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monahrq.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/perinatal_care_toolkit_fullcolor.pdf
May 01, 2017 - Ways to reduce obstetrical adverse events include improving teamwork and communication
among care teams … Root cause analyses of adverse
events and near-misses (events that did not produce
patient injury) … EARLY IMPACTS
The most recent root cause analyses of adverse events
and near-misses indicated that … poor communication is
no longer a root cause; in fact, near-misses and adverse
events attributed to … The weighted
adverse events included in the measure are in-house maternal death, in-house
neonatal
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monahrq.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/perinatal_care_toolkit_lowvision.pdf
May 01, 2017 - Ways to reduce obstetrical adverse events include improving teamwork and communication
among care teams … Root cause analyses of adverse
events and near-misses (events that did not produce
patient injury) … EARLY IMPACTS
The most recent root cause analyses of adverse events
and near-misses indicated that … poor communication is
no longer a root cause; in fact, near-misses and adverse
events attributed to … The weighted
adverse events included in the measure are in-house maternal death, in-house
neonatal
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monahrq.ahrq.gov/news/events/ahrq-research-summit-diagnostic-safety-biosketches.html
September 01, 2016 - for health care safety and quality in a variety of fields, including patient engagement, response to adverse … events, diagnostic error reduction, rapid response, and infection prevention, among others. … Safety Monitoring System, a nationwide surveillance project aimed at identifying the rates of specific adverse … events within the Medicare population. … paper, and led the AHRQ-Brigham medication safety HIT CERT CEDAR (Calling for Earlier Detection of Adverse
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monahrq.ahrq.gov/news/newsletters/e-newsletter/878.html
August 01, 2023 - Studies
Blog
AHRQ Views
Newsletter
AHRQ News Now
Events … section
News
Newsroom
Blog
Newsletter
AHRQ News Now
Events … (Source: JAMA Network Open , Complications, Adverse Drug Events, High Costs, and Disparities in Multisystem … include:
Common contributing factors of diagnostic error: a retrospective analysis of 109 serious adverse
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monahrq.ahrq.gov/talkingquality/explain/share-info/highlight.html
September 01, 2019 - Studies
Blog
AHRQ Views
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AHRQ News Now
Events … For example, in the next few years, we may see systems that enable patients to report on adverse events
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monahrq.ahrq.gov/news/newsletters/e-newsletter/821.html
June 01, 2022 - Studies
Blog
AHRQ Views
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AHRQ News Now
Events … section
News
Newsroom
Blog
Newsletter
AHRQ News Now
Events … Analysis of Hospital-Level Readmission Rates and Variation in Adverse Events Among Patients With Pneumonia … Assessing adverse event reports of hysteroscopic sterilization device removal using natural language
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monahrq.ahrq.gov/news/newsletters/e-newsletter/803.html
March 01, 2022 - Studies
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AHRQ Views
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AHRQ News Now
Events … section
News
Newsroom
Blog
Newsletter
AHRQ News Now
Events … This included reductions in the use of fluoroquinolones, a class of antibiotics known to cause adverse … Relative risks of adverse events among older adults receiving opioids versus NSAIDs after hospital discharge
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monahrq.ahrq.gov/topics/hospital-readmissions.html
January 01, 2012 - Studies
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AHRQ Views
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AHRQ News Now
Events … Readmissions and Adverse Events After Discharge
This Patient Safety Primer from AHRQ's Patient Safety
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monahrq.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/engagingfamilies/strategy4/Strat4_Tool_4_PPT_508.pptx
April 01, 2011 - For example, one study found that more than 70 percent of adverse events are caused by breakdowns in … be prevented
Common complications post-discharge are adverse drug events, hospital-acquired infections … have been prevented or ameliorated.1
Common post-discharge complications include adverse drug events … The incidence and severity of adverse events affecting patients after discharge from the hospital. … events and prevent readmissions.
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monahrq.ahrq.gov/sites/default/files/wysiwyg/teamstepps/webinars/2016-materials/teamstepps-monthly-webinar-april2016.pptx
January 01, 2016 - 05.2 Page ‹#›
TeamSTEPPS®
Clinical Performance & Safety Culture
Slide ‹#›
Upcoming TeamSTEPPS Events … 05.2 Page ‹#›
TeamSTEPPS®
Clinical Performance & Safety Culture
Slide ‹#›
Upcoming TeamSTEPPS Events … Register at: https://tslms.org
Learn more and register for all events at www.TeamSTEPPSportal.org … healthcare
Optimizing patient outcomes by improving communication and other teamwork skills
Reducing adverse … patient events related to communication breakdowns and/or poor teamwork
TEAMSTEPPS 05.2
Mod 1 05.2
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monahrq.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/strategies/medication/tool_safe-mgso4.docx
May 30, 2013 - fractures.3,9
Staff with requisite training and supplies available to respond to magnesium-related adverse … Defects (CUSP Module)
Key Perinatal Safety Elements
Examples
Debrief and analyze near misses and adverse … events related to magnesium sulfate use … Have a process in place to review severe maternal or neonatal morbidity and mortality events. … events including respiratory depression
2.
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monahrq.ahrq.gov/patient-safety/patients-families/engagingfamilies/strategy4/index.html
December 01, 2017 - Studies
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AHRQ Views
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AHRQ News Now
Events … Primary Care Settings
About AHRQ's Quality & Patient Safety Work
Patient Safety News and Events … requires the successful transfer of information from clinicians to the patient and family to reduce adverse … events and prevent readmissions.
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monahrq.ahrq.gov/diagnostic-safety/research/index.html
March 01, 2024 - Studies
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AHRQ Views
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AHRQ News Now
Events … Learning more about the link between diagnostic errors and outcomes, including adverse events.
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monahrq.ahrq.gov/news/blog/ahrqviews/comments-pso-draft-report.html
February 01, 2021 - Studies
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AHRQ Views
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AHRQ News Now
Events … this section
News
Newsroom
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AHRQ Views
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Events … Although we still see too many events such as adverse drug reactions, infections, or falls, momentum
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monahrq.ahrq.gov/news/newsroom/press-releases/carbon-emissions.html
September 01, 2022 - Studies
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AHRQ Views
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Events … AHRQ Social Media
AHRQ Stats
Impact Case Studies
Blog
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Events … Healthcare is both a significant contributor to climate change and responsible for managing the adverse … “Extreme weather events, declining air quality, and growing food and water insecurity now threaten healthcare
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monahrq.ahrq.gov/sites/default/files/wysiwyg/teamstepps/webinars/2017-materials/teamstepps-webinar-051017.pptx
January 01, 2017 - presentation
TEAMSTEPPS 05.2
Slide ‹#›
May TeamSTEPPS Monthly Webinar
2
Upcoming TeamSTEPPS Events … Set the tone for the training sessions
Be transparent about the Peri Op safety events & trends
Weave … May TeamSTEPPS Monthly Webinar
Changes Since TS Training
Increased reporting of patient safety events … Optimizing patient outcomes by early identification and resolution of patient safety concerns
Reducing adverse … patient events related to communication breakdowns and poor teamwork
TEAMSTEPPS 05.2
Slide ‹#›
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monahrq.ahrq.gov/research/findings/studies/index.html?page=3
January 01, 2024 - 1279)
2015
(1430)
2014
(662)
2013
(195)
Topics
Access to Care
(417)
Adverse … Drug Events (ADE)
(321)
Adverse Events
(736)
Alcohol Use
(61)
Ambulatory Care and Surgery … Results of the Pediatric Care BefOre Deterioration Events (CODE) survey. … Results of the Pediatric Care BefOre Deterioration Events (CODE) survey. … Keywords: Provider: Pharmacist, Medication, Adverse Drug Events (ADE), Adverse Events, Medical Errors
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monahrq.ahrq.gov/health-literacy/improve/pharmacy/tools.html
January 01, 2024 - Studies
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AHRQ News Now
Events … (MTM) is a patient-centric and comprehensive approach to improve medication use, reduce the risk of adverse … events, and improve medication adherence.
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monahrq.ahrq.gov/patient-safety/settings/hospital/candor/modules/facguide3/ape.html
August 01, 2022 - Studies
Blog
AHRQ Views
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AHRQ News Now
Events … Patients and Families
About AHRQ's Quality & Patient Safety Work
Patient Safety News and Events … The comprehensive toolkit will allow hospitals to improve the management of patient safety events by … implementing processes that facilitate full disclosure of an adverse event, apology, and fair and rapid
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monahrq.ahrq.gov/sops/international/hospital/translators.html
October 01, 2014 - Studies
Blog
AHRQ Views
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AHRQ News Now
Events … Hospital management seems interested in patient safety only after an adverse event happens. … usually show interest in patient safety—they show interest in patient safety only when there is an adverse … Frequency of Events Reported
( More about this item: Refers to reports made to someone in authority … The term "rating" can be used instead of "grade." )
Number of Events Reported
(No event reports,