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www.ahrq.gov/patient-safety/reports/liability/neumiller.html
August 01, 2017 - Advances in Patient Safety and Medical Liability
Medication Discrepancies and Potential Adverse Drug Events During Transfer of Care from Hospital to Home
Previous Page
Table of Contents
Advances in Patient Safety and Medical Liability
Preface
Acknowledgments
Prologue
Silence A Commentary
…
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www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/mrsa-2/003-ss-antimicrobial-prophylaxis-part-2-fg.docx
April 01, 2025 - AHRQ Safety Program for MRSA
Prevention: Targeting SSI
Antimicrobial Prophylaxis: Part 2 Beyond the Basics
Surgical Services
For: Cardiac, Hip and Knee Joint Replacement, and Spinal Fusion Surgeries
Slide Title and Commentary
Slide Number and Slide
Antimicrobial Prophylaxis: Part 2, Beyond the Basics
SAY:
This pr…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol1/Reige.pdf
March 01, 2004 - A Patient Safety Program & Research Evaluation of U.S. Navy Pharmacy Refill Clinics
213
A Patient Safety Program &
Research Evaluation of U.S. Navy
Pharmacy Refill Clinics
Valerie J. Riege
Abstract
Historically, pharmacists have been safety consultants for patients with minor
illnesses and have assisted…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/f1_combo_returnoninvestment.docx
January 01, 2013 - Return on Investment Tool
Return on Investment Estimation
What is the purpose of this tool? When your hospital invests in a new program, quality improvement intervention, or technology, leaders often need to know what kind of financial return the investment will yield. A return on investment (ROI) analysis is a way to…
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www.ahrq.gov/sites/default/files/wysiwyg/patient-safety/resources/simulation/simulation-issue-brief.pdf
July 01, 2024 - Issue Brief: Simulation To Improve Patient Safety: Getting Started
Issue Brief
Simulation To Improve Patient Safety:
Getting Started
e PATIENT
SAFETY
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e
Issue Brief
Simulation To Improve Patient Safety:
Getting Started
Prepared for:
Agency for Healthcare Research …
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol2/Martin.pdf
March 01, 2004 - Development and Implementation of The University of Texas Close Call Reporting System
149
Development and Implementation
of The University of Texas
Close Call Reporting System
Sharon K. Martin, Jason M. Etchegaray, Debora Simmons,
W. Thomas Belt, Kelly Clark
Abstract
This report describes the development…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol4/Gavin.pdf
January 01, 2001 - Development of a Screening Tool for Safe Wheelchair Seating
127
Development of a Screening Tool
for Safe Wheelchair Seating
Deborah Gavin-Dreschnack, Lawrence Schonfeld,
Audrey Nelson, Stephen Luther
Abstract
Objectives: Most elderly nursing home residents who need wheelchairs are not
being assessed i…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol4/Patey.pdf
January 01, 2004 - Developing a Taxonomy of Anesthetists’ Nontechnical Skills (ANTS)
325
Developing a Taxonomy of Anesthetists’
Nontechnical Skills (ANTS)
Rona Patey, Rhona Flin, Georgina Fletcher,
Nicola Maran, Ronnie Glavin
Abstract
Safety research in high-reliability industries, such as aviation, has clearly shown
that t…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol2/Advances-Layde_34.pdf
March 14, 2008 - Confidential Performance Feedback and Organizational Capacity Building to Improve Hospital Patient Safety: Results of a Randomized Trial
Confidential Performance Feedback and
Organizational Capacity Building to Improve
Hospital Patient Safety: Results of a Randomized Trial
Peter M. Layde, MD, MSc; Linda N. Meurer…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol3/Advances-Drews_16.pdf
January 01, 2003 - Patient Monitors in Critical Care: Lessons for Improvement
Patient Monitors in Critical Care: Lessons for
Improvement
Frank A. Drews, PhD
Abstract
Unexpected incidents are common in intensive care medicine. One means of detecting,
diagnosing, and treating these events is use of physiologic displays that sho…
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www.ahrq.gov/sites/default/files/2024-11/gregory-report.pdf
January 01, 2024 - Final Progress Report: What About Mom? Using Administrative Data To Develop Measures for Monitoring Healthcare Quality in Pregnancy & Childbirth
1
AHRQ Final Progress Report
Title: What about mom? Using Administrative Data to Develop Measures for Monitoring
Healthcare Quality in Pregnancy & Childbirth
Principal In…
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www.ahrq.gov/sites/default/files/wysiwyg/takeheart/training/expanding-cardiac-rehab-implementation-guide.pdf
December 01, 2022 - Hybrid Cardiac Rehabilitation (HYCR) Expanding Capacity Implementation Guide
Expanding Capacity Implementation Guide
December 2022
…
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www.ahrq.gov/sites/default/files/publications/files/ccreroadmap.pdf
July 01, 2013 - Clinical-Community Relationships Evaluation Roadmap
Clinical-Community
Relationships
Evaluation Roadmap
Clinical-Community Relationships Evaluation
Roadmap
Prepared for:
Agency for Healthcare Research and Quality
U.S. Department of Health and Human Services
540 Gaither Road
Rockville, MD 20850
ww…
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www.ahrq.gov/sites/default/files/wysiwyg/cahps/news-and-events/events/20140115_DB/Final_Using_the_CAHPS_Database_Webcast_Transcript.pdf
January 01, 2014 - Using the CAHPS Database to Compare, Report, and Improve Organizational Performance
Using the CAHPS Database to Compare, Report, and Improve Organizational
Performance
January 2014 Webcast
Speakers
Janice Ricketts, Senior Study Director, CAHPS Database, Westat, Rockville, MD
Deborah Kilstein, BSN, MBA, Vice…
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www.ahrq.gov/sites/default/files/wysiwyg/research/findings/making-healthcare-safer/mhs3/failure-to-rescue-1.pdf
March 01, 2020 - Chapter-2 - Failure-To-Rescue
Failure To Rescue 2-1
2. Failure To Rescue
Authors: Kendall K. Hall, M.D., M.S., Andrea Lim, and Bryan Gale, M.A.
Introduction
Background
Failure to rescue (FTR) is failure or delay in recognizing and responding to a hospitalized patient
experiencing complications from a disease p…
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www.ahrq.gov/sites/default/files/2024-01/gallagher2-report.pdf
January 01, 2024 - coding of additional videos until a) the coding scheme met our criteria of capturing all data and b) we
achieved
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www.ahrq.gov/sites/default/files/wysiwyg/cahps/surveys-guidance/helpful-resources/analysis/2020-instructions-for-analyzing-data.pdf
January 01, 2020 - Substantive significance refers to an absolute difference between the entities being compared that must be
achieved … A new method of specifying an absolute difference that must be
achieved before a difference is meaningful
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www.ahrq.gov/sites/default/files/wysiwyg/cahps/surveys-guidance/helpful-resources/analysis/instructions-for-analyzing-data-50.pdf
June 01, 2025 - Substantive significance refers to an absolute difference between the entities being compared that must be
achieved … A new method of specifying an absolute difference that must be
achieved before a difference is meaningful
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www.ahrq.gov/sites/default/files/wysiwyg/research/findings/making-healthcare-safer/mhs3/opioids-1.pdf
March 01, 2020 - measured by urine
drug tests (UDTs), as opposed to tapering off the medication after stabilization was achieved … al. (2011)
examined the cost of providing long-term buprenorphine and naloxone for patients who had achieved
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/sppc-summary_report.pdf
May 01, 2017 - Units achieved these changes by
introducing routine hemorrhage risk assessment protocols and processes