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41. Physician-Reported Adverse Events and Medical Errors in Obstetrics and Gynecology (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol1/Advances-November_45.pdf
    January 01, 2007 - Incidence of adverse drug events and potential adverse drug events. JAMA 1995; 274: 29-34. 5. … The incident reporting system does not detect adverse drug events: A problem for quality improvement

42. Developing the Tools to Administer a Comprehensive Hospital Discharge Program: The ReEngineered Discharge (RED) Program (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol3/Advances-Jack_28.pdf
    February 21, 2008 - The cost of treating an adverse drug event in a hospital averages $3,244 to $5,857 per case.47, 48, … 49, 50 3 Adverse Drug Events: Common, Serious, and Costly Adverse drug events (ADEs) are the … Adverse drug reactions as cause of admission to hospital: Prospective analysis of 18,820 patients. … The costs of adverse drug events in hospitalized patients. … Can the frequency and risks of fatal adverse drug events be determined?

43. Final Progress Report: Adverse Event-Directed Analysis in Ambulatory Primary Care (pdf file)
    www.ahrq.gov/sites/default/files/2024-10/kennerly-ballard-report.pdf
    January 01, 2024 - In ambulatory care, adverse drug events alone are estimated to be 8.8 million yearly, with 3 million … Adverse drug events in ambulatory care. N Engl J Med. Apr 17 2003;348(16):1556-1564. 17. … Description of a computerized adverse drug event monitor using a hospital information system. … Computerized surveillance of adverse drug events in hospital patients. Jama. … Adverse drug event trigger tool: a practical methodology for measuring medication related harm.

44. Prologue: Technology and Medication Safety (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol4/Advances-Prologue_Grady_Vol4.pdf
    June 02, 2025 - We are already using health IT in a number of ways: to help prevent medical errors, including adverse … drug events; reduce costs through streamlining processes and providing more targeted, efficient care … Medication errors are a frequent cause of adverse drug events, and they can occur at any point in the … drug events, ranging from increased involvement of pharmacists, to e-prescribing technologies, to computer-based … drug events.

45. Post-fielding Surveillance of a Guideline-based Decision Support System (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol1/Chan.pdf
    January 01, 2004 - Timely analysis of such feedback revealed omissions of medications, diagnoses, and adverse drug reactions … Similarly, “missing” adverse drug reactions noted by clinicians were confirmed by chart review as not … One comment highlighted an instance where an adverse drug reaction (ADR) reaction to a substance was … Incorrect adverse drug reaction (ADR) notification 1 Error in the data conversion, leading to the

46. Declines in Hospital-Acquired Conditions (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/data/infographics/hac-rates-2019-updated.pdf
    January 01, 2019 - in Hospital- Acquired Conditions National efforts to reduce hospital-acquired conditions such as adverse … drug events and injuries from falls helped prevent 20,700 deaths and saved $7.7 billion between 2014 … Adverse Drug Events -28% CAUTI* -5% CLABSI+ -6% Clostridioides difficile Infections -37%

47. Final Progress Report: Enhancing the Safety of Warfarin in the Nursing Home (pdf file)
    www.ahrq.gov/sites/default/files/2024-01/gurwitz-report.pdf
    January 01, 2024 - drug events. … Although an adverse drug event in this setting may be directly linked to a “human error,” the root cause … Relationship between Nurse Staffing, Health Inspection Deficiencies and Adverse Drug Events in Nursing … drug event incidence. … Dementia and the Incidence of Adverse Drug Events in the Nursing Home.

48. Final Progress Report: Drug-Drug Interaction Clinical Decision Support Conference Series (pdf file)
    www.ahrq.gov/sites/default/files/2024-01/malone-report.pdf
    January 01, 2024 - Injury due to a known DDI is a preventable adverse drug event and constitutes a serious medication … Injury due to a known DDI is a preventable adverse drug event and serious medication error. … Incidence of adverse drug events and potential adverse drug events. Implications for prevention. … Drug-drug interactions among elderly patients hospitalized for drug toxicity. … Gender differences in drug toxicity. Trends Pharmacol Sci. Mar 2010;31(3):108-114.

49. Draft Final Report Estimating the Additional Hospital Inpatient Cost and Mortality Associated with Selected Hospital Acquired Conditions (pdf file)
    www.ahrq.gov/sites/default/files/publications2/files/hac-cost-report2017.pdf
    November 01, 2017 - Adverse Drug Events (anticoagulants, opioids, and hypoglycemic agents) 2. … “drug overdose”[mh] OR “Drug-related side effects and adverse reactions”[mh] OR “adverse drug event … ”[tiab] OR “adverse drug events”[tiab] OR “adverse drug reaction”[tiab] OR “adverse drug reactions”[ … Clinical and economic impact of adverse drug reactions in hospitalized patients. … Adverse Drug Events Exhibit D2. Catheter-Associated Urinary Tract Infection Exhibit D2.

50. Draft Final Report Estimating the Additional Hospital Inpatient Cost and Mortality Associated with Selected Hospital Acquired Conditions (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/pfp/hac-cost-report2017.pdf
    November 01, 2017 - Adverse Drug Events (anticoagulants, opioids, and hypoglycemic agents) 2. … “drug overdose”[mh] OR “Drug-related side effects and adverse reactions”[mh] OR “adverse drug event … ”[tiab] OR “adverse drug events”[tiab] OR “adverse drug reaction”[tiab] OR “adverse drug reactions”[ … Clinical and economic impact of adverse drug reactions in hospitalized patients. … Adverse Drug Events Exhibit D2. Catheter-Associated Urinary Tract Infection Exhibit D2.

51. Final Progress Report: Improving Transplant Med Safety through a Pharmacist-Led, mHealth-Based Program (pdf file)
    www.ahrq.gov/sites/default/files/2024-02/taber-report.pdf
    January 01, 2024 - drug events (p=0.020). … In other chronic disease states, adverse drug events have been clearly established as a major risk factor … Therefore, early recognition of adverse drug events in kidney transplant recipients will likely help … drug events. … Incidence and impact of adverse drug events contributing to hospital readmissions in kidney transplant

52. Clinical Pharmacists in Emergency Medicine (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol4/Advances-fairbanks_20.pdf
    February 21, 2008 - adverse drug events that occur in the ED are a significant public health problem and need to be reduced … Adverse drug events in emergency department patients. Ann Emerg Med 2002; 39: 258-267. 1. … Systems analysis of adverse drug events. ADE Prevention Study Group. … Pharmacist participation on physician rounds and adverse drug events in the intensive care unit. … The clinical pharmacist’s role in preventing adverse drug events.

53. Final Progress Report: Transforming the Medication Regimen Review Process of High-Risk Drugs Using a Patient-Centered, Telemedicine-Based Approach to Prevent ADEs in the Nursing Home (pdf file)
    www.ahrq.gov/sites/default/files/2024-02/kane-gill-report.pdf
    January 01, 2024 - Adverse drug event, telemedicine, nursing home, pharmacist Purpose We conducted a quality improvement … The National Action Plan for Adverse Drug Event Prevention identified the nearly 16,000 NHs as a clinical … Post-admission Alerts Evaluated for Adverse Drug Events Telemedicine Communications. … Drug Reaction Probability Scale. … Adverse drug events were defined as injuries resulting from a medication.

54. Final Progress Report: Pharmacist Technology for Nursing Home Resident Safety (pdf file)
    www.ahrq.gov/sites/default/files/2024-01/lapane-report.pdf
    January 01, 2024 - Both usual-care and intervention homes experienced a decline in potential adverse drug event related … 4.4 (.56) 4.0 (.88) -9.1 Adverse Drug Event Related Hospitalization based on Primary Diagnosis … Heightened awareness of adverse drug events may have occurred in the intervention homes. … The prevention of adverse drug events. ECPN 2005;June:26-32. Feinberg JL. … Incidence and preventability of adverse drug events in nursing homes.

55. What Happens After a Patient Safety Event? Medical Expenditures and Outcomes in Medicare (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol1/Encinosa.pdf
    January 01, 2003 - ; and Bates and colleagues4 estimated the cost of Expenditures and Outcomes in Medicare 425 adverse … drug events using 247 adverse drug events in 207 hospitalized patients in 2 hospitals in Boston over … The costs of adverse drug events in hospitalized patients. JAMA 1997;277(4):307–11. 5.

56. AHRQ National Scorecard on Hospital-Acquired Conditions: Final Results for 2014 Through 2017 (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/pfp/Updated-hacreportFInal2017data.pdf
    July 01, 2020 - drug events, and injuries due to procedures, as well as pressure ulcers/pressure injuries and falls … For example, measured adverse drug events continued to drop from 2014 to 2017, while measured pressure … Drug Events 33.7 30.0 27.1 24.2 -28% Catheter-Associated Urinary Tract Infections 5.7 6.4 5.7 … Measures used to estimate the national HAC rate HAC Type Source Measure Adverse Drug Event MPSMS … Drug Event MPSMS ADE Associated With Digoxin 6,204 0.21 795 0.03 169 0.01 2,671 0.09 MPSMS ADE

57. Adverse Events Among In-Hospital Medicare Patients in 2021 and 2022 (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/patient-safety/quality-measures/qsrs/qsrs-2021-2023-adverse-event-data-report.pdf
    January 01, 2023 - MPSMS data, AHRQ determined that national efforts to reduce hospital-acquired conditions, such as adverse … drug events and injuries from falls, helped prevent 20,700 deaths and saved $7.7 billion between 2014 … Major additions when compared to the MPSMS include additional adverse drug events (such as opioid AEs … Drug Events 41 AEs in the following categories: - Birth events (maternal and neonatal) - Blood … xx Office of Disease Prevention and Health Promotion, "National Action Plan for Adverse Drug Event Prevention

58. A | Agency for Healthcare Research and Quality
    www.ahrq.gov/topics/a.html
    September 04, 2025 - Topics Browse A - Z A Access to Care Adverse Drug Events (ADE) Adverse Events

59. Care Coordination | Agency for Healthcare Research and Quality
    www.ahrq.gov/topics/care-coordination.html
    January 01, 2014 - who often have difficulty reconciling and managing medications after a hospital discharge, leading to adverse … drug events and harm.

60. Risk of Concurrent Use of Prescription Drugs with Herbal and Dietary Supplements in Ambulatory Care (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol4/Advances-Graham_77.pdf
    March 05, 2008 - drug events (ADEs) related to drug-HDS interactions. … drug events (ADEs) related to HDS. … Adverse Drug Events Among Herbal and Dietary Supplement Users Twenty-nine (29 percent) of the 101 HDS … Adverse drug events in ambulatory care. N Engl J Med 2003; 348: 1556-1564. 15. … Incidence of adverse drug events and potential adverse drug events. Implications for prevention.