University Faculty Scholarship
Publications and Grants

Alan Card

acard@sdsu.eduorcid.org/0000-0003-2266-5954

Appointments

  • Associate Professor
    School of Public Health, San Diego State University, San Diego, California, US

  • PhD (Intervention design for patient safety)
    Department of Engineering, University of Cambridge, Cambridge, England, GB
  • MPH (Global communicable disease)
    Department of Global Health / School of Public Health, University of South Florida, Tampa, Florida, US

  • Fellow, Higher Education Academy, 2025-Present
    Advance HE, York, England, GB
  • Distinguished Fellow, American Society for Health Care Risk Management, 2021-Present
    American Society for Health Care Risk Management, Chicago, IL, US
  • Certified Professional in Healthcare Risk Management, 2015-Present
    American Society for Health Care Risk Management, Chicago, IL, US
  • Certified Professional in Healthcare Quality, 2009-Present
    Healthcare Quality Certification Board, Chicago, IL, US

Profile updated November 10, 2026.

Scholarship

Academic Publications

Psychosocial Safety Is Patient Safety: Gender-affirming Care as an Exemplar for Health Equity
Barton, H.J.; Cohen, T.N.; Kanji, F.F.; Trasvina, V.; Anger, J.T.; Alan Card
Journal of Patient Safety, 2026, journal article
Gender-affirming care Patient safety Transgender people
IMPACT OF EXECUTIVE ORDER 14183 ON TRANSGENDER AND NONBINARY U. S. SERVICE MEMBERS' ACCESS TO GENDER AFFIRMING SURGERY
Alan Card
Journal of Urology, 2026, journal article
Gender reassignment surgery Medicine, Military Transgender military personnel Transgender people
IMPACT OF EXECUTIVE ORDER 14183 ON TRANSGENDER AND NONBINARY US SERVICE MEMBERS' ACCESS TO GENDER AFFIRMING SURGERY
Alan Card
Neurourology and Urodynamics, 2026, journal article
Gender reassignment surgery Medicine, Military Transgender military personnel Transgender people
Patient and clinician perspectives on misgendering in healthcare
Okamuro, K.; Alan Card; et al.
BMJ Quality and Safety, 2026, journal article
Gender identity Medical care Transgender people Transphobia
The perceived impact of executive order 14183 on transgender and nonbinary U.S. Service members
Kyle Okamuro; Okamuro, K.; Andres R. Schneeberger; Schneeberger, A.R.; Barton, H.J.; Hanna J. Barton; Cony Mardonez-Segovia; Mardonez-Segovia, C.; Trasvina, V.; Victor Trasvina; Parija, S.; Sweta Parija; Cohen, T.N.; Tara N. Cohen; Alan Card; et al.
International Journal of Transgender Health, 2026, journal article
Gender-nonconforming people Transgender military personnel Transgender people

“I don’t like fitting a box, except the box I am”: genderqueer and nonbinary (GQNB) patient strategies for navigating healthcare
Shanaya Sidhu; Sidhu, S.; Anger, J.T.; Jennifer T. Anger; Trasvina, V.; Victor Trasvina; Falisha Kanji; Kanji, F.; Kyle Okamuro; Okamuro, K.; Mangiameli, S.; Sunny Mangiameli; Alan Card; et al.
International Journal for Equity in Health, 2026, journal article
Gender-nonconforming people Health services accessibility Physician and patient
The TRANS-SAFE Patient Safety Learning Laboratory: A Protocol for Systems Improvement for Psychosocial Safety in Transgender Care
Cohen, T.N.; Anger, J.T.; Barton, H.; Blumenthal, J.; Gosman, A.; Kanji, F.; Khamisa, R.; Koola, J.; Lewis, P.; Marinkovic, M.; Marino-Kibbee, B.; Moore, M.; Okamuro, K.; Sidhu, S.; Trasvina, V.; Vaida, F.; Alan Card
Journal of Patient Safety, 2025, journal article
Medical care Patient safety Transgender people
THREATS TO PSYCHOSOCIAL SAFETY IN PRE-OPERATIVE CARE FOR TRANSGENDER AND NON-BINARY INDIVIDUALS UNDERGOING GENDER AFFIRMING SURGERY
Alan Card
Neurourology and Urodynamics, 2025, journal article
Gender reassignment surgery Gender-nonconforming people Preoperative care Transgender people
EXPLORING THE EXPERIENCES OF TRANSGENDER PATIENTS THROUGH REVIEW OF INTER-PATIENT REDDIT DISCUSSION THREADS
Alan Card
Neurourology and Urodynamics, 2025, journal article
Online discussion forums Social media Transgender people
IDENTIFYING BARRIERS AND FACILITATORS TO AFFIRMING CARE FOR ADULT GENDERQUEER AND NONBINARY PATIENTS: PATIENT AND CLINICIAN PERSPECTIVES
Alan Card
Journal of Urology, 2025, journal article
Gender-affirming care Gender-nonconforming people Health services accessibility Physician and patient
Bridging K-12 Student Mental Health Policy to Practice Gaps with a Multi-Component Framework
Brindley, L.; Bauer, P.; Alan Card; Crocker, J.; Ialongo, N.; Tien, A.
Administration and Policy in Mental Health and Mental Health Services Research, 2024, journal article
Child mental health Education Mental health policy School mental health services
The biopsychosociotechnical model: a systems-based framework for human-centered health improvement
Alan Card
Health Systems, 2023, journal article
Human engineering Medical care Medical informatics System theory
TRANSGENDER PATIENT AND GENDER AFFIRMING CARE PROVIDER PERSPECTIVES ON BARRIERS TO CARE
Alan Card
Neurourology and Urodynamics, 2023, journal article
Health services accessibility Patient participation Transgender people
TRANSGENDER PATIENT AND GENDER AFFIRMING CARE PROVIDER PERSPECTIVES ON MISGENDERING IN HEALTHCARE
Alan Card
Journal of Urology, 2023, journal article
Gender identity Medical care Transgender people Transphobia
MP06-10 TRANSGENDER PATIENT AND GENDER AFFIRMING CARE PROVIDER PERSPECTIVES ON MISGENDERING IN HEALTHCARE
Kyle Okamuro; Jill Blumenthal; Alan Card; Tara Cohen; Isabella Dolendo; Jennifer Anger
Journal of Urology, 2023, journal article
Gender identity Gender-affirming care Transgender people Transphobia
Patient Safety 2.0: Slaying Dragons, Not Just Investigating Them
Alan Card
Journal of Patient Safety, 2023, journal article
Medical errors Patient safety
Burnout and Sources of Stress Among Health Care Risk Managers and Patient Safety Personnel During the COVID-19 Pandemic: A Pilot Study
Alan Card
Disaster Medicine and Public Health Preparedness, 2022, journal article
Burn out (Psychology) Job stress Medical personnel Patient safety
What Is Ethically Informed Risk Management?
Alan Card
Ama Journal of Ethics, 2020, journal article
Business ethics Ethics Risk management
Patient safety professionals as the third victims of adverse events
Holden, J.; Julie Holden; Alan Card
Journal of Patient Safety and Risk Management, 2019, journal article
Medical errors Medical personnel Patient safety
Flourishing as a Definition of Health
Alan Card
JAMA Journal of the American Medical Association, 2019, journal article
Health Public health Well-being
Single-Occupancy Patient Rooms: A Systematic Review of the Literature Since 2006
Ellen Taylor; Taylor, E.; Alan Card; Melissa Piatkowski; Piatkowski, M.
Herd: Health Environments Research & Design Journal, 2018, journal article
Hospital architecture Patient rooms Systematic reviews (Medical research)
Physician Burnout: Resilience Training is Only Part of the Solution
Alan Card
The Annals of Family Medicine, 2018, journal article
Job stress Medical personnel Physicians
The underlying narrative of risk management
Alan Card
Journal of Healthcare Risk Management, 2017, journal article
Financial risk Financial risk management Risk management
Risks without walls
Alan Card
Journal of Healthcare Risk Management, 2017, journal article
Prisons Risk
Learning: New avenues and new topics
Alan Card
Journal of Healthcare Risk Management, 2017, journal article
Education Learning
Moving Beyond the WHO Definition of Health: A New Perspective for an Aging World and the Emerging Era of Value-Based Care: Redefining Health
Alan Card
World Medical & Health Policy, 2017, journal article
Aging Health Public health World Health Organization
A time of uncertainty, a time to step forward
Alan Card
Journal of Healthcare Risk Management, 2017, journal article
Social change Uncertainty
The varied and expanding role of risk management practice
Alan Card
Journal of Healthcare Risk Management, 2016, journal article
Corporate governance Risk management
Organizational multimorbidity and polypharmacy
Alan Card
Journal of Healthcare Risk Management, 2016, journal article
Comorbidity Polypharmacy
Making the invisible visible
Alan Card
Journal of Healthcare Risk Management, 2016, journal article
Invisibility Visibility
A new frontier in healthcare risk management: Working to reduce avoidable patient suffering
Alan Card; Klein, V.R.; Victor R. Klein
Journal of Healthcare Risk Management, 2016, journal article
Medical errors Patient safety Risk management
Shaping research and practice
Alan Card
Journal of Healthcare Risk Management, 2016, journal article
Research
The problem with ‘5 whys’
Alan Card
BMJ Quality & Safety, 2016, journal article
Problem solving Quality control Root cause analysis
Rebalancing risk management-Part 2: The Active Risk Control (ARC) Toolkit
Alan Card; James R. Ward; Ward, J.R.; Clarkson, P.J.; P. John Clarkson
Journal of Healthcare Risk Management, 2015, journal article
Corporate governance Risk management
A comparison of the methods used to support risk identification for patient safety in one UK NHS foundation trust
MC Emre Simsekler; Simsekler, M.C.E.; Alan Card; et al.
Clinical Risk, 2015, journal article
Great Britain Great Britain. National Health Service Patient safety Risk management
Trust-level risk identification guidance in the NHS East of England
M.C. Emre Simsekler; Simsekler, M.C.E.; Alan Card; et al.
International Journal of Risk and Safety in Medicine, 2015, journal article
Eastern England Great Britain. National Health Service Risk management
The problem with Plan-Do-Study-Act cycles
Julie E Reed; Reed, J.E.; Alan Card
BMJ Quality & Safety, 2015, journal article
Business planning Continuous improvement process Total quality management
Use of the Generating Options for Active Risk Control (GO-ARC) Technique can lead to more robust risk control options
Alan Card; et al.
International Journal of Risk and Safety in Medicine, 2014, journal article
Decision making Problem solving Risk management
The Active Risk Control (ARC) toolkit: A new approach to designing risk control interventions
Alan Card
Journal of Healthcare Risk Management, 2014, journal article
Loss control Risk management
Rebalancing risk management-Part 1: The Process for Active Risk Control (PARC)
Alan Card; James R. Ward; Ward, J.R.; Clarkson, P.J.; P. John Clarkson
Journal of Healthcare Risk Management, 2014, journal article
Risk management
Patient safety: This is public health
Alan Card
Journal of Healthcare Risk Management, 2014, journal article
Patient safety Public health
Generating Options for Active Risk Control (GO-ARC): Introducing a Novel Technique
Alan Card; James R. Ward; Ward, J.R.; Clarkson, P.J.; John P. Clarkson
Journal for Healthcare Quality, 2014, journal article
Decision making Problem solving Risk management
Importance of Sleep Disorders in Assessing the Association Between Coffee Consumption and All-Cause Mortality
Alan Card
Mayo Clinic Proceedings, 2013, journal article
Caffeine Coffee Mortality Sleep disorders
A new tool for hazard analysis and force-field analysis: The Lovebug diagram
Alan Card
Clinical Risk, 2013, journal article
Earthquake hazard analysis
Trust-Level Risk Evaluation and Risk Control Guidance in the NHS East of England: Trust-Level Risk Evaluation and Risk Control Guidance
Alan Card; James R. Ward; Ward, J.R.; Clarkson, P.J.; P. John Clarkson
Risk Analysis, 2013, journal article
Great Britain. National Health Service Health services administration Risk assessment Risk management
Using prospective hazard analysis to assess an active shooter emergency operations plan
Alan Card; et al.
Journal of Healthcare Risk Management, 2012, journal article
Emergency management Security systems
Successful risk assessment may not always lead to successful risk control: A systematic literature review of risk control after root cause analysis
Alan Card; James Ward; Ward, J.; Clarkson, P.J.; P. John Clarkson
Journal of Healthcare Risk Management, 2012, journal article
Risk assessment Risk management Root cause analysis Systematic reviews (Medical research)
Sustainability of Public Health Programs
Alan Card
American Journal of Public Health, 2012, journal article
Health services administration Public health Public health administration Sustainability
Getting to Zero: Evidence-based healthcare risk management is key
Alan Card; James R. Ward; Ward, J.R.; Clarkson, P.J.; P. John Clarkson
Journal of Healthcare Risk Management, 2012, journal article
Evidence-based medicine Medical errors Patient safety Quality assurance
Pandemicity and Severity are Separate Constructs
Alan Card
American Journal of Public Health, 2012, journal article
Epidemiology Pandemics
Beyond FMEA: The structured what-if technique (SWIFT)
Alan Card; James R. Ward; Ward, J.R.; Clarkson, P.J.; P. John Clarkson
Journal of Healthcare Risk Management, 2012, journal article
Failure mode and effects analysis Risk assessment
Risk control after root cause analysis: A systematic literature review
Alan Card
Healthcare Systems Ergonomics and Patient Safety 2011: An Alliance Between Professionals and Citizens for Patient Safety and Quality of Life, 2011, journal article
Risk management Root cause analysis Systematic reviews (Medical research)
Flu vaccination prevents nosocomial outbreaks
Alan Card
BMJ, 2011, journal article
Influenza vaccines Nosocomial infections Vaccination
Designing with Care: The Future of Pervasive Healthcare
Ingrid Mulder; Mulder, I.; Schikhof, Y.; Yvonne Schikhof; Martijn Vastenburg; Vastenburg, M.; Alan Card; et al.
IEEE Pervasive Computing, 2009, journal article
Design Medical care Medical technology
SMS Text Message Healthcare Appointment Reminders in England
Car, J.; Josip Car; Cindy Ng; Ng, C.; Atun, R.; Rifat Atun; Alan Card
Journal of Ambulatory Care Management, 2008, journal article
England Medical appointments and schedules Text messaging (Cell phone systems)

Other

You can’t manage what you can’t imagine: The Digital Health Checklist-Risk Management (DHC-RM) Tool to enhance participant protections in digital health research
Alan Card; Vital, D.; Nebeker, C.
Medrxiv, 2026, other