The PSNet Collection

Weber L, Jewett C. Kaiser Health News. 2021-2022.

The infectious nature of COVID continues to impact the safety of hospitalized patients. This article series examines factors contributing to hospital-acquired COVID-19 infection that include weaknesses in oversight, patient legal protections, and documentation.

Pharmacy Education and Practice.

Cohen M, Degnan D, McDonnell P, eds. Patient Saf J. 2022;4(s1):1-45

Pharmacists play a unique role in patient safety that educational methods are shifting to address. This special issue covers several topics including strategies to reduce the susceptibility of hospitalized infants and children to medication errors, and infusing safety culture into pharmacy school curriculum.

Patient Safety.

Dean J, Subbe C, eds. Future Healthc J. 2021;8(3):e559-e618.

Full realization of the patient voice as a resource for safety is challenging. This special section provides global perspectives examining cultural, organizational, and system-focused opportunities to fully use patient knowledge in improvement initiatives.

Diagnostic Excellence.

JAMA. 2021-2022.

Diagnostic excellence achievement is becoming a primary focus in health care. This article series covers diagnosis as it relates to the Institute of Medicine quality domains, clinical challenges, and priorities for improvement across the system.

Technology, Education and Safety.

Ruskin KJ, ed. Curr Opin Anaesthesiol. 2021;34(6):720-765

Anesthesia services are high risk despite progress made in the specialty to improve its safety. This special section covers issues that affect anesthesia safety such as critical incident debriefing, human factors, and educational strategies.

Diagnostic Excellence in the ICU: Thinking Critically and Masterfully.

Bergl PA, Nanchal RS, eds. Crit Care Clin. 2022;38(1):1-158.

Critical care diagnosis is complicated by factors such as stress, patient acuity and uncertainty. This special issue summarizes individual and process challenges to the safety of diagnosis in critical care. Articles included examine educational approaches, teamwork and rethinking care processes as improvement strategies.

Medicine's Shadowside: Revisiting Clinical Iatrogenesis.

Varley E, Varma S, eds. Anthropol Med. 2021;28(2);141-278.

Implicit biases are rooted in culture and context. This special issue examines a broad range of influences and impacts of medical harm enabled by societal acceptance of inequalities both within medicine and beyond it.

Empowering Patients and Supporting Health Care Providers—New Avenues for High Quality Care and Safety.

Rimondini M, Busch IM, eds. Int J Environ Res Public Health. 2021;18.

Patient/clinician relationships supported by organizational culture and individual wellness efforts are core to the provision of high-quality care and process improvement engagement. This article collection highlights trainee attitudes about patient safety and how respect and support for enhancing the care experience of both patients and those who care for them are foundational to safe, effective care.

The 2020 John M. Eisenberg Patient Safety and Quality Awards.

Jt Comm J Qual Patient Saf. 2021;47(8):463-488.

The Eisenberg Award honors individuals and organizations who have made significant advancements in the pursuit of safe, high-quality health care. The 2020 honorees are Dr. David Gaba; Veterans Health Administration Rapid Naloxone Initiative, Washington, DC, and Northwestern Medicine Academy for Quality and Safety Improvement, Chicago IL.

Intravenous admixture preparation considerations, Parts 9-A and 9-B: error prevention in intravenous admixture preparation.

Allen LV, Jr. Int J Pharm Compd. 2021;25:131-139; 222-229.

Intravenous admixture compounding is a complex activity that harbors risks for patients and health care staff. This two-part series reviews the types of errors that compromise the safety of compounding practices, steps in the process where they occur and prevention tactics.

Safety and Quality in Perioperative Anaesthesia Care.

Preckel B, ed. Best Pract Res Clin Anaesthesiol. 2021;35(1):1-154.

Surgical patients are at high risk for harm, should errors occur. This special issue covers areas of concern in perioperative anesthesia care that include patient allergies, age, sex and gender considerations, and incident reporting system effectiveness.

Patient Safety/Quality Improvement Primer: Parts I, II and III.

Otolaryngol Head Neck Surg. 2018-2021.

Otolaryngology-head and neck surgery is vulnerable to wrong site errors and other challenges present in surgical care. This series of articles highlights key areas of importance for the specialty as they work to enhance patient safety. The 2021 installment covers the role of simulation.

Medical Residents and Burnout

Coverdale J, West CP, Roberts LW, eds. Acad Med. 2021;96(5):611-769;e14-e21.

Medical training is a demanding experience that impacts a learner’s ability to provide safe care, cope, and remain healthy. This issue covers a range of topics exploring the mental health consequences of residency, factors influencing well-being, and approaches to help individuals successfully navigate the stress of residency.

Safety and Quality in Perioperative Anesthesia Care.

Preckel B, ed. Best Pract Res Clin Anaesthesiol. 2021;35(1):1-154.

The field of anesthesiology has realized impressive improvements in safety, yet challenges still exist in its practice. This special issue provides discussions on a variety of concerns that require continued effort, including use of early warning scores, differences associated with sex and gender, and use of incident reporting systems.

Quality and Safety in Health Care.

Harolds JA, Harolds LB. Clin Nucl Med. 2015–2021.

This monthly commentary explores a wide range of subjects associated with patient safety, such as infection prevention, surgical quality improvement, and high reliability organizations.

Human Factors and Ergonomics in Healthcare.

Carayon P, Hignett S, Albolino S eds. Int J Qual Health Care. 2021;33(Supp1):1-71.

Human factors approaches have been identified as one of the primary vehicles to create lasting patient safety innovation. Articles in this special supplement examine the role of human factors engineering and ergonomics in establishing improvement in organizational learning, pandemic response, and primary care management.

On Patient Safety.

Rickert J, Lee MJ. Clin Orthop Relat Res. 2013-2021.

This quarterly commentary explores a wide range of subjects associated with patient safety, such as the impact of disruptive behavior on teams, the value of apologies, and safety challenges due to COVID-19. Older materials are available online for free.

COVID-19 Content. ISMP Medication Safety Alert!

March 2020--January 2021.

Medication safety is improved through the sharing of frontline improvement experiences and concerns. These articles share recommendations to reduce risks associated with distinct areas of the medication use process. The topics discuss areas that require specific attention during the COVID-19 pandemic such as the use of smart pumps and automated dispensing cabinets.

Two decades since To Err Is Human: progress, but still a "chasm".

Dzau VJ, Shine KI. JAMA. 2020;324(24):2489-2490.

To Err is Human and Crossing the Quality Chasm changed the trajectory of improvement efforts worldwide. This editorial and the associated viewpoints outline the impact of the reports on global, COVID-19, anesthesiology, and ambulatory care.

Patient Safety

Zheng F ed. Surg Clin North Am. 2021;101(1):1-160.

Surgical safety is a recognized area of emphasis in patient safety improvement. Articles in this special issue cover topics such as human factors, checklists, teamwork, and telemedicine as a safe support mechanism.

All Content

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

All Content

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

PSNet Log in

Provide Feedback Anonymously

Submit Your Case

Continue as a Guest

Continue Logged In

Submit Your Case

Continue as a Guest

Already have a PSNet

Account?

New Users