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The PSNet Collection: All Content

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.

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Displaying 1 - 1 of 1 Results
Harms-Ringdahl L. Safety. 2021;7:19.
The primary purpose of incident reporting and analysis is to propose safety reforms. This study reviewed three sets of event investigations (one from industrial companies and two from hospitals) using two methods of investigation (in-depth or root cause analysis). In-depth analysis resulted in more suggestions for reform targeted at the federal, regional, health system, or department level. Root cause analysis resulted in suggestions at the department or ward level. The authors conclude there is room for improvement in  in the management and performance of event investigations in the healthcare sector.