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21. Methods To Estimate the Baseline 2010 PFP National Hospital-Acquired Condition Rate | Agency for Healthcare Research and Quality
    ce.effectivehealthcare.ahrq.gov/hai/pfp/methods.html
    December 01, 2017 - Events Associated With Hip Joint Replacements MPSMS Adverse Events Associated With Knee Joint Replacements … events for all patients to adverse events for patients with one of the four diagnoses. … Events Associated With Hip Joint Replacements 1.02 3.70 0.28 All Other HACs Adverse Events … Events Associated With Hip Joint Replacements 30,413 32,750,000 0.929 MPSMS Adverse Events … events for all diagnoses to adverse events for the four diagnoses.

22. Views of Emergency Medicine Trainees on Adverse Events and Negligence: Survey Results from an Emergency Medicine Training Program in a Regional Health Care System Following the National Standard of Care (pdf file)
    ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol2/Advances-Shah_99.pdf
    March 23, 2008 - Quantitative questions included: “General Issues of Adverse Events,” “Causes of Adverse Events,” “Strategies … to Reduce Adverse Events,” and “Malpractice Issues.” … to think of adverse events. … Causes of adverse events. … Strategies for reducing adverse events.

23. Using ICD-9-CM Codes in Hospital Claims Data to Detect Adverse Events in Patient Safety Surveillance (pdf file)
    ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol1/Advances-Hougland_26.pdf
    October 01, 2011 - events, misadventures, infections, device events, and other adverse events. … Adverse drug events. 2. Surgical events. 3. Misadventures. 4. Device events. 5. … events, and other adverse events. … Adverse events related to medical care, 1995-1999. … Events Surgical Events Misadventures Infections Device Events Miscellaneous Adverse Events Discussion

24. Medication Discrepancies and Potential Adverse Drug Events During Transfer of Care from Hospital to Home | Agency for Healthcare Research and Quality
    ce.effectivehealthcare.ahrq.gov/patient-safety/reports/liability/neumiller.html
    August 01, 2017 - Incidence and preventability of adverse drug events in nursing homes. … Incidence of adverse drug events and potential adverse drug events; implications for prevention: ADE … The Canadian adverse events study: the incidence of adverse events among hospital patients in Canada. … National surveillance of emergency department visits for outpatient adverse drug events. … Adverse drug events in ambulatory care. N Engl J Med 2003; 348:1556‑64. 33.

25. Lessons Learned from the Evolution of Mandatory Adverse Event Reporting Systems (pdf file)
    ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol3/Flink.pdf
    April 09, 2004 - The program required reporting of preventable adverse events and a description of steps taken to address … The Anesthesia Patient Safety Foundation (APSF), a pioneer in reporting adverse events/medical errors … Incidence of adverse events and negligence in hospitalized patients. … Detecting adverse events using information technology. … Reporting on adverse events. NEJM 2002 Nov20;347(20):1633–8.

26. Major Study Shows Significant Drop in In-Hospital Adverse Event Rates Pre-COVID | Agency for Healthcare Research and Quality
    ce.effectivehealthcare.ahrq.gov/news/newsletters/e-newsletter/822.html
    July 01, 2022 - Today's Headlines: Major Study Shows Significant Drop in In-Hospital Adverse Event Rates Pre-COVID … adverse events for healthcare-related patient harm fell significantly in the United States in the decade … The authors of the study, published in JAMA , tracked 21 adverse events of nearly 245,000 patients in … Examples of the events included adverse medication events such as those associated with the use of insulin … Monitoring preventable adverse events and near misses: number and type identified differ depending on

27. A Study of Adverse Occurrences and Major Functional Impairment Following Surgery (pdf file)
    ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol1/Rojas.pdf
    March 15, 2004 - We examined adverse occurrences, not adverse events. … Adverse events in surgical patients in Australia. … Proportion of hospital deaths associated with adverse events. … Adverse drug events in hospitalized patients. … The costs of adverse drug events in hospitalized patients.

28. Final Progress Report: Improving Medication Safety Across Clinical Settings (pdf file)
    ce.effectivehealthcare.ahrq.gov/sites/default/files/2024-01/bates-report.pdf
    January 01, 2024 - events. 2) Assessment of the epidemiology of medication errors and adverse drug events in the outpatient … Key Words: Surveillance and reporting of adverse events; adverse drug events in ambulatory pediatrics … adverse warfarin-related events were identified. … Bates DW, Cullen D, Laird N, et al: Incidence of adverse drug events and potential adverse drug events … Adverse drug events in ambulatory care.

29. What Happens After a Patient Safety Event? Medical Expenditures and Outcomes in Medicare (pdf file)
    ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol1/Encinosa.pdf
    January 01, 2003 - drug events using 247 adverse drug events in 207 hospitalized patients in 2 hospitals in Boston over … adverse events. … events and 8.37 percent for those without potentially preventable adverse medical events. … medical events, and 5.61 percent for those without potentially preventable adverse medical events. … by patients experiencing adverse events.

30. The Brighton Collaboration: Creating a Global Standard for Case Definitions (and Guidelines) for Adverse Events Following Immunization (pdf file)
    ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol2/Kohl.pdf
    April 01, 2004 - Case Definitions (and Guidelines) for Adverse Events Following Immunization Katrin S. … Safety can only be inferred indirectly from the relative absence of multiple, likely adverse events … Case Definitions for Adverse Events After Immunization 91 Global standardization in immunization … Case Definitions for Adverse Events After Immunization 101 23. Rigau-Perez JG, Bonilla GL. … Surveillance of adverse events following immunization.

31. Developing a Veterans Health Administration (VHA) Serious Injury Surveillance System that Includes Adverse Event Hospitalizations (pdf file)
    ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol1/Campbell.pdf
    January 01, 2003 - Hospitalizations for adverse events associated with medical care, or medication adverse events, represented … events involving hospitalizations and will also include veteran injuries and adverse events that are … Incidence and types of adverse events and negligent care in Utah and Colorado. … Adverse events related to medical care, Utah: 1995–99. … Adverse events in New Zealand public hospitals I: occurrence and impact.

32. AHRQ Quality and Safety Review System (QSRS) | Agency for Healthcare Research and Quality
    ce.effectivehealthcare.ahrq.gov/patient-safety/quality-measures/qsrs/index.html
    September 01, 2022 - events were occurring in order to prevent them. … This chart review-based surveillance system determines national rates for 21 types of adverse events, … events. … use/misuse, surgical site infections, and other surgical and anesthesia-related adverse events, as well … as obstetric and neonatal adverse events.

33. Module 7: Resolution | Agency for Healthcare Research and Quality
    ce.effectivehealthcare.ahrq.gov/patient-safety/settings/hospital/candor/modules/notes7.html
    August 01, 2022 - Slide 1 Say: When adverse patient events occur, the patient and their family are looking for … events. … Following patient harm events, the patient and/or family might sue the caregiver and/or organization, … When harm occurs, patients often express the desire to protect others from future events. … These metrics include organizational performance relative to adverse events, financial impact, as well

34. Implementation Guide for the CANDOR Process: Appendix A | Agency for Healthcare Research and Quality
    ce.effectivehealthcare.ahrq.gov/patient-safety/settings/hospital/candor/impguide/apa.html
    August 01, 2022 - Analyze the organization's frequency of adverse events and malpractice claims to support the rationale … Discuss efforts to improve communication and response to adverse events to date, including the clinical … event: Number of adverse events reported >24 hours after occurrence Severity level of adverse … (Track, analyze, and compare adverse events managed pre‑implementation, then follow up with additional … Determine a return on investment that ties to reduced adverse events.  

35. Using Digital Health Tools to Improve Patient Safety during Acute Care | Agency for Healthcare Research and Quality
    ce.effectivehealthcare.ahrq.gov/funding/grantee-profiles/grtprofile-dalal.html
    January 01, 2024 - Between 19 to 28 percent of patients experience adverse events during care transitions. … These adverse events, which may lead to hospital readmissions, represent an ongoing threat to patient … events. … Building on his efforts to reduce adverse events during care transitions, Dr. … It also will help patients to understand their individualized risks of adverse events during care transitions

36. Development of a Computerized Adverse Drug Event (ADE) Monitor in the Outpatient Setting (pdf file)
    ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol2/Seger.pdf
    January 01, 2003 - Introduction Adverse drug events (ADEs) contribute to overall morbidity and mortality. … Incidence of adverse drug events and potential adverse drug events: Implications for prevention. … Adverse drug events in ambulatory care. NEJM 2003;348:1,556–64. 4. … Multifacted approach to reducing preventable adverse drug events. … Relationship between medication errors and adverse drug events.

37. Fundamentals of Medicare Patient Safety Surveillance: Intent, Relevance, and Transparency (pdf file)
    ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol2/Hunt.pdf
    July 01, 2004 - This system is immense in scope and provides national rates of adverse events by employing explicit … adverse events beyond the list of MPSMS topics. … Adverse event (a list of adverse events to be examined for each measure). … episode,2 the MPSMS only has the capacity to identify rates for select adverse events. … Thus, the five criteria for selecting adverse medical events were— • the adverse event can be found

38. Methods To Estimate the Baseline 2010 PFP National Hospital-Acquired Condition Rate (pdf file)
    ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/pfp/pfphac.pdf
    September 01, 2014 - Events Associated With Hip Joint Replacements MPSMS Adverse Events Associated With Knee Joint Replacements … events for all patients to adverse events for patients with one of the four diagnoses. … Events Associated With Hip Joint Replacements 1.02 3.70 0.28 All Other HACs Adverse Events Associated … Events Associated With Hip Joint Replacements 30,413 32,750,000 0.929 MPSMS Adverse Events Associated … events for all diagnoses to adverse events for the four diagnoses.

39. Implementation Guide for the CANDOR Process | Agency for Healthcare Research and Quality
    ce.effectivehealthcare.ahrq.gov/patient-safety/settings/hospital/candor/impguide.html
    August 01, 2022 - events. … events and promote better care for patients through candid, caring communication in the wake of an adverse … events from happening in the future. … It also emphasizes the organization's commitment to improve the reporting and monitoring of adverse events … event (see Adverse Event (Reasonable Care) and Adverse Event (Unreasonable Care)) .

40. Table 5.A.1. Evidence Table (pdf file)
    ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-143-section-5a-evidence-table.pdf
    January 01, 2014 - events, including adverse drug events (ADEs). … adverse events, including 256 ADEs. The 2010;11(5):568-578. … The Canadian Adverse Events Study: the incidence of adverse events among hospital patients in … Adverse events among children in Canadian hospitals: the Canadian Paediatric Adverse Events Study … Detecting Adverse Events Using Information Technology.