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psnet.ahrq.gov/issue/sentinel-event-program
October 15, 2008 - Government Resource
Sentinel Event Program. … Citation Text:
Sentinel Event Program. … Copy URL
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Sentinel Event … June 10, 2020
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Adverse Health Events … October 3, 2017
Consumer Guide to Adverse Health Events.
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psnet.ahrq.gov/issue/medication-event-huddles-tool-reducing-adverse-drug-events
December 19, 2014 - Commentary
Medication event huddles: a tool for reducing adverse drug events. … Medication event huddles: a tool for reducing adverse drug events. … adverse drug events contemporaneously. … drug event and used a formal protocol to identify active and latent errors leading to the incident … Medication event huddles: a tool for reducing adverse drug events.
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psnet.ahrq.gov/issue/investigating-adverse-event-free-admissions-medicare-inpatients-patient-safety-indicator
May 04, 2016 - Study
Investigating adverse event free admissions in Medicare inpatients as a patient … Investigating Adverse Event Free Admissions in Medicare Inpatients as a Patient Safety Indicator. … This study proposes adverse event–free admissions as a potential measure of safety, defining the term … as any hospitalization in which the patient does not experience a preventable adverse event. … Investigating Adverse Event Free Admissions in Medicare Inpatients as a Patient Safety Indicator.
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psnet.ahrq.gov/issue/consensus-building-development-outpatient-adverse-drug-event-triggers
November 10, 2010 - Study
Consensus building for development of outpatient adverse drug event triggers … Consensus building for development of outpatient adverse drug event triggers. … Consensus building for development of outpatient adverse drug event triggers. … drug event triggers designed for the outpatient setting. … March 3, 2010
Understanding pharmacist decision making for adverse drug event (ADE) detection
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psnet.ahrq.gov/issue/designing-highly-reliable-adverse-event-detection-systems-predict-subsequent-claims
September 01, 2018 - Study
Designing highly reliable adverse-event detection systems to predict subsequent … Designing highly reliable adverse-event detection systems to predict subsequent claims. … This study demonstrated that modeling based on automated data mining of event reports could identify … This suggests that actions to address adverse events, such as disclosure programs , could be deployed … Designing highly reliable adverse-event detection systems to predict subsequent claims.
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psnet.ahrq.gov/issue/safety-analysis-over-time-seven-major-changes-adverse-event-investigation
September 24, 2018 - Commentary
Safety analysis over time: seven major changes to adverse event investigation … Safety analysis over time: seven major changes to adverse event investigation. … In-depth review and analysis of adverse events can both inform and detract from progress in patient … This commentary suggests that the early event analysis approaches have not achieved their potential … Safety analysis over time: seven major changes to adverse event investigation.
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psnet.ahrq.gov/issue/sentinel-event-alert
May 30, 2012 - Newsletter/Journal
Sentinel Event Alert. … Citation Text:
Sentinel Event Alert. Oakbrook Terrace, IL: The Joint Commission. … Preventable Harms – Point, Counterpoint, and Areas of Agreement
September 24, 2024
Adverse … Analysis in Health Care: A Joint Commission Guide to Analysis and Corrective Action of Sentinel and Adverse … December 23, 2016
Sentinel Event.
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psnet.ahrq.gov/issue/adverse-events-hospitalized-pediatric-patients
July 11, 2017 - Adverse Events in Hospitalized Pediatric Patients. … event rates at 16 randomly selected children's hospitals. … Adverse event rates did not significantly change at either teaching or nonteaching hospitals from 2007 … Adverse Events in Hospitalized Pediatric Patients. … July 3, 2016
Families as partners in hospital error and adverse event surveillance.
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digital.ahrq.gov/ahrq-funded-projects/electronic-support-public-health-vaccine-adverse-event-reporting-system/final-report
January 01, 2023 - Electronic Support for Public Health - Vaccine Adverse Event Reporting System (ESP:VAERS) - Final Report … Electronic Support for Public Health - Vaccine Adverse Event Reporting System (ESP:VAERS) - Final Report … PDF
Electronic Support for Public Health - Vaccine Adverse Event Reporting System (ESP:VAERS) … Investigator
Lazarus, Ross
Project Name
Electronic Support for Public Health - Vaccine Adverse … Event Reporting System (ESP:VAERS)
Technology
Public Health Informatics
Bar Coding
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psnet.ahrq.gov/issue/adverse-event-and-complication-tracking-anaesthesiology-dependence-self-reporting-despite
March 17, 2021 - Commentary
Adverse event and complication tracking in anaesthesiology: dependence … Adverse event reporting and tracking are essential components to safety improvement. … This letter to the editor summarizes the barriers to accurate adverse event tracking in anesthesiology … April 7, 2019
Adverse event reviews in healthcare: what matters to patients and their … October 29, 2017
Barriers to adverse event and error reporting in anesthesia.
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psnet.ahrq.gov/issue/connecting-perspectives-quality-and-safety-patient-level-linkage-incident-adverse-event-and
April 28, 2021 - event and complaint data. … Connecting perspectives on quality and safety: patient-level linkage of incident, adverse event and complaint … Connecting perspectives on quality and safety: patient-level linkage of incident, adverse event and complaint … July 2, 2019
Families as partners in hospital error and adverse event surveillance. … February 1, 2017
Electronic approaches to making sense of the text in the adverse event
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psnet.ahrq.gov/issue/reporting-death-us-food-and-drug-administration-medical-device-adverse-event-reports
April 07, 2019 - Reporting of death in US Food and Drug Administration medical device adverse event reports in categories … Based on medical device adverse event data reported to the FDA's Manufacturer and User Facility Device … March 17, 2021
Disparities in adverse event reporting for hospitalized children. … June 22, 2022
Trends in adverse event rates in hospitalized patients, 2010-2019. … used in daily workflow increases adverse event reporting by physicians.
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psnet.ahrq.gov/issue/adverse-event-reporting-practices-us-hospitals-results-national-survey
December 30, 2014 - Study
Adverse-event-reporting practices by US hospitals: results of a national survey … Adverse-event-reporting practices by US hospitals: results of a national survey. … Reducing adverse events on an institutional level requires a comprehensive error-reporting system and … Adverse-event-reporting practices by US hospitals: results of a national survey. … September 20, 2011
Families as partners in hospital error and adverse event surveillance
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psnet.ahrq.gov/issue/adverse-event-screening-tool-based-routinely-collected-hospital-acquired-diagnoses
July 23, 2008 - Study
An adverse event screening tool based on routinely collected hospital-acquired … An adverse event screening tool based on routinely collected hospital-acquired diagnoses. … This study found high levels of physician agreement using an adverse event screening tool for patients … An adverse event screening tool based on routinely collected hospital-acquired diagnoses. … March 4, 2015
Relationship between medication event rates and the Leapfrog computerized
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psnet.ahrq.gov/issue/assessing-residents-communication-skills-disclosure-adverse-event-standardized-patient
December 21, 2016 - Study
Assessing residents' communication skills: disclosure of an adverse event to … Assessing residents' communication skills: disclosure of an adverse event to a standardized patient. … Assessing residents' communication skills: disclosure of an adverse event to a standardized patient. … November 16, 2022
Families as partners in hospital error and adverse event surveillance … December 19, 2018
Sustaining and spreading the reduction of adverse drug events in a
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psnet.ahrq.gov/issue/maximizing-use-state-adverse-event-data-improve-patient-safety
November 29, 2009 - Book/Report
Maximizing the Use of State Adverse Event Data to Improve Patient Safety … Citation Text:
Maximizing the Use of State Adverse Event Data to Improve Patient Safety. … Event Reporting Systems. … November 29, 2009
2014 Guide to State Adverse Event Reporting Systems. … December 23, 2012
2007 Guide to State Adverse Event Reporting Systems.
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digital.ahrq.gov/ahrq-funded-projects/automated-adverse-drug-event-detection-and-intervention/annual-summary/2008
January 01, 2008 - Automated Adverse Drug Event Detection and Intervention - 2008
Project Name
Automated … Adverse Drug Event Detection and Intervention
Principal Investigator
Ferranti, Jeffrey … Business Goal: Knowledge Creation
Summary: The primary purpose of the Automated Adverse Drug Event … Sharing adverse drug event data using business intelligence technology. … Sharing Adverse Drug Event Surveillance Results Using Business Intelligence Technology. 2008 AMIA Spring
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psnet.ahrq.gov/issue/systematic-review-evaluate-accuracy-electronic-adverse-drug-event-detection
October 05, 2011 - Study
A systematic review to evaluate the accuracy of electronic adverse drug event … A systematic review to evaluate the accuracy of electronic adverse drug event detection. … A systematic review to evaluate the accuracy of electronic adverse drug event detection. … event classification. … October 29, 2014
Quality assessment of spontaneous triggered adverse event reports received
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psnet.ahrq.gov/issue/vaccination-errors-reported-vaccine-adverse-event-reporting-system-vaers-united-states-2000
May 18, 2022 - Study
Vaccination errors reported to the Vaccine Adverse Event Reporting System ( … Vaccination errors reported to the Vaccine Adverse Event Reporting System, (VAERS) United States, 2000 … Vaccination-related errors reported to the National Vaccine Adverse Event Reporting System grew from … One-fourth of reported errors caused an adverse health event, with 8% of these resulting in serious harm … Vaccination errors reported to the Vaccine Adverse Event Reporting System, (VAERS) United States, 2000
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psnet.ahrq.gov/issue/automated-surveillance-adverse-drug-events-community-hospital-and-academic-medical-center
September 23, 2020 - This study determined that an automated adverse drug event (ADE) surveillance system captured higher … event rates than did existing voluntary systems, particularly in a community setting. … Application of emergency preparedness principles to a pharmacy department’s approach to a “black swan” event … drug event surveillance and voluntary reporting in the pediatric environment. … February 16, 2011
Effects of an adverse-drug-event alert system on cost and quality outcomes