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Lee MJ. Clin Orthop Relat Res. 2013-2017.
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 work hour reforms. Older materials are available online for free.
Effects of the I-PASS nursing handoff bundle on communication quality and workflow.
Starmer AJ, Schnock KO, Lyons A, et al. BMJ Qual Saf. 2017 Jul 5; [Epub ahead of print].
Effectiveness of pharmacist intervention to reduce medication errors and health-care resources utilization after transitions of care: a meta-analysis of randomized controlled trials.
De Oliveira GS Jr, Castro-Alves LJ, Kendall MC, McCarthy R. J Patient Saf. 2017 Jun 30; [Epub ahead of print].
Safe practice recommendations for the use of copy-forward with nursing flow sheets in hospital settings.
Patterson ES, Sillars DM, Staggers N, et al. Jt Comm J Qual Patient Saf. 2017;8:375–385.
Intraoperative handoffs among anesthesia providers increase the incidence of documentation errors for controlled drugs.
Epstein RH, Dexter F, Gratch DM, Lubarsky DA. Jt Comm J Qual Patient Saf. 2017;43:396-402.
Diagnostic Overshadowing Dangers
Maria C. Raven, MD, MPH, MSc
Handoffs and Signouts
Implementation of a modified bedside handoff for a postpartum unit.
Wollenhaup CA, Stevenson EL, Thompson J, Gordon HA, Nunn G. J Nurs Adm. 2017;47:320-326.
Readmissions and Adverse Events After Discharge
Mortality risks associated with emergency admissions during weekends and public holidays: an analysis of electronic health records.
Walker AS, Mason A, Quan TP, et al. Lancet. 2017;390:62-72.
Introducing a new junior doctor electronic weekend handover on an orthopaedic ward.
Maroo S, Raj D. BMJ Qual Improv Rep. 2017;6:u212695.w5059.
Improving patient safety in handover from intensive care unit to general ward: a systematic review.
Wibrandt I, Lippert A. J Patient Saf. 2017 Apr 27; [Epub ahead of print].
Quality of handoffs in community pharmacies.
Abebe E, Stone JA, Lester CA, Chui MA. J Patient Saf. 2017 Apr 27; [Epub ahead of print].
Beyond medication reconciliation: the correct medication list.
Rose AJ, Fischer SH, Paasche-Orlow MK. JAMA. 2017;317:2057-2058.
A quality improvement approach to standardization and sustainability of the hand-off process.
Fryman C, Hamo C, Raghavan S, Goolsarran N. BMJ Qual Improv Rep. 2017;6:u222156.w8291.
Measuring to improve medication reconciliation in a large subspecialty outpatient practice.
Kern E, Dingae MB, Langmack EL, Juarez C, Cott G, Meadows SK. Jt Comm J Qual Patient Saf. 2017;43:212-223.
A systematic review of the prevalence and types of adverse events in interfacility critical care transfers by paramedics.
Alabdali A, Fisher JD, Trivedy C, Lilford RJ. Air Med J. 2017;36:116-121.
High-reliability and the I-PASS communication tool.
Clements K. Nurs Manage. 2017;48:12-13.
Crossing the communication chasm: challenges and opportunities in transitions of care from the hospital to the primary care clinic.
Rattray NA, Sico JJ, Cox LM, Russ AL, Matthias MS, Frankel RM. Jt Comm J Qual Patient Saf. 2017;43:127-137.
Exploring physician perspectives of residency holdover handoffs: a qualitative study to understand an increasingly important type of handoff.
Duong JA, Jensen TP, Morduchowicz S, Mourad M, Harrison JD, Ranji SR. J Gen Intern Med. 2017;32:654-659.
Improving communication with primary care physicians at the time of hospital discharge.
Destino LA, Dixit A, Pantaleoni JL, et al. Jt Comm J Qual Patient Saf. 2017;43:80-88.
Improving physician's hand over among oncology staff using standardized communication tool.
Alolayan A, Alkaiyat M, Ali Y, Alshami M, Al-Surimi K, Jazieh AR. BMJ Qual Improv Rep. 2017;6:u211844.w6141.
Year-end resident clinic handoffs: narrative review and recommendations for improvement.
Pincavage AT, Donnelly MJ, Young JQ, Arora VM. Jt Comm J Qual Patient Saf. 2017;43:71-79.
Large-scale implementation of the I-PASS handover system at an academic medical centre.
Shahian DM, McEachern K, Rossi L, Chisari RG, Mort E. BMJ Qual Saf. 2017 Mar 9; [Epub ahead of print].
A QI initiative: implementing a patient handoff checklist for pediatric hospitalist attendings.
Lo HY, Mullan PC, Lye C, Gordon M, Patel B, Vachani J. BMJ Qual Improv Rep. 2016;5:u212920.w5661.
Patient safety in community dementia services: what can we learn from the experiences of caregivers and healthcare professionals?
Behrman S, Wilkinson P, Lloyd H, Vincent C. Age Ageing. 2016 Dec 7; [Epub ahead of print].
PSNET: Patient Safety Network
PSNet is produced for the Agency for Healthcare Research and Quality by a team of editors at the University of California, San Francisco with guidance from a prominent Technical Expert/Advisory Panel. The AHRQ PSNet site was designed and implemented by Silverchair.
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