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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 - 20 of 22 Results

Feske-Kirby K, Whittington J, McGaffigan P. Boston, MA: Institute for Healthcare Improvement; 2022.

The potential of machine learning to improve care and safety is emerging as its application increases across health care. This report examines how machine learning can improve activities such as risk identification and prediction. It also discusses barriers to its use such as workload, expertise gaps, and system integration.

Laderman M, Renton M. Boston, MA: Institute for Healthcare Improvement; 2020.

Maternal care safety is challenged by operational, public health and individual provider limitations. The report outlines specific areas of concern for rural hospitals and suggests avenues for improvement. Strategies suggested using simulation to prepare staff and training on implicit bias.
Scoville R, Little K, Rakover J, et al. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2016.
… in clinicians' daily work over time. … Scoville R, Little K, Rakover J, et al. Cambridge, Massachusetts: Institute for Healthcare … R … KJKK … Scoville … Little … Rakover … Luther … Mate … R Scoville … K Little … J Rakover … K Luther … K Mate
Faherty LJ, Mate KS, Moses JM. Acad Med. 2016;91:503-9.
Involving trainees in patient safety work can ground their development in quality improvement. This commentary discusses a three-level framework to engage trainees in quality improvement and patient safety work. The authors review insights regarding strengths and weaknesses of each level of the model and use scenarios to illustrate its use in hospitals.
Moriarty JP, Schiebel NE, Johnson MG, et al. Int J Qual Health Care. 2014;26:49-57.
Although effectiveness of rapid response teams has traditionally been measured by using rates of cardiac arrests or intensive care unit transfers, this study advocates for using the AHRQ failure to rescue metric instead. Failure to rescue rates declined in the second year after implementation of the rapid response team in concert with increased utilization of the team.

Patel VL, Kahol K, Buchman T, eds. J Biomed Inform. 2011;44:385-506.   

… clinical workflow, and decision making. … Patel VL, Kahol K, Buchman T, eds. J Biomed Inform. 2011;44:385-506.    … K … … … T … Z … M … DJ … A … J … L … PP … J … OD … ED … M … CM … TK … C … Y … V … TR … N … B … A … C … T … K … A … B … CM … S … Jonker … Dankelman … James … Godlewski … Shubina … Coley … Gandhi … Broverman … Liu … Nguyen … Johnson … Okafor … King … …

Health Aff (Millwood). 2011;30(4):554-800.  

This special issue contains articles on progress made in patient safety since the landmark Institute of Medicine report, Crossing the Quality Chasm.
J Am Med Inform Assoc. 2007 Jan-Feb;14(1):25-75
… order sets and decision support programs with CPOE. … J Am Med Inform Assoc. 2007 Jan-Feb;14(1):25-75 … Nebeker JJR … PA … DW … GJ … AM … TH … AJ … TK … G … DC … Y … J … DC … DC … D … A … WN … WP … GP … M … CR … B … F … Gross … Bates … Kuperman … Bobb … Payne … Avery … Gandhi … Burns … Classen … Ko … Abarca … Malone … Dare … …
Perspective on Safety July 1, 2006
… Trustee. 2003;56:17-20. [ go to PubMed ] 2. Reason J. Managing the Risks of Organizational Accidents. Aldershot, … A, Graydon-Baker E, Neppl C, Simmonds T, Gustafson M, Gandhi TK. Patient Safety Leadership WalkRounds. Jt Comm J Qual Saf. …
One of the most important interventions is for hospital leadership to get the hospital's board involved with safety and quality. Not only does the board have fiduciary responsibility for the organization, but they have responsibility for quality and safety...
Allan Frankel, MD, is Director of Patient Safety for Partners HealthCare, the merged entity of Harvard hospitals and clinics that includes Massachusetts General and Brigham and Women's Hospital. Dr. Frankel, an anesthesiologist by training, has been a key member of the faculty of the Institute for Healthcare Improvement, co-chairing numerous Adverse Drug Events and Patient Safety Collaboratives. Dr. Frankel's work in patient safety focuses on leadership training, high reliability in health care, teamwork development, and cultural change. We asked Dr. Frankel to speak with us about developing a comprehensive patient safety program.