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.
Kotwal S, Fanai M, Fu W, et al. Diagnosis (Berl). 2021;8:489-496.
Previous studies have used virtual patient cases to help trainees and practicing physicians improve diagnostic accuracy. Using virtual patients, this study found that brief lectures combined with 9 hours of supervised deliberate practice improved the ability of medical interns to correctly diagnose dizziness.
Morgan DJ, Dhruva SS, Coon ER, et al. JAMA Intern Med. 2019;179:1568.
… JAMA Intern Med … Medical overuse has been described as a patient safety problem among both adult and pediatric … cause harm to patients. … Morgan DJ, Dhruva SS, Coon ER, Wright SM, Korenstein D. 2019 Update on Medical Overuse: A Review [published online ahead of print, 2019 Sep 9]. JAMA …
Ayyala MS, Rios R, Wright SM. JAMA. 2019;322:576-578.
Nearly 1 in 7 internal medicine residents reported being the victim of bullying during training. Of these, many described burnout as the most common consequence. Bullying is one example of disruptive and unprofessional behaviors that are known to affect patient safety.
Eid SM, Ponor L, Reed DA, et al. J Grad Med Educ. 2019;11:146-155.
Long work hours and fatigue among health care workers can adversely impact patient safety. In 2011, the Accreditation Council for Graduate Medical Education made changes to resident duty hours, but research on the effect of those reforms on resident wellness and patient safety remains somewhat inconclusive. In this retrospective observational study, researchers examined the impact of the 2011 duty hour reforms on patient mortality, length of stay, and cost using data on patients hospitalized in the 2-year periods before and after the work hour changes were implemented. Nonteaching hospitals served as the control group. They found no difference in mortality or length of stay but did find that cost associated with hospitalization decreased slightly at teaching hospitals after the 2011 changes. A past PSNet interview discussed the effect of less restrictive duty hours on patients and residents.
This retrospective cohort study examined diagnosis through simulated cases administered over an online platform. Attending and resident physicians had higher diagnostic accuracy scores than medical students. Diagnostic efficiency was better among attending physicians than resident physicians, interns, and medical students. The team also developed and validated a novel diagnostic performance measure combining these two constructs.
… outcomes. However, this analysis of medical admissions to a teaching hospital found indications of an opposite association. Analyzing admissions over a 6-year period, investigators found that a higher total patient census and a greater number of daily …
Harris CM, Sridharan A, Landis R, et al. J Patient Saf. 2013;9:150-3.
… of elderly patients discharged from the medical service at a teaching hospital found that, on average, patients had two … as previously prescribed and had discontinued taking a significant proportion of new medications. This study …
… safety is that residents who are excessively fatigued have a greater chance of committing errors that result in adverse … ResearchMedical College of Wisconsin, Milwaukee, WI … DarcyA. Reed, MD, MPH … Associate Professor of … [go to PubMed] 8. Chang VY, Arora VM, Lev-Ari S, D'Arcy M, Keysar B. Interns overestimate the effectiveness of their …
This article discusses evidence surrounding the impact of resident duty hour limits on safety in health care.
Christopher P. Landrigan, MD, MPH, of Brigham and Women's Hospital has performed key studies on how sleep deprivation affects clinicians and strategies to mitigate such fatigue to improve patient safety, including seminal articles published in the New England Journal of Medicine in 2004 and 2010.
Antiel RM, Reed DA, Van Arendonk K, et al. JAMA Surg. 2013;148:448-55.
Recent research has examined residents' perceptions about the impact of duty hour restrictions. In this survey, surgical interns reported decreased patient care coordination, continuity of care, and time spent in the operating room, with no significant improvements in quality of life or reduced risk of burnout.
Antiel RM, Van Arendonk K, Reed DA, et al. Arch Surg. 2012;147:536-41.
The duty hour regulations for resident physicians implemented in 2011 were intended to improve patient safety by minimizing resident fatigue. Teaching faculty evinced skepticism about the effect of these regulations from the outset, mirroring the frosty reception given to the 2003 regulations. Even residents themselves—who the regulations are intended to benefit—doubt the rules will achieve their goal. The majority of surgical residents surveyed in this study believe the regulations will result in greater discontinuity and more fragmented patient care and will harm their overall educational experience. Another recent survey of residents in multiple specialties noted similar findings, with the majority of residents disapproving of the new regulations. A systematic review of the 2003 duty hour regulations found no overall improvement in patient safety or educational outcomes after the rules were implemented.
Wittich CM, Reed DA, Drefahl MM, et al. Acad Med. 2011;86:737-41.
This study found that residents’ reflections on improvement opportunities were stable over their 3-year training period, lower for systems reflections than for personal ones, and associated with the preventability of adverse events.
Fletcher KE, Reed DA, Arora V. J Gen Intern Med. 2011;26:907-919.
This systematic review of the effect of physician duty hour regulations found that the regulations were associated with improved resident well-being, but had mixed effects on resident educational outcomes and clinical outcomes.
Szostek JH, Wieland ML, Loertscher LL, et al. Am J Med. 2010;123:663-668.
… Am. J. Med. … Am J Med … Morbidity and Mortality (M&M) conferences are designed to explore systems that … teach important principles of quality and safety through a variety of different frameworks . This study shares a …