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  1. www.cahps.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/pfp/Updated-hacreportFInal2017data.pdf
    July 01, 2020 - the same 28 measures of patient safety events, including many types of hospital-acquired infections, adverse … For example, measured adverse drug events continued to drop from 2014 to 2017, while measured pressure … National number of adverse events captured by PSIs 18 and 19 on obstetric injury and national number … To estimate the rate of adverse events for each of the 21 HACs for all patients for which the MPSMS … Due to changes in how some conditions and adverse events are described in ICD-9 and ICD-10, the data
  2. www.cahps.ahrq.gov/hai/pfp/hacrate2013-appendix.html
    October 01, 2015 - 2013) Femoral Artery Puncture for Catheter Angiographic Procedures 59,000 1.8 MPSMS (2013) Adverse … Events Associated With Hip Joint Replacements 21,000 0.63 MPSMS (2013) Adverse Events Associated … in Measured HACs c Projected Cost Savings in 2013 d Projected Reductions in Deaths in 2013 e Adverse … $149,600,000 1,628 Falls 260,000 240,000 20,000 8% $144,680,000 1' 100 Obstetric Adverse … 50% 25% 10,000 $17,000 Falls 200,000 25% 50% 12.5% 25,000 $7,234 Obstetric Adverse
  3. www.cahps.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/pfp/hacreport-2019.pdf
    January 01, 2019 - the same 28 measures of patient safety events, including many types of hospital-acquired infections, adverse … For example, measured adverse drug events continued to drop from 2014 to 2017, while measured pressure … Preliminary 2017 2019 Goal (20% Reduction of each HAC) Adverse Drug Events 33.7 30.0 27.1 … National number of adverse events captured by PSIs 18 and 19 on obstetric injury and national number … Due to changes in how some conditions and adverse events are described in ICD-9 and ICD-10, the data
  4. www.cahps.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/teamwork/engage/engagement.pptx
    May 01, 2017 - Events An adverse event is an injury to a patient caused by medical intervention rather than by the … The mission of health care providers is to help and care for patients without harming them, but adverse … Prompt, compassionate, and honest communication with the patient and family after an adverse event is … essential. 17 AHRQ Safety Program for Perinatal Care Patient & Family Immediate Response to an Adverse … Organizations should be prepared to respond and communicate proactively when adverse events occur.
  5. www.cahps.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/candor/module5/mod5-disclosure-checklist.pdf
    April 01, 2016 - ■ Within 60 minutes after the CANDOR event is identified, advise the patient and/or family that an adverse … ■ Identify the adverse event early in the disclosure. … ■ Explain what is known about why the adverse event occurred; do not speculate. … ■ Tell the patient whether the adverse event was preventable, if known. … Apologize ■ Say you are sorry for the adverse event in a sincere manner early in the conversation.
  6. www.cahps.ahrq.gov/hai/pfp/2015-interim.html
    December 01, 2016 - About 42 percent of this reduction is from adverse drug events, about 23 percent from pressure ulcers … The MPSMS methodology to identify adverse events within each chart is identical to prior years. … It should be noted that for every year from 2010 to 2014, the VTE adverse events contributed less than … Events Associated With Hip Joint Replacements 16,000 0.49 MPSMS (2015) Adverse Events Associated … indicated that in 2012 and 2013, adverse events were less frequent at hospitals that had implemented
  7. www.cahps.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/teamwork/engage/pf-engagement-facilitator-guide.docx
    May 01, 2017 - Discuss how to communicate an adverse event to patients and family members. … Immediately after an adverse event, care providers: Provide care. … Slide 21 SAY: Adverse events are often system failures. … Rarely does an adverse event occur as a result of intent. … Organizations need to engage in strategies to address adverse events.
  8. www.cahps.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/availability/chipra-233-hrob-section-3-table-2.pdf
    August 08, 2018 - Category C Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate … Category D There is positive evidence of human fetal risk based on adverse reaction data from investigational … have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse
  9. www.cahps.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/pfp/2014FinalHACreport4Web-13Dec2016.pdf
    December 01, 2016 - has occurred during a period of concerted attention by hospitals throughout the country to reduce adverse … About 40 percent of the overall reduction is from adverse drug events, about 28 percent from pressure … Healthcare Cost and Utilization Project. 39.6% 16.1% 1.1%2.4% 0.9% 27.9% 2.8% 0.4% 0.8% 8.1% Adverse … Most of the deaths averted occurred as a result of reductions in the rates of pressure ulcers and adverse … (see https://www.ncbi.nlm.nih.gov/pubmed/26854418) indicated that in 2012 and 2013, adverse events were
  10. www.cahps.ahrq.gov/hai/pfp/hacrate2011-12.html
    January 01, 2018 - The annual estimates include a wide variety of adverse events, including the nine HACs selected for special … Normalized to 32,750,000 Discharges— Based on 2010 Baseline) 2012 PFP Measured HACs per 1,000 Discharges Adverse … 17,000 0.51 Falls MPSMS In-Hospital Patient Falls 260,000 7.80 230,000 7.16 Obstetric Adverse … Femoral Artery Puncture for Catheter Angiographic Procedures 57,000 1.75 65,000 1.97 MPSMS Adverse … Events Associated With Hip Joint Replacements 33,000 1.00 31,000 0.93 MPSMS Adverse Events
  11. www.cahps.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/staff-safety-assessment.docx
    June 01, 2021 - Safety Assessment PURPOSE OF THIS FORM: To discuss issues that may result in antibiotic-associated adverse … events or have the potential to cause adverse events that could negatively impact patient safety.
  12. www.cahps.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/pfp/updatedhacrateinfo.pdf
    June 01, 2014 - The annual estimates include a wide variety of adverse events, including the nine HACs selected for … 32,750,000 Discharges— Based on 2010 Baseline) 2012 PFP Measured HACs per 1,000 Discharge s Adverse … 1,000 Discharge s Falls MPSMS In-Hospital Patient Falls 260,000 7.80 230,000 7.16 Obstetric Adverse … MPSMS Femoral Artery Puncture for Catheter Angiographic Procedures 57,000 1.75 65,000 1.97 MPSMS Adverse … Events Associated With Hip Joint Replacements 33,000 1.00 31,000 0.93 MPSMS Adverse Events Associated
  13. www.cahps.ahrq.gov/hai/pfp/2014-final.html
    January 01, 2018 - About 40 percent of the overall reduction is from adverse drug events, about 28 percent from pressure … Most of the deaths averted occurred as a result of reductions in the rates of pressure ulcers and adverse … Events Associated With Hip Joint Replacements 19,000 0.59 MPSMS (2014) Adverse Events Associated … vs. 2010, and Baseline Projections Made in 2011 on the Additional Inpatient Mortality per HAC Adverse … indicated that in 2012 and 2013, adverse events were less frequent at hospitals that have implemented
  14. www.cahps.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/c1_combo_prioritizationworksheetinstructions.pdf
    June 05, 2016 - • Appropriate comparator: When trying to identify the cost attributable to an adverse event captured … Patients who experience adverse events often tend to have more comorbidities and other risk factors … and thus have accrued more costs even prior to the adverse event. … Therefore, choose a group that did not experience the adverse event that is as comparable as possible … Compare the total costs of having an adverse event (Column G, Total Cost) with the anticipated cost
  15. www.cahps.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/teamwork/engage/pf-engagement-facilitator-guide.pdf
    May 01, 2017 - • Discuss how to communicate an adverse event to patients and family members. … Immediately after an adverse event, care providers: • Provide care. … SAY: Patients and family members experience a number of emotions when an adverse event occurs. … Rarely does an adverse event occur as a result of intent. … • Organizations need to engage in strategies to address adverse events.
  16. www.cahps.ahrq.gov/health-literacy/professional-training/lepguide/app-f.html
    September 01, 2020 - (continued) Slide 10: Causes of Adverse Events for LEP and Culturally Diverse Patients Slide 11: Systems … Language proficiency and adverse events in U.S. hospitals: a pilot study. … Types of Physical Harm Experienced From Adverse Events by English Speaking and LeP Patients. … Common Causes: Adverse Events for LEP Culturally Diverse Patients Use of Family Members/Friends or … Language proficiency and adverse events in US hospitals: a pilot study. Int J Qual Health Care .
  17. www.cahps.ahrq.gov/data/infographics/hac-rates_2019.html
    July 01, 2020 - (PDF, 11.1 MB) Text Description: National efforts to reduce hospital-acquired conditions such as adverse … Specific rates are: Adverse drug events: 28% decrease. CAUTI: 5% decrease. CLABSI: 6% decrease.
  18. Section 7C (pdf file)

    www.cahps.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-143-section-7c.pdf
    February 02, 2018 - Table VII.C.1 – Distribution of insurance types and adverse … 58.2%) 0.10 <0.001 No Insurance 102 (3.2%) 0.04 0.001 Table VII.C.2 – Analysis of differences in adverse
  19. Table 7.A (pdf file)

    www.cahps.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-143-section-7a.pdf
    February 02, 2018 - Table VII.A.1 – Distribution of race/ethnicity and adverse … Hispanic 352 (12.4%) 0.18 <0.001 Other 161 (5.7%) 0.12 0.12 Table VII.A.2 – Analysis of differences in adverse
  20. www.cahps.ahrq.gov/patient-safety/settings/hospital/candor/index.html
    August 01, 2022 - In short, the CANDOR process is a more patient-centered approach that emphasized early disclosure of adverse … Support Interaction—Nurse Module 7: Resolution Resolution Facilitator Notes ( PowerPoint , 757 KB) Adverse … Event—Reasonable Care Video; Resolution Planning Video: Conversation with Family Adverse Event—Unreasonable … Care Video: Notification of Adverse Event Video: Planning for Meetings with Family Video: Disclosure

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