in care. … WuAW, Holzmueller CG, Lubomski LH, et al. J Patient Saf. 2005;1(1):23-32. … AW … CG … LH … DA … M … T … LL … L … F … DM … PJ … Wu … …
A unique and authoritative introduction to the field of patient safety. This article draws on the expertise of many leaders in the field as each of them share their perspectives with short pieces on distinct topics. Readers will quickly gain insight into both the field and those responsible for some of the progress.