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Citations Database Search Results

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259 records found for:
Title = Patient Safety
Year =

  1. Preston-Suni K, Celedon MA, Cordasco KM. Patient Safety and Ethical Implications of Health Care Sick Leave Policies in the Pandemic Era. Joint Commission Journal on Quality and Patient Safety. 2021 Oct 1; 47(10):673-676.
  2. Fauer A, Wright N, Lafferty M, Harrod M, Manojlovich M, Friese CR. Influences of Physical Layout and Space on Patient Safety and Communication in Ambulatory Oncology Practices: A Multisite, Mixed Method Investigation. HERD. 2021 Jun 25; 19375867211027498.
  3. Datta R, Barrett A, Burk M, Salone C, Au A, Cunningham F, Fisher A, Dembry LM, Akgün KM. Surveillance of adverse drug events associated with tocilizumab in hospitalized veterans with coronavirus disease 2019 (COVID-19) to inform patient safety and pandemic preparedness. Infection control and hospital epidemiology. 2021 May 14; 1-4.
  4. Mull HJ, Rosen AK, Charns MP, Itani KMF, Rivard PE. Identifying Risks and Opportunities in Outpatient Surgical Patient Safety: A Qualitative Analysis of Veterans Health Administration Staff Perceptions. Journal of Patient Safety. 2021 Apr 1; 17(3):e177-e185.
  5. Singh H, Carayon P. A Roadmap to Advance Patient Safety in Ambulatory Care. JAMA. 2020 Dec 22; 324(24):2481-2482.
  6. Ziemba JB, Tessier CD, Harris AM. Patient safety education and perceptions of safety culture in American and Canadian urological residency training programs. The Canadian Journal of Urology. 2020 Dec 1; 27(6):10431-10436.
  7. Hannawa AF, Spitzberg BH, Childress MD, Frankel RM, Pham JC, Wu AW. Communication science lessons for patient safety and quality care. Journal of Patient Safety and Risk Management. 2020 Oct 27; 25(5):doi.org/10.1177/2516043520926424.
  8. Keating JA, McKinley L, Safdar N. Coronavirus disease 2019 (COVID-19) and antibiotic stewardship: Using a systems engineering approach to maintain patient safety. Infection control and hospital epidemiology. 2020 Oct 12; 1-3.
  9. George J, Parker VA, Sullivan JL, Greenan MA, Chan J, Shin MH, Chen Q, Shwartz M, Rosen AK. How hospitals select their patient safety priorities: An exploratory study of four Veterans Health Administration hospitals. Health care management review. 2020 Oct 1; 45(4):E56-E67.
  10. Grubenhoff JA, Ziniel SI, Cifra CL, Singhal G, McClead RE, Singh H. Pediatric Clinician Comfort Discussing Diagnostic Errors for Improving Patient Safety: A Survey. Pediatric quality & safety. 2020 Mar 1; 5(2):e259.
  11. Greeley AM, Tanner EP, Mak S, Begashaw MM, Miake-Lye IM, Shekelle PG. Sitters as a Patient Safety Strategy to Reduce Hospital Falls: A Systematic Review. Annals of internal medicine. 2020 Mar 3; 172(5):317-324.
  12. Skokan AJ, Dobbs RW, Harris AM, Tessier CD, Sajadi KP, Talwar R, Berger I, Guzzo TJ, Ziemba JB. Implementing a patient safety culture survey to identify and target process improvements in academic ambulatory urology practices: a multi-institutional collaborative. The Canadian Journal of Urology. 2020 Feb 1; 27(1):10087-10092.
  13. Kravet S, Bhatnagar M, Dwyer M, Kjaer K, Evanko J, Singh H. Prioritizing Patient Safety Efforts in Office Practice Settings. Journal of Patient Safety. 2019 Dec 1; 15(4):e98-e101.
  14. Stocking JC, Utter GH, Drake C, Aldrich JM, Ong MK, Amin A, Marmor RA, Godat L, Cannesson M, Gropper MA, Romano PS. Postoperative respiratory failure: An update on the validity of the Agency for Healthcare Research and Quality Patient Safety Indicator 11 in an era of clinical documentation improvement programs. American journal of surgery. 2020 Jul 1; 220(1):222-228.
  15. Borzecki AM, Rosen AK. Is there a 'best measure' of patient safety?. BMJ quality & safety. 2020 Mar 1; 29(3):185-188.
  16. Saint S, Meddings J, Fowler KE, Vaughn VM, Ameling JM, Rohde JM, Popovich KJ, Calfee DP, Krein SL, Chopra V. The Guide to Patient Safety for Health Care-Associated Infections. Annals of internal medicine. 2019 Oct 1; 171(7_Suppl):S7-S9.
  17. Bates DW, Singh H. Patient Safety As A Priority: The Authors Reply. Health affairs (Project Hope). 2019 Apr 1; 38(4):693.
  18. Bates DW, Singh H. Priorities in Patient Safety: The Authors Reply. Health Informatics Journal. 2019 Feb 4; 38(2):https://doi.org/10.1377/hlthaff.2018.05376.
  19. Bates DW, Singh H. Priorities In Patient Safety: The Authors Reply. Health affairs (Project Hope). 2019 Feb 1; 38(2):330.
  20. Sittig DF, Wright A, Coiera E, Magrabi F, Ratwani R, Bates DW, Singh H. Current challenges in health information technology-related patient safety. Health Informatics Journal. 2020 Mar 1; 26(1):181-189.
  21. Bates DW, Singh H. Two Decades Since To Err Is Human: An Assessment Of Progress And Emerging Priorities In Patient Safety. Health affairs (Project Hope). 2018 Nov 1; 37(11):1736-1743.
  22. Brauner D, Werner RM, Shippee TP, Cursio J, Sharma H, Konetzka RT. Does Nursing Home Compare Reflect Patient Safety In Nursing Homes? Health affairs (Project Hope). 2018 Nov 1; 37(11):1770-1778.
  23. Giardina TD, Haskell H, Menon S, Hallisy J, Southwick FS, Sarkar U, Royse KE, Singh H. Learning From Patients' Experiences Related To Diagnostic Errors Is Essential For Progress In Patient Safety. Health affairs (Project Hope). 2018 Nov 1; 37(11):1821-1827.
  24. Manojlovich M, Hofer TP, Krein SL. Advancing Patient Safety Through the Clinical Application of a Framework Focused on Communication. Journal of Patient Safety. 2018 Oct 31.
  25. Watts BV, Williams L, Mills PD, Paull DE, Cully JA, Gilman SC, Hemphill RR. Curriculum Development and Implementation of a National Interprofessional Fellowship in Patient Safety. Journal of Patient Safety. 2018 Sep 1; 14(3):127-132.
  26. Schnipper JL, Mixon A, Stein J, Wetterneck TB, Kaboli PJ, Mueller S, Labonville S, Minahan JA, Burdick E, Orav EJ, Goldstein J, Nolido NV, Kripalani S. Effects of a multifaceted medication reconciliation quality improvement intervention on patient safety: final results of the MARQUIS study. BMJ quality & safety. 2018 Dec 1; 27(12):954-964.
  27. Jindai K, Goto M, MacKay K, Forrest GN, Musuuza J, Safdar N, Pfeiffer CD. Improving fluoroquinolone use in the outpatient setting using a patient safety initiative. Infection control and hospital epidemiology. 2018 Sep 1; 39(9):1108-1111.
  28. Borzecki AM, Chen Q, O'Brien W, Shwartz M, Najjar PA, Itani KMF, Rosen AK. The Patient Safety Indicator Perioperative Pulmonary Embolism or Deep Vein Thrombosis: Is there associated surveillance bias in the Veterans Health Administration? American journal of surgery. 2018 Nov 1; 216(5):974-979.
  29. Bereknyei Merrell S, Gaba DM, Agarwala AV, Cooper JB, Nevedal AL, Asch SM, Howard SK, Goldhaber-Fiebert SN. Use of an Emergency Manual During an Intraoperative Cardiac Arrest by an Interprofessional Team: A Positive-Exemplar Case Study of a New Patient Safety Tool. Joint Commission Journal on Quality and Patient Safety. 2018 Aug 1; 44(8):477-484.
  30. Shin MH, Rivard PE, Shwartz M, Borzecki A, Yaksic E, Stolzmann K, Zubkoff L, Rosen AK. Tailoring an educational program on the AHRQ Patient Safety Indicators to meet stakeholder needs: lessons learned in the VA. BMC health services research. 2018 Feb 14; 18(1):114.
  31. Sarkar U, McDonald K, Motala A, Smith P, Zipperer L, Wachter RM, Shanman R, Shekelle PG. Pragmatic Insights on Patient Safety Priorities and Intervention Strategies in Ambulatory Settings. Joint Commission Journal on Quality and Patient Safety. 2017 Dec 1; 43(12):661-670.
  32. Benzer JK, Meterko M, Singer SJ. The patient safety climate in healthcare organizations (PSCHO) survey: Short-form development. Journal of evaluation in clinical practice. 2017 Aug 1; 23(4):853-859.
  33. Meddings J, Reichert H, Greene MT, Safdar N, Krein SL, Olmsted RN, Watson SR, Edson B, Albert Lesher M, Saint S. Evaluation of the association between Hospital Survey on Patient Safety Culture (HSOPS) measures and catheter-associated infections: results of two national collaboratives. BMJ quality & safety. 2017 Mar 1; 26(3):226-235.
  34. Saint SK, Krein SL, Meddings J. Enhancing Patient Safety by Preventing Device-Associated Harm. [Cyberseminar]. 2017 Jan 12.
  35. Chen Q, Rosen AK, Borzecki A, Shwartz M. Using Harm-Based Weights for the AHRQ Patient Safety for Selected Indicators Composite (PSI-90): Does It Affect Assessment of Hospital Performance and Financial Penalties in Veterans Health Administration Hospitals? Health services research. 2016 Dec 1; 51(6):2140-2157.
  36. Russo E, Sittig DF, Murphy DR, Singh H. Challenges in patient safety improvement research in the era of electronic health records. Healthcare (Amsterdam, Netherlands). 2016 Dec 1; 4(4):285-290.
  37. Fletcher KE, Tyszka JT, Harrod M, Fowler KE, Saint S, Krein SL. Qualitative validation of the CAUTI Guide to Patient Safety assessment tool. American journal of infection control. 2016 Oct 1; 44(10):1102-1109.
  38. Shekelle PG, Sarkar U, Shojania K, Wachter RM, McDonald K, Motala A, Smith P, Zipperer L, Shanman R. Patient Safety in Ambulatory Settings. Technical Brief No. 27. (Prepared by the Southern California Evidence-based Practice Center under Contract No. 290-2015-00010-I.). Rockville (MD): Agency for Healthcare Research and Quality (US); 2016 Oct 1. 91 p. Report No.: 16(17)-EHC033-EF.
  39. Singh H. Improving patient safety through electronic communication. Paper presented at: ECRI Institute Meeting; 2016 Sep 16; Philadelphia, PA.
  40. George J, Elwy AR, Maguire EM, Baker E, Burgess JF, Charns MP, Meterko MM. Improving Patient Safety by Using Organizational Climate as a Leading Indicator to Assess Large-Scale Adverse Event Risk: Briefing before the VISN and Medical Center Chief Medical Officer/Chief of Staff/Quality Manager Group convened by the Assistant Deputy Undersecretary for Health for Clinical Operations (Virtual Briefing); 2016 Sep 12; Bedford, MA.
  41. Hansen M, Meckler G, O'Brien K, Engle P, Dickinson C, Dickinson K, Jui J, Lambert W, Cottrell E, Guise JM. Pediatric Airway Management and Prehospital Patient Safety: Results of a National Delphi Survey by the Children's Safety Initiative-Emergency Medical Services for Children. Pediatric emergency care. 2016 Sep 1; 32(9):603-7.
  42. Thom KA, Heil EL, Croft LD, Duffy A, Morgan DJ, Johantgen M. Advancing interprofessional patient safety education for medical, nursing, and pharmacy learners during clinical rotations. Journal of Interprofessional Care. 2016 Nov 1; 30(6):819-822.
  43. George J, Elwy AR, Maguire E, Baker E, Burgess JF, Charns MP, Meterko MM. Improving Patient Safety by Using Organizational Climate as a Leading Indicator to Assess Large-Scale Adverse Event Risk: Briefing before the VA Clinical Executive Review Board convened by the Assistant Deputy Undersecretary for Health for Clinical Operations (Virtual Briefing); 2016 Aug 1; Bedford, MA.
  44. Classen D, Singh H. The Role of Standards in Managing & Mitigating Health IT Patient Safety Risks. Paper presented at: Agency for Healthcare Research and Quality National Institute of Standards and Technology Annual Conference; 2016 Jul 25; Gaithersburg, MD.
  45. Singh H. Diagnostic Errors: A New Chapter in Patient Safety Improvement Science. Paper presented at: Australian Institute of Health Innovation Seminar Series; 2016 Jul 21; Sydney, Australia.
  46. Singh H. The Hazardous Intersection of Electronic Health Records and Patient Safety. Presented at: Louisiana Hospital Association Trust Funds Trends in Healthcare Risk Annual Seminar; 2016 Jul 14; Baton Rouge, LA.
  47. Singh H. Identification and Prioritization of Health IT Patient Safety Measures. Presented at: AcademyHealth Annual Research Meeting; 2016 Jun 27; Boston, MA.
  48. George J, Baker E, Burgess JF, Maguire EM, Elwy AR. Improving Patient Safety by Using Organizational Climate as a Leading Indicator to Assess Large-Scale Adverse Event Risk. Poster session presented at: AcademyHealth Annual Research Meeting; 2016 Jun 14; Boston, MA.
  49. Jindai K, Musuuza J, Forrest GN, MacKay K, Safdar N, Pfeiffer CD. Can a Patient Safety Initiative Change Outpatient Antibiotic Prescription Practice? Paper presented at: Society for Healthcare Epidemiology of America Spring Conference; 2016 May 18; Atlanta, GA.
  50. Hatoun J, Chan JA, Yaksic E, Greenan MA, Borzecki AM, Shwartz M, Rosen AK. A Systematic Review of Patient Safety Measures in Adult Primary Care. American journal of medical quality : the official journal of the American College of Medical Quality. 2017 May 1; 32(3):237-245.
  51. Singh H, Sittig DF. Measuring and improving patient safety through health information technology: The Health IT Safety Framework. BMJ quality & safety. 2016 Apr 1; 25(4):226-32.
  52. Chen Q, Shin MH, Chan JA, Sullivan JL, Borzecki AM, Shwartz M, Rivard PE, Hatoun J, Rosen AK. Partnering With VA Stakeholders to Develop a Comprehensive Patient Safety Data Display: Lessons Learned From the Field. American journal of medical quality : the official journal of the American College of Medical Quality. 2016 Mar 1; 31(2):178-86.
  53. Kohatsu N, Alexander M, Singh H. Advancing Patient Safety in the Outpatient Setting. Paper presented at: American College of Preventive Medicine Annual Conference; 2016 Feb 26; Washington, DC.
  54. Kachalia A, Mello MM, Nallamothu BK, Studdert DM. Legal and Policy Interventions to Improve Patient Safety. Circulation. 2016 Feb 16; 133(7):661-71.
  55. Belmont E, Singh H, Adelman J, Alexander G, Castro E, Classen D, Dimitropoulos L, Freeman L, Ghandi T, Gelzer A, Grace E, Haynes K, Langford LH, Hrlopcsak G, Jones J, Khunlertkit N, Marella W, Mendelsohn D, Russell J, Schneider E, Segal M, Zimmer KP. Identification and Prioritization of Health IT Patient Safety Measures: Final Report from the National Quality Forum Health IT Safety Committee. Washington, DC: National Quality Forum; 2016 Feb 11. 98 p.
  56. Rosen AK, Mull HJ. Identifying adverse events after outpatient surgery: improving measurement of patient safety. [Editorial]. BMJ quality & safety. 2016 Jan 1; 25(1):3-5.
  57. Singh H, Graber ML. Improving Diagnosis in Health Care--The Next Imperative for Patient Safety. The New England journal of medicine. 2015 Dec 24; 373(26):2493-5.
  58. King JP, McCarthy DM, Serper M, Jacobson KL, Mullen RJ, Parker RM, Wolf MS. Variability in Acetaminophen Labeling Practices: a Missed Opportunity to Enhance Patient Safety. Journal of medical toxicology : official journal of the American College of Medical Toxicology. 2015 Dec 1; 11(4):410-4.
  59. Russo E, Sittig DF, Murphy DR, Smith MW, Singh H. Challenges in Patient Safety Improvement Research in the Era of Electronic Health Records: Lessons from an AHRQ Funded Multi-Site Study. Paper presented at: Agency for Healthcare Research and Quality Annual Conference; 2015 Oct 6; Crystal City, VA.
  60. Singh H. Correct and Timely Clinical Diagnosis: An Emerging National Patient Safety Priority – Keynote Speaker. Paper presented at: VA Madison VA Hospital Research Day Annual Assembly; 2015 May 22; Madison, WI.
  61. Saint SK. Enhancing Patient Safety by Preventing Hospital-Acquired Infections. Paper presented at: Saint Francis Health System Grand Rounds; 2015 May 20; Tulsa, OK.
  62. Cowan LJ. Successful Comprehensive Staff Education and Maximizing Documentation/National Webinar. Pressure Ulcer Prevention VA Patient Safety Virtual Breakthrough Series 2015. [Cyberseminar]. 2015 May 13.
  63. Singh H, Allen JI. Patient safety counterpoint: systems approaches and multidisciplinary strategies at the centerpiece of error prevention. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. 2015 May 1; 13(5):824-6.
  64. Rubio DA, Stewart D, Hortstman M, Naik AD, Trautner B. Stop the Blame Game: Restructuring Morbidity and Mortality Conference to Teach Patient Safety and Quality Improvement to Internal Medicine Residents – finalist for poster competition. Paper presented at: Society of Hospital Medicine Annual Meeting; 2015 Mar 29; National Harbor, MD.
  65. Sittig DF, Classen DC, Singh H. Patient safety goals for the proposed Federal Health Information Technology Safety Center. Journal of the American Medical Informatics Association : JAMIA. 2015 Mar 1; 22(2):472-8.
  66. Elnitsky CA, Lind JD, Rugs D, Powell-Cope G. Implications for patient safety in the use of safe patient handling equipment: a national survey. International journal of nursing studies. 2014 Dec 1; 51(12):1624-33.
  67. Meeks DW, Meyer AN, Rose B, Walker YN, Singh H. Exploring new avenues to assess the sharp end of patient safety: an analysis of nationally aggregated peer review data. BMJ quality & safety. 2014 Dec 1; 23(12):1023-30.
  68. Shin MH, Sullivan JL, Rosen AK, Solomon JL, Dunn EJ, Shimada SL, Hayes J, Rivard PE. Examining the validity of AHRQ's patient safety indicators (PSIs): is variation in PSI composite score related to hospital organizational factors? Medical care research and review : MCRR. 2014 Dec 1; 71(6):599-618.
  69. Saint SK. The Art & Science of Leadership, Followership & Culture in enhancing Patient Safety. Paper presented at: Westfall Surgery Center Seminar; 2014 Nov 18; Rochester, NY.
  70. Meeks DW, Smith MW, Taylor L, Sittig DF, Scott JM, Singh H. An analysis of electronic health record-related patient safety concerns. Journal of the American Medical Informatics Association : JAMIA. 2014 Nov 1; 21(6):1053-9.
  71. Singh H, Sittig DF. An analysis of electronic health record-related patient safety concerns. 2014 Oct 23.
  72. Menon S, Smith M, Sittig DF, Petersen NJ, Hysong SJ, Modi V, Singh H. Defining the context of electronic health record (EHR)-based safe test result follow-up: perspectives of Veterans Affairs patient safety managers and IT personnel. Poster session presented at: Diagnostic Error in Medicine Annual International Conference; 2014 Sep 16; Atlanta, GA.
  73. Meyer A, Payne V, Singh H, Graber ML. Patient Safety and Healthcare Improvement at a Glance. In: Panesar S, Carson-Stevens A, Salvilla S, Sheikh A, editors. Diagnostic Errors. Chichester, United Kingdom: John Wiley & Sons, Ltd; 2014. 40-43 p.
  74. Rosen AK. Overview of the Agency for Healthcare Research and Quality Patient Safety Indicators. 2014 Jul 8.
  75. Chen Q, Hanchate A, Shwartz M, Borzecki AM, Mull HJ, Shin MH, Rosen AK. Comparison of the Agency for Healthcare Research and Quality Patient Safety Indicator Rates Among Veteran Dual Users. American journal of medical quality : the official journal of the American College of Medical Quality. 2014 Jul 1; 29(4):335-43.
  76. Saleem JJ, Frankel RM, Doebbeling BN, Patterson-Muterko S. Patterns in patient safety with computerized consult management and clinical documentation. [Abstract]. Human Factors and Ergonomics Society Annual Meeting Proceedings. 2014 Jun 1; 3(1):134-141.
  77. Menon S, Smith M, Sittig DF, Petersen NJ, Hysong SJ, Modi V, Singh H. Defining the Context of Electronic Health Record (EHR)-Based Safe Test Result Follow-Up: Perspectives of Veterans Affairs Patient Safety Managers and IT Personnel. Poster session presented at: Baylor College of Medicine Quality and Safety Annual Conference; 2014 May 15; Houston, TX.
  78. Mull HJ, Borzecki AM, Chen Q, Shin MH, Rosen AK. Using AHRQ patient safety indicators to detect postdischarge adverse events in the Veterans Health Administration. American journal of medical quality : the official journal of the American College of Medical Quality. 2014 May 1; 29(3):213-9.
  79. Saint S, Gaies E, Fowler KE, Harrod M, Krein SL. Introducing a catheter-associated urinary tract infection (CAUTI) prevention guide to patient safety (GPS). American journal of infection control. 2014 May 1; 42(5):548-50.
  80. Singh H, Smith MW, Sittig DF. Supporting the Assessment of Electronic Health Records to Improve Patient Safety. [Newsletter]. 2014 May 1; (6).
  81. Schnipper J, Kripalani S, Stein J, Wetterneck TB, Kaboli PJ, Mueller S, Salanitro A, Minahan JA, Nolido NV, Burdick E. The Effects of a Multi-Faceted Medication Reconciliation Quality Improvement Intervention on Patient Safety: Preliminary Results of the MARQUIS Study. Paper presented at: Society of General Internal Medicine Annual Meeting; 2014 Apr 24; San Diego, CA.
  82. Mull HJ, Borzecki AM, Loveland S, Hickson K, Chen Q, MacDonald S, Shin MH, Cevasco M, Itani KM, Rosen AK. Detecting adverse events in surgery: comparing events detected by the Veterans Health Administration Surgical Quality Improvement Program and the Patient Safety Indicators. American journal of surgery. 2014 Apr 1; 207(4):584-95.
  83. Powell-Cope GM. Connecting Patient Safety and Worker Safety through Culture. Paper presented at: Safe Patient Handling and Movement Annual Conference; 2014 Mar 25; Orlando, FL.
  84. Krein SL. Enhancing Patient Safety by Preventing Catheter-Associated Urinary Tract Infection. [Cyberseminar]. 2014 Mar 4.
  85. Beadles CA, Hassmiller Lich K, Viera AJ, Greene SB, Brookhart MA, Weinberger M. A non-experimental study of oral anticoagulation therapy initiation before and after national patient safety goals. BMJ open. 2014 Feb 12; 4(2):e003960.
  86. Meeks DW, Takian A, Sittig DF, Singh H, Barber N. Exploring the sociotechnical intersection of patient safety and electronic health record implementation. Journal of the American Medical Informatics Association : JAMIA. 2014 Feb 1; 21(e1):e28-34.
  87. Meeks D, Takian A, Sittig DF, Singh H, Barber N. Sociotechnical Analysis of Patient Safety Concerns Involving Electronic Health Record Implementation. Poster session presented at: Kelsey Research Foundation Health Services and Outcomes Research Annual Conference; 2013 Dec 10; Houston, TX.
  88. Singh H. Becoming a Patient Safety Researcher. 2013 Dec 1.
  89. Saint SK. Enhancing Patient Safety by Disrupting the Lifecycle of the Urinary Catheter. Paper presented at: Greater New York Hospital Association Annual Meeting; 2013 Sep 17; New York, NY.
  90. Saint SK. Enhancing Patient Safety by Disrupting the Lifecycle of the Urinary Catheter. Paper presented at: Healthcare Association of New York State Meeting; 2013 Sep 16; Albany, NY.
  91. Hecht MI, McGlynn G, Singh H. Short Video-07: Diagnostic Errors and Patient Safety. 2013 Sep 1; 3(7).
  92. Borzecki AM, Cevasco M, Chen Q, Shin M, Itani KM, Rosen AK. Improving identification of postoperative respiratory failure missed by the patient safety indicator algorithm. American journal of medical quality : the official journal of the American College of Medical Quality. 2013 Jul 1; 28(4):315-23.
  93. Singh H. Center for Information and Education Resources (CIDER) Video on Patient Safety. 2013 Jun 25.
  94. Borzecki AM, Cevasco M, Mull H, Shin M, Itani K, Rosen AK. Improving the identification of postoperative wound dehiscence missed by the Patient Safety Indicator algorithm. American journal of surgery. 2013 Jun 1; 205(6):674-80.
  95. Chen Q, Borzecki AM, Cevasco M, Shin MH, Shwartz M, Itani KM, Rosen AK. Examining the relationship between processes of care and selected AHRQ patient safety indicators postoperative wound dehiscence and accidental puncture or laceration using the VA electronic medical record. American journal of medical quality : the official journal of the American College of Medical Quality. 2013 May 1; 28(3):206-13.
  96. Singh H. Safe and Effective Communication to Prevent Diagnostic Errors. Patient Safety & Quality Healthcare. Patient Safety & Quality Healthcare. 2013 May 1; 10(3):14-16.
  97. Apisarnthanarak A, Khawcharoenporn T, Greene MT, Kennedy E, Krein S, Saint S. National survey of Thai infection preventions in the era of patient safety. American journal of infection control. 2013 Apr 1; 41(4):362-4.
  98. Halpin HA, McMenamin SB, Simon LP, Jacobsen D, Vanneman M, Shortell S, Milstein A. Impact of participation in the California Healthcare-Associated Infection Prevention Initiative on adoption and implementation of evidence-based practices for patient safety and health care-associated infection rates in a cohort of acute care general hospitals. American journal of infection control. 2013 Apr 1; 41(4):307-11.
  99. Saint SK. Implementing Change: The Art and Science of Leaders, Followers, and Bundles in Enhancing Patient Safety. Paper presented at: Colorado Hospital Association Annual Meeting; 2013 Mar 6; Greenwood Village, CO.
  100. Miake-Lye IM, Hempel S, Ganz DA, Shekelle PG. Inpatient fall prevention programs as a patient safety strategy: a systematic review. Annals of internal medicine. 2013 Mar 5; 158(5 Pt 2):390-6.
  101. Shekelle PG. Nurse-patient ratios as a patient safety strategy: a systematic review. Annals of internal medicine. 2013 Mar 5; 158(5 Pt 2):404-9.
  102. Shekelle PG, Pronovost PJ, Wachter RM, McDonald KM, Schoelles K, Dy SM, Shojania K, Reston JT, Adams AS, Angood PB, Bates DW, Bickman L, Carayon P, Donaldson L, Duan N, Farley DO, Greenhalgh T, Haughom JL, Lake E, Lilford R, Lohr KN, Meyer GS, Miller MR, Neuhauser DV, Ryan G, Saint S, Shortell SM, Stevens DP, Walshe K. The top patient safety strategies that can be encouraged for adoption now. Annals of internal medicine. 2013 Mar 5; 158(5 Pt 2):365-8.
  103. Shekelle PG, Wachter RM, Pronovost P, Schoelles K, McDonald KM, Dy SM. Making Health Care Safer II: An Updated Critical Analysis of the Evidence for Patient Safety Practices. Rockville, MD: Agency for Healthcare Research and Quality (US); 2013 Mar 5. 945 p. Report No.: 13-E001-EF.
  104. Wachter RM, Pronovost P, Shekelle P. Strategies to improve patient safety: the evidence base matures. Annals of internal medicine. 2013 Mar 5; 158(5 Pt 1):350-2.
  105. Rivard PE, Parker VA, Rosen AK. Quality improvement for patient safety: project-level versus program-level learning. Health care management review. 2013 Jan 1; 38(1):40-50.
  106. Rosen AK, Loveland S, Shin M, Shwartz M, Hanchate A, Chen Q, Kaafarani HM, Borzecki A. Examining the impact of the AHRQ Patient Safety Indicators (PSIs) on the Veterans Health Administration: the case of readmissions. Medical care. 2013 Jan 1; 51(1):37-44.
  107. Sittig DF, Singh H. Electronic health records and patient safety (SAFER). Poster session presented at: Institute for Healthcare Improvement on Quality Improvement in Health Care National Forum; 2012 Dec 11; Orlando, FL.
  108. Scandrett KG, Anichini MA, Berdes C, Estabrook S, Boockvar K, Saliba D, Emanuel L, Taylor SL. Patient safety in the nursing home: how nursing staff assess and communicate about change in condition. Journal of gerontological nursing. 2012 Nov 1; 38(11):28-37; quiz 38-9.
  109. Shafer PO, Buelow JM, Noe K, Shinnar R, Dewar S, Levisohn PM, Dean P, Ficker D, Pugh MJ, Barkley GL. A consensus-based approach to patient safety in epilepsy monitoring units: recommendations for preferred practices. Epilepsy & Behavior : E&B. 2012 Nov 1; 25(3):449-56.
  110. Saint SK. Implementing Socio-Adaptive Change: Enhancing Patient Safety by Preventing CAUTI. Paper presented at: California Department of Public Health State Meeting; 2012 Oct 16; Los Angeles, CA.
  111. Gill AC, Nelson EA, Kathuria N, Singh H. Teaching patient safety to medical students: Lessons learned in the development, implementation and evaluation of a required UME course. Poster session presented at: University Health System Consortium; 2012 Sep 12; Orlando, FL.
  112. Singh H. The complex intersection of EHRs and patient safety. HIT forum - the Delhi Chapter of IAMI. Presented at: Indian Association for Medical Informatics Biennial Conference; 2012 Sep 3; New Delhi, India.
  113. Singh H. Health information technology related errors and their implications for patient safety. Poster session presented at: International Conference on Transforming Healthcare with Information Technology; 2012 Aug 31; Hyderabad, India.
  114. Smith EG, Zhao S, Rosen AK. Using the patient safety indicators to detect potential safety events among US veterans with psychotic disorders: clinical and research implications. International journal for quality in health care : journal of the International Society for Quality in Health Care. 2012 Aug 1; 24(4):321-9.
  115. Hoover D, Laxmisan A, Sittig D, Singh H. Research needs in health information technology safety based on case studies from the VA National Center for Patient Safety. Presented at: VA HSR&D National Meeting; 2012 Jul 16; Washington, DC.
  116. Mull HJ, Borzecki AM, Loveland S, Shin M, Chen Q, Rosen AK. Detecting Adverse Events with AHRQ Patient Safety Indicators: Assessing the Usefulness of Post-Discharge Administrative Data in the Veterans Health Administration. Poster session presented at: AcademyHealth Annual Research Meeting; 2012 Jun 24; Orlando, FL.
  117. Latlief G, Elnitsky C, Hart-Hughes S, Phillips SL, Adams-Koss L, Kent R, Highsmith MJ. Patient safety in the rehabilitation of the adult with an amputation. Physical Medicine and Rehabilitation Clinics of North America. 2012 May 1; 23(2):377-92.
  118. Powell-Cope GM. Intersection of Patient Safety and Staff Safety. Presented at: Safe Patient Handling and Movement Annual Conference; 2012 Mar 20; Orlando, FL.
  119. Saint SK. Implementing Change: Enhancing Patient Safety by Preventing Healthcare-Associated Infection. Paper presented at: Emory Healthcare Hospital Medicine Grand Rounds; 2012 Mar 6; Atlanta, GA.
  120. Rosen AK, Itani KM, Cevasco M, Kaafarani HM, Hanchate A, Shin M, Shwartz M, Loveland S, Chen Q, Borzecki A. Validating the patient safety indicators in the Veterans Health Administration: do they accurately identify true safety events? Medical care. 2012 Jan 1; 50(1):74-85.
  121. Carey K, Stefos T. Measuring the cost of hospital adverse patient safety events. Health economics. 2011 Dec 1; 20(12):1417-30.
  122. Saint S, Krein SL, Manojlovich M, Kowalski CP, Zawol D, Shojania KG. Introducing the patient safety professional: why, what, who, how, and where? Journal of Patient Safety. 2011 Dec 1; 7(4):175-80.
  123. Singh H, Classen DC, Sittig DF. Creating an oversight infrastructure for electronic health record-related patient safety hazards. Journal of Patient Safety. 2011 Dec 1; 7(4):169-74.
  124. Shin M, Borzecki A, Cevasco M, Shwartz M, Loveland S, Chen Q, Rosen AK. Admission Coding: Implications for Patient Safety Indicator Rates in the Veterans Health Administration. Presented at: AcademyHealth Annual Research Meeting; 2011 Jul 11; Seattle, WA.
  125. Dy SM, Taylor SL, Carr LH, Foy R, Pronovost PJ, Ovretveit J, Wachter RM, Rubenstein LV, Hempel S, McDonald KM, Shekelle PG. A framework for classifying patient safety practices: results from an expert consensus process. BMJ quality & safety. 2011 Jul 1; 20(7):618-24.
  126. Ovretveit JC, Shekelle PG, Dy SM, McDonald KM, Hempel S, Pronovost P, Rubenstein L, Taylor SL, Foy R, Wachter RM. How does context affect interventions to improve patient safety? An assessment of evidence from studies of five patient safety practices and proposals for research. BMJ quality & safety. 2011 Jul 1; 20(7):604-10.
  127. Taylor SL, Dy S, Foy R, Hempel S, McDonald KM, Ovretveit J, Pronovost PJ, Rubenstein LV, Wachter RM, Shekelle PG. What context features might be important determinants of the effectiveness of patient safety practice interventions? BMJ quality & safety. 2011 Jul 1; 20(7):611-7.
  128. Campbell DG, Bonner LM, Chaney EF, Felker BL, Sherman SE, Rubenstein LV. Suicide risk management: development and analysis of a telephone-based approach to patient safety. Translational behavioral medicine. 2011 Jun 29; 1(3):372-383.
  129. Taylor SL, Dy S, Foy RC, Hempel S, McDonald KM, Øvretveit J, Pronovost PJ, Rubenstein LV, Wachter RM, Shekelle PG. What context features might be important determinants of the effectiveness of patient safety practice interventions? Poster session presented at: AcademyHealth Annual Research Meeting; 2011 Jun 24; Seattle, WA.
  130. Borzecki AM, O'Brien W, Mull H, Chen Q, Loveland S, Cevasco M, Shin M, Rosen AK. Do the Patient Safety Indicators Postoperative Respiratory Failure and Postoperative Wound Dehiscence Miss True Events? Poster session presented at: AcademyHealth Annual Research Meeting; 2011 Jun 12; Seattle, WA.
  131. Sternke EA. The Mind-Body Connection and its Implications for Patient Safety for Patients with Comorbid Pain and Depression. Paper presented at: VA National Center for Patient Safety / VA Patient Safety Fellows Annual Conference; 2011 Jun 8; Washington, DC.
  132. Borzecki AM, Kaafarani H, Cevasco M, Hickson K, Macdonald S, Shin M, Itani KM, Rosen AK. How valid is the AHRQ Patient Safety Indicator "postoperative hemorrhage or hematoma"? Journal of the American College of Surgeons. 2011 Jun 1; 212(6):946-953.e1-2.
  133. Borzecki AM, Kaafarani HM, Utter GH, Romano PS, Shin MH, Chen Q, Itani KM, Rosen AK. How valid is the AHRQ Patient Safety Indicator "postoperative respiratory failure"? Journal of the American College of Surgeons. 2011 Jun 1; 212(6):935-45.
  134. Cevasco M, Borzecki AM, Chen Q, Zrelak PA, Shin M, Romano PS, Itani KM, Rosen AK. Positive predictive value of the AHRQ Patient Safety Indicator "Postoperative Sepsis": implications for practice and policy. Journal of the American College of Surgeons. 2011 Jun 1; 212(6):954-61.
  135. Cevasco M, Borzecki AM, McClusky DA, Chen Q, Shin MH, Itani KM, Rosen AK. Positive predictive value of the AHRQ Patient Safety Indicator "postoperative wound dehiscence". Journal of the American College of Surgeons. 2011 Jun 1; 212(6):962-7.
  136. Cevasco M, Borzecki AM, O'Brien WJ, Chen Q, Shin MH, Itani KM, Rosen AK. Validity of the AHRQ Patient Safety Indicator "central venous catheter-related bloodstream infections". Journal of the American College of Surgeons. 2011 Jun 1; 212(6):984-90.
  137. Chen Q, Rosen AK, Cevasco M, Shin M, Itani KM, Borzecki AM. Detecting patient safety indicators: How valid is "foreign body left during procedure" in the Veterans Health Administration? Journal of the American College of Surgeons. 2011 Jun 1; 212(6):977-83.
  138. Kaafarani HM, Borzecki AM, Itani KM, Loveland S, Mull HJ, Hickson K, Macdonald S, Shin M, Rosen AK. Validity of selected Patient Safety Indicators: opportunities and concerns. Journal of the American College of Surgeons. 2011 Jun 1; 212(6):924-34.
  139. Rosen AK, Itani KM. Validating the patient safety indicators in the Veterans Health Administration: are they ready for prime time? Journal of the American College of Surgeons. 2011 Jun 1; 212(6):921-3.
  140. Shekelle PG, Pronovost PJ, Wachter RM, Taylor SL, Dy SM, Foy R, Hempel S, McDonald KM, Ovretveit J, Rubenstein LV, Adams AS, Angood PB, Bates DW, Bickman L, Carayon P, Donaldson L, Duan N, Farley DO, Greenhalgh T, Haughom J, Lake ET, Lilford R, Lohr KN, Meyer GS, Miller MR, Neuhauser DV, Ryan G, Saint S, Shojania KG, Shortell SM, Stevens DP, Walshe K. Advancing the science of patient safety. Annals of internal medicine. 2011 May 17; 154(10):693-6.
  141. Foy R, Ovretveit J, Shekelle PG, Pronovost PJ, Taylor SL, Dy S, Hempel S, McDonald KM, Rubenstein LV, Wachter RM. The role of theory in research to develop and evaluate the implementation of patient safety practices. BMJ quality & safety. 2011 May 1; 20(5):453-9.
  142. Saint SK. Enhancing Patient Safety by Translating Infection Prevention Research into Practice. Paper presented at: Baylor College of Medicine Infectious Diseases Journal Club; 2011 Mar 9; Houston, TX.
  143. Borzecki AM, Cevasco M, Shin M, Chen Q, Rosen AK. Valid is the AHRQ Patient Safety Indicator Postoperative Metabolic Derangements? Poster session presented at: VA HSR&D National Meeting; 2011 Feb 18; National Harbor, MD.
  144. Borzecki A, Shin M, Cevasco M, Rosen AK. How Valid is the AHRQ Patient Safety Indicator Postoperative Metabolic Derangements? Presented at: VA HSR&D National Meeting; 2011 Feb 16; National Harbor, MD.
  145. Utter GH, Borzecki AM, Rosen AK, Zrelak PA, Sadeghi B, Baron R, Cuny J, Kaafarani HM, Geppert JJ, Romano PS. Designing an abstraction instrument: lessons from efforts to validate the AHRQ patient safety indicators. Joint Commission Journal on Quality and Patient Safety. 2011 Jan 1; 37(1):20-8.
  146. Krein SL, Damschroder LJ, Kowalski CP, Forman J, Hofer TP, Saint S. The influence of organizational context on quality improvement and patient safety efforts in infection prevention: a multi-center qualitative study. Social science & medicine (1982). 2010 Nov 1; 71(9):1692-701.
  147. Singh H, Garber M, Moy E. Improving quality and the patient safety: Identifying, preventing, and reducing diagnostic error in health care. Poster session presented at: Agency for Healthcare Research and Quality Annual Conference; 2010 Sep 26; Bethesda, MD.
  148. Carey K. Measuring the Cost of Hospital Adverse Patient Safety Events. Paper presented at: AcademyHealth Annual Research Meeting; 2010 Jun 29; Boston, MA.
  149. Evans (Mayfield) C, Hill JN, Cameron K, Risa K, Kellie S, Richardson M, Doruelo P, Anderson V, Rosin LD, Williamson P, Gruber S, Goldstein B, Guihan M. Development of MRSA educational materials for Veterans with a spinal cord injury: A patient safety research agenda between QUERI and operations. Poster session presented at: VA “One Team toward One Dream” National Quality, Patient Safety and Systems Redesign Conference; 2010 Jun 22; San Francisco, CA.
  150. Doebbeling BN, Zillich AJ, Jaynes HA, Schmelz AN, Gonzalvo JD. A qualitative study of communication between physicians and pharmacists: Implications for Patient Safety. Poster session presented at: Society of General Internal Medicine Annual Meeting; 2010 Apr 28; Minneapolis, MN.
  151. Saint SK. Enhancing Patient Safety by Translating Infection Prevention Research into Practice. Paper presented at: John H. Stroger Jr. Hospital Grand Rounds; 2010 Apr 23; Chicago, IL.
  152. Halbesleben JR, Savage GT, Wakefield DS, Wakefield BJ. Rework and workarounds in nurse medication administration process: implications for work processes and patient safety. Health care management review. 2010 Apr 1; 35(2):124-33.
  153. Nelson AL. Linking Patient Safety and Caregiver Safety. Presented at: Safe Patient Handling and Movement Annual Conference; 2010 Apr 1; Lake Buena Vista, FL.
  154. Singer SJ, Rosen A, Zhao S, Ciavarelli AP, Gaba DM. Comparing safety climate in naval aviation and hospitals: implications for improving patient safety. Health care management review. 2010 Apr 1; 35(2):134-46.
  155. Saint SK. Enhancing Patient Safety by Translating Catheter-associated Urinary Tract Infection Research into Practice. Paper presented at: North Carolina Center for Hospital Quality and Patient Safety Meeting; 2010 Mar 12; Raleigh, NC.
  156. Zillich AJ. How Physicians and Pharmacists Communicate: Implications for Patient Safety. Poster session presented at: VA HSR&D Career Development Annual Meeting; 2010 Feb 25; San Francisco, CA.
  157. Saint SK. Enhancing Patient Safety by Preventing Hospital-Acquired Infection. Paper presented at: VA West Los Angeles VAMC Grand Rounds; 2010 Jan 13; Los Angeles, CA.
  158. McGlynn G. FORUM-1, Patient Safety, Drug Facts, Suicide Prevention. 2009 Dec 10; 2(1).
  159. Kaafarani HM, Rosen AK. Using administrative data to identify surgical adverse events: an introduction to the Patient Safety Indicators. American journal of surgery. 2009 Nov 1; 198(5 Suppl):S63-8.
  160. Krein SL. Implementing Evidence to Prevent Catheter-Associated Urinary Tract Infection and Enhance Patient Safety. Paper presented at: University of Michigan School of Nursing Dean's Lecture and Research Day Conference; 2009 Oct 15; Ann Arbor, MI.
  161. Singer SJ, Falwell A, Gaba DM, Meterko M, Rosen A, Hartmann CW, Baker L. Identifying organizational cultures that promote patient safety. Health care management review. 2009 Oct 1; 34(4):300-11.
  162. Hysong SJ, Sawhney MK, Wilson L, Sittig DF, Esquivel A, Watford M, Davis T, Espadas D, Singh H. Improving outpatient safety through effective electronic communication: a study protocol. Implementation science : IS. 2009 Sep 25; 4:62.
  163. LaCivita C, Funkhouser E, Miller MJ, Ray MN, Saag KG, Kiefe CI, Cobaugh DJ, Allison JJ. Patient-reported communications with pharmacy staff at community pharmacies: the Alabama NSAID Patient Safety Study, 2005-2007. Journal of the American Pharmacists Association : JAPhA. 2009 Sep 1; 49(5):e110-7.
  164. Wakefield DS, Wakefield BJ. Are verbal orders a threat to patient safety? Postgraduate Medical Journal. 2009 Sep 1; 85(1007):460-3.
  165. Saleem JJ. RN Stacking: Cognitive Workflow Management Process with Implications for Patient Safety and Quality Care. Presented at: Midwest Nursing Research Society Annual Conference; 2009 Aug 15; Chicago, IL.
  166. Bossi KE. HSR&D Pub eBriefs-e, Aug 09, OEF/OIF, Alcohol Use, Patient Safety, HIV. 2009 Aug 3; 1(5).
  167. Kaafarani HM, Itani KM, Rosen AK, Zhao S, Hartmann CW, Gaba DM. How does patient safety culture in the operating room and post-anesthesia care unit compare to the rest of the hospital? American journal of surgery. 2009 Jul 1; 198(1):70-5.
  168. Michel M, Trafton JA, Martins SB, Wang D, Tu S, Johnson NA, Goldstein MK. Improving Patient Safety using ATHENA-Decision Support System Technology: Opioid Therapy for Chronic Pain. AHRQ Advances in Patient Safety: New Directions and Alternative Approaches. 2009 Jul 1; Vol 4.
  169. Rosen AK, Loveland SA, Romano PS, Itani KM, Silber JH, Even-Shoshan OO, Halenar MJ, Teng Y, Zhu J, Volpp KG. Effects of resident duty hour reform on surgical and procedural patient safety indicators among hospitalized Veterans Health Administration and Medicare patients. Medical care. 2009 Jul 1; 47(7):723-31.
  170. Borzecki AM, Borzecki AM. Validating the Patient Safety Indicators in the Veterans Health Administration. Presented at: AcademyHealth Annual Research Meeting; 2009 Jun 30; Chicago, IL.
  171. Sawhney MK, Sittig DF, Petersen LA, Thomas EJ, Hysong SJ, Singh H. Improving Outpatient Safety through Effective Electronic Communication. Poster session presented at: Agency for Healthcare Research and Quality National Research Service Award Trainees Research Conference; 2009 Jun 27; Chicago, IL.
  172. Hartmann CW, Meterko M, Rosen AK, Shibei Zhao, Shokeen P, Singer S, Gaba DM. Relationship of hospital organizational culture to patient safety climate in the Veterans Health Administration. Medical care research and review : MCRR. 2009 Jun 1; 66(3):320-38.
  173. Wakefield DS, Wakefield BJ. Are verbal orders a threat to patient safety? Quality & Safety in Health Care. 2009 Jun 1; 18(3):165-8.
  174. Rall M, Gaba DM. Human performance and patient safety. In: Miller R, editor. Anesthesia. 7 ed. New York, NY: Elsevier; 2009. Chapter 6. 93-150 p.
  175. Saleem JJ. RN Stacking: Cognitive Workflow Management Process With Implications for Patient Safety and Quality Care. Presented at: National Patient Safety Foundation Patient Safety Annual Congress; 2009 May 18; Orlando, FL.
  176. Rosen AK, Borzecki AM, Kaafarani H, Hanchate AD, Loveland S, Hartmann CW, Shwartz M, Rivard P, Shin M. Validating the Patient Safety Indicators (PSIs): Do They Reflect True Safety Events? Poster session presented at: VA HSR&D National Meeting; 2009 Feb 14; Baltimore, MD.
  177. Chaney EF, Simon B, Bonner L, Simons C, Ober S, Rubenstein LV, Cody M. Ensuring Patient Safety and Confidentiality in Multi-Site Quality Improvement Research: A Proactive Partnership Approach to Risk Management. Presented at: VA HSR&D National Meeting; 2009 Feb 12; Washington, DC.
  178. Singer SJ, Gaba DM, Falwell A, Lin S, Hayes J, Baker L. Patient safety climate in 92 US hospitals: differences by work area and discipline. Medical care. 2009 Jan 1; 47(1):23-31.
  179. Bowlby L, Rodgers P, Colquhoun J, Crowley M, McNeil D, Burgess L. Improving patient safety and care via eBrowser protocol in the C-II prescription process. Poster session presented at: Duke University Health System Patient Safety Center Duke Medicine Annual Patient Safety and Quality Conference; 2008 Dec 12; Durham, NC.
  180. Bonner LM, Chaney EF, Fortney JC, Williams JW, Oslin D, Dobscha S, Campbell DG. Telephone Contact with Suicidal Patients: How Does Research Experience Address Patient Safety? Poster session presented at: VA QUERI National Meeting; 2008 Dec 10; Phoenix, AZ.
  181. Box TL, Gethoffer H, Noonan G, Jesse R, Fihn SD, Rumsfeld JS. A Collaborative VA Patient Safety Surveillance Network for Cardiac Catheterization Devices. Poster session presented at: VA QUERI National Meeting; 2008 Dec 10; Phoenix, AZ.
  182. Singer SJ, Falwell A, Gaba DM, Baker LC. Patient safety climate in US hospitals: variation by management level. Medical care. 2008 Nov 1; 46(11):1149-56.
  183. Singh H. Implementing and Using EHRs in Ways that Reliably Increase Patient Safety. Paper presented at: Agency for Healthcare Research and Quality Electronic Health Record Safety Institute Annual Meeting; 2008 Oct 22; Washington, DC.
  184. Singh. Patient Safety: Medical Errors: A Snapshot. Paper presented at: University of Texas School of Public Health Annual Workshop; 2008 Sep 16; Houston, TX.
  185. Hartmann CW, Rosen AK, Meterko M, Shokeen P, Zhao S, Singer S, Falwell A, Gaba DM. An overview of patient safety climate in the VA. Health services research. 2008 Aug 1; 43(4):1263-84.
  186. Shimada SL, Montez-Rath ME, Loveland SA, Zhao S, Kressin NR, Rosen AK. Racial Disparities in Patient Safety Indicator (PSI) Rates in the Veterans Health Administration. 2008.
  187. Dolor, Touchette, Masica, Schumock, Smith. Evaluation of a Medication Therapy Management Program Modeled on Patient Safety in Medicare Beneficiaries at High Risk of Adverse Drug Events. Poster session presented at: Agency for Healthcare Research and Quality Practice-Based Research Network Annual Meeting; 2008 Jun 11; Bethesda, MD.
  188. Rosen A, Loveland S, Romano P, Rosenbaum P, Silber J, Volpp K. Rates of patient safety indicators (PSIs) among VA patients in the first two years following ACGME resident duty hour reform. Paper presented at: AcademyHealth Annual Research Meeting; 2008 Jun 8; Washington, DC.
  189. Hartmann CW, Rosen AK, Zhao S, Meterko M, Shokeen P, Gaba D. Relationship of hospital characteristics to patient safety in the VA. Presented at: AcademyHealth Annual Research Meeting; 2008 Jun 6; Washington, DC.
  190. Brown C, Hofer T, Johal A, Thomson R, Nicholl J, Franklin BD, Lilford RJ. An epistemology of patient safety research: a framework for study design and interpretation. Part 1. Conceptualising and developing interventions. Quality & Safety in Health Care. 2008 Jun 1; 17(3):158-62.
  191. Brown C, Hofer T, Johal A, Thomson R, Nicholl J, Franklin BD, Lilford RJ. An epistemology of patient safety research: a framework for study design and interpretation. Part 2. Study design. Quality & Safety in Health Care. 2008 Jun 1; 17(3):163-9.
  192. Brown C, Hofer T, Johal A, Thomson R, Nicholl J, Franklin BD, Lilford RJ. An epistemology of patient safety research: a framework for study design and interpretation. Part 3. End points and measurement. Quality & Safety in Health Care. 2008 Jun 1; 17(3):170-7.
  193. Brown C, Hofer T, Johal A, Thomson R, Nicholl J, Franklin BD, Lilford RJ. An epistemology of patient safety research: a framework for study design and interpretation. Part 4. One size does not fit all. Quality & Safety in Health Care. 2008 Jun 1; 17(3):178-81.
  194. Volpp KG. A delicate balance: physician work hours, patient safety, and organizational efficiency. Circulation. 2008 May 20; 117(20):2580-2.
  195. Kaafarani HMA, Itani KMF, Rosen AK, Zhoa S, Hartmann CW, Gaba DM. How does patient safety culture compare in the operating room and post anesthesia care unit to the rest of the hospital? Presented at: American College of Surgeons Spring Meeting; 2008 May 4; Dallas, TX.
  196. Valenta A, Hynes DM. VIReC Clinical Informatics Cyber Seminar Series: IT and Patient Safety. 2008 Mar 18.
  197. Loveland SA, Rosen AK, Romano PS, Silber JH, Rosenbaum PR, Even-Shoshan O, Halenar M, Volpp KG. The effect of ACGME resident duty hour reform on three patient safety indicator composite measures. Poster session presented at: VA HSR&D National Meeting; 2008 Feb 14; Baltimore, MD.
  198. Rivard PE, Luther SL, Christiansen CL, Shibei Zhao, Loveland S, Elixhauser A, Romano PS, Rosen AK. Using patient safety indicators to estimate the impact of potential adverse events on outcomes. Medical care research and review : MCRR. 2008 Feb 1; 65(1):67-87.
  199. Wald HL, Epstein AM, Radcliff TA, Kramer AM. Extended use of urinary catheters in older surgical patients: a patient safety problem? Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America. 2008 Feb 1; 29(2):116-24.
  200. Weeks WB, West AN, Rosen AK, Bagian JP. Comparing measures of patient safety for inpatient care provided to veterans within and outside the VA system in New York. Quality & Safety in Health Care. 2008 Feb 1; 17(1):58-64.
  201. West AN, Weeks WB, Bagian JP. Rare adverse medical events in VA inpatient care: reliability limits to using patient safety indicators as performance measures. Health services research. 2008 Feb 1; 43(1 Pt 1):249-66.
  202. Kaldjian LC, Jones EW, Wu BJ, Forman-Hoffman VL, Levi BH, Rosenthal GE. Reporting medical errors to improve patient safety: a survey of physicians in teaching hospitals. Archives of internal medicine. 2008 Jan 14; 168(1):40-6.
  203. Harrison TK, Gaba DM. New Vistas in Patient Safety and Simulation. Anesthesia Clinics. [Book Review]. Anesthesia and analgesia. 2008 Jan 1; 106(1):354.
  204. Singh H. Patient Safety: medical errors: a snapshot. Paper presented at: University of Texas School of Public Health / Health Outcomes Annual Workshop; 2007 Nov 20; Houston, TX.
  205. Singer S, Meterko M, Baker L, Gaba D, Falwell A, Rosen AK. Workforce perceptions of hospital safety culture: development and validation of the patient safety climate in healthcare organizations survey. Health services research. 2007 Oct 1; 42(5):1999-2021.
  206. Weeks B, Schmidek M, Wallace E, Dimick B. JCAHO accreditation associated with improved surgical outcomes: use of the accreditation process to improve patient safety. Paper presented at: Patient Safety Research Annual Conference; 2007 Sep 24; Porto, Portugal.
  207. Kerfoot BP, Conlin PR, Travison T, McMahon GT. Patient safety knowledge and its determinants in medical trainees. Journal of general internal medicine. 2007 Aug 1; 22(8):1150-4.
  208. Rivard P, Parker V, Rosen AK. Moving Patient Safety Improvement Practices to the Next Level: Closing the Organizational Learning Loop. Poster session presented at: AcademyHealth Annual Research Meeting; 2007 Jun 3; Orlando, FL.
  209. Shimada SL, Montez-Rath ME, Loveland SA, Zhao S, Kressin NR, Rosen AK. Are Minorities at Higher Risk of Patient Safety Events in the VA? Poster session presented at: AcademyHealth Annual Research Meeting; 2007 Jun 3; Orlando, FL.
  210. Johnson RG, Arozullah AM, Neumayer L, Henderson WG, Hosokawa P, Khuri SF. Multivariable predictors of postoperative respiratory failure after general and vascular surgery: results from the patient safety in surgery study. Journal of the American College of Surgeons. 2007 Jun 1; 204(6):1188-98.
  211. Speroff. Partnerships in Implementing Patient Safety (PIPS): Safe Critical Care - Testing Improvement Strategies: Toolkits. Paper presented at: National Patient Safety Foundation Patient Safety Annual Congress; 2007 May 4; Washington, DC.
  212. Neily, Mills D, Watts V, Dunn J, Williams, Bagian P, Weeks B. Development of an interprofessional fellowship program for patient safety. Poster session presented at: National Patient Safety Foundation Patient Safety Annual Congress; 2007 May 3; Washington, DC.
  213. Speroff. Safety Culture in Intensive Care Units Varies by Hospital Size: Results from a Partnerships in Implementing Patient Safety (PIPS) Study. Poster session presented at: National Patient Safety Foundation Patient Safety Annual Congress; 2007 May 3; Washington, DC.
  214. West N, Weeks B, Bagian P. AHRQ's patient safety indicators in nine years of VA inpatient data: Low reliability limits their use as performance measures. Poster session presented at: VA HSR&D National Meeting; 2007 Feb 22; Arlington, VA.
  215. Shimada SL, Montez-Rath ME, Loveland SA, Zhao S, Kressin NR, Rosen AK. Are Minorities at Higher Risk of Patient Safety Events in the VA? Poster session presented at: VA HSR&D National Meeting; 2007 Feb 16; Arlington, VA.
  216. Handler SM, Castle NG, Studenski SA, Perera S, Fridsma DB, Nace DA, Hanlon JT. Patient safety culture assessment in the nursing home. Quality & Safety in Health Care. 2006 Dec 1; 15(6):400-4.
  217. Sung S, Forman-Hoffman V, Wilson MC, Cram P. Direct reporting of laboratory test results to patients by mail to enhance patient safety. Journal of general internal medicine. 2006 Oct 1; 21(10):1075-8.
  218. Rosen AK, Zhao S, Rivard P, Loveland S, Montez-Rath ME, Elixhauser A, Romano PS. Tracking rates of Patient Safety Indicators over time: lessons from the Veterans Administration. Medical care. 2006 Sep 1; 44(9):850-61.
  219. Rivard PE, Rosen AK, Carroll JS. Enhancing patient safety through organizational learning: Are patient safety indicators a step in the right direction? Health services research. 2006 Aug 1; 41(4 Pt 2):1633-53.
  220. Christiansen CL, Elixhauser A, Loveland SA, Rivard PE, Zhou S, Rosen AK. How Do VA Hospitals Compare to Non-VA Hospitals on Rates of Patient Safety Events? Paper presented at: VA HSR&D National Meeting; 2006 Feb 1; Arlington, VA.
  221. Rosen AK, Rivard PE, Zhao S, Tsilimingras D, Loveland SA, Christiansen CL, Henderson W, Khuri S, Elixhauser A, Romano PS. Identification of Patient Safety Events from VA Administrative Data: Is It Valid. Paper presented at: VA HSR&D National Meeting; 2006 Feb 1; Arlington, VA.
  222. Saint S. Enhancing Patient Safety by Preventing Catheter-Related Infection. Paper presented at: VA Career Development Award Program Annual Conference; 2006 Feb 1; Arlington, VA.
  223. Schmidek JM, Weeks WB. What do we know about financial returns on investments in patient safety? A literature review. Joint Commission Journal on Quality and Patient Safety. 2005 Dec 1; 31(12):690-9.
  224. Colla JB, Bracken AC, Kinney LM, Weeks WB. Measuring patient safety climate: a review of surveys. Quality & Safety in Health Care. 2005 Oct 1; 14(5):364-6.
  225. Rosen AK, Rivard P, Zhao S, Loveland S, Tsilimingras D, Christiansen CL, Elixhauser A, Romano PS. Evaluating the patient safety indicators: how well do they perform on Veterans Health Administration data? Medical care. 2005 Sep 1; 43(9):873-84.
  226. Hayward RA, Asch SM, Hogan MM, Hofer TP, Kerr EA. Sins of omission: getting too little medical care may be the greatest threat to patient safety. Journal of general internal medicine. 2005 Aug 1; 20(8):686-91.
  227. Hysong SJ, Best RG, Moore FI. Patient safety in primary care: the relationship between human error consequence and physician discretion. Paper presented at: AcademyHealth Annual Research Meeting; 2005 Jun 26; Boston, MA.
  228. Tsilimingras D, Romano P, Christiansen C, Henderson W, Khuri S, Elixhauser A, Rivard P, Loveland S, Zhao S, Rosen A. Validating AHRQ Patient Safety Indicators with NSQIP Postoperative Adverse Events. Paper presented at: AcademyHealth Annual Research Meeting; 2005 Jun 26; Boston, MA.
  229. Poulose BK, Ray WA, Arbogast PG, Needleman J, Buerhaus PI, Griffin MR, Abumrad NN, Beauchamp RD, Holzman MD. Resident work hour limits and patient safety. Annals of surgery. 2005 Jun 1; 241(6):847-56; discussion 856-60.
  230. Popescu I. Patient safety on the primary care setting: the case of diagnostic results reporting. Paper presented at: VA Quality Scholars Annual Symposium; 2005 May 13; Hanover, NH.
  231. Bonner L, Felker B, Chaney E, Vollen K, Berry K, Revay B, Simon B, Kofoed L, Ober S, Worley L, Fotiades J, Sherman S. Suicide risk response: enhancing patient safety through development of effective institutional policies. In: Advances in Patient Safety: From Research to Implementation [electronic compendium] Volume 3. Agency for Healthcare Research and Quality; 2005 Feb 1. 501-519 p. Report No.: 3.
  232. Christiansen C, Rivard P, Tsilimingra D, Zhao S, Loveland S, Rosen A. Using Patient Safety Indicators to Identify VA Outlier Hospitals: A Picture is Worth 1000 Statistics. Paper presented at: AcademyHealth Annual Research Meeting; 2005 Feb 1; Boston, MA.
  233. Christiansen CL, Rivard PE, Zhao S, Loveland S, Tsilimingras D, Rosen AK. Using Patient Safety Indicators to Identify VA Outlier Hospitals: A Picture is Worth 1000 Statistics. Paper presented at: VA HSR&D National Meeting; 2005 Feb 1; Baltimore, MD.
  234. Rivard PE, Elwy AR, Loveland S, Zhao S, Tsilimingras D, Elixhauser A, Romano PS, Rosen AK. Applying Patient Safety Indicators (PSIs) Across Health Care Systems: Achieving Data Comparability. Rockville (MD): Agency for Healthcare Research and Quality (US); 2005 Feb 1. Report No.: 050021.
  235. Johnson CE, Handberg E, Dobalian A, Gurol N, Pearson V. Improving perinatal and neonatal patient safety: The AHRQ patient safety indicators. The Journal of Perinatal & Neonatal Nursing. 2005 Jan 1; 19(1):15-23.
  236. Piotrowski MM, Cohen MR, Mercier J, Saint S, Steinbinder A, Thompson M. Introducing the National Patient Safety Goals Department: sharing programs of excellence from individual organizations. Joint Commission Journal on Quality and Patient Safety. 2005 Jan 1; 31(1):43-6, 1.
  237. Gavin-Dreschnack D. Effects of wheelchair posture on patient safety. Rehabilitation Nursing : The Official Journal of The Association of Rehabilitation Nurses. 2004 Nov 1; 29(6):221-6.
  238. Gordon AJ. Improving patient safety: the physician pinch [invited paper]. [Editorial]. Bulletin of the Allegheny County Medical Society. 2004 Nov 1; 93(11):528-531.
  239. Weinger MB. Using Simulations to Improve Patient Safety. Paper presented at: Sharp HealthCare Patient Safety Annual Conference; 2004 Sep 12; San Diego, CA.
  240. Rutberg H, Weeks WB. [Extensive initiatives for improved patient safety in the USA]. Lakartidningen. 2004 Jun 24; 101(26-27):2276-9.
  241. Rivard P, Zhao S, Loveland S, Christiansen C, Elixhauser A, Rosen A. Estimating Increased Mortality, Cost and Length of Stay Associated with Safety Events: An Application of Patient Safety Indicators in the Veterans Health Administration. Paper presented at: AcademyHealth Annual Research Meeting; 2004 Jun 4; San Diego, CA.
  242. Weinger MB. Simulation in Patient Safety Research. Paper presented at: National Patient Safety Foundation Annual Patient Safety Congress; 2004 May 6; Boston, MA.
  243. Weinger MB, Gonzales DC, Slagle J, Syeed M. Video capture of clinical care to enhance patient safety. Quality & Safety in Health Care. 2004 Apr 1; 13(2):136-44.
  244. Zhao S, Elwy R, Loveland S, Tsilimingras D, Elixhauser A, Romano P, Rivard P, Rosen A. Patient Safety Indicators: Comparing Rates in the VA and Non-VA Settings. Paper presented at: VA HSR&D National Meeting; 2004 Mar 17; Washington, DC.
  245. Chan AS, Martins S, Bosworth HB, Oddone EZ, Schlipak MG, Goldstein KM. Clinician feedback of a guideline-based decision support systems and identification of areas for improvement in patient safety and quality of clinical information. Paper presented at: Society for Medical Decision Making Annual Meeting; 2003 Oct 1; Chicago, IL.
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