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Showing results for "adverse events".
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81. Federal Interagency Workgroup: Improving Diagnostic Safety and Quality in Healthcare (pdf file)
    pcmh.ahrq.gov/sites/default/files/wysiwyg/topics/public-notes-meeting-summary-111921.pdf
    March 11, 2022 - Indian Health Service • Enhanced Adverse Event Reporting Capabilities: o Reporting of adverse events

82. Making Healthcare Safer IV | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/research/findings/making-healthcare-safer/mhs4/index.html
    April 01, 2024 - Cards and Outcome Measurements Report Protocol Opioid Stewardship Report Protocol Reducing Adverse … Events Related to Anticoagulants Report Protocol Implicit Bias Training Report Protocol … Deprescribing Report Protocol Computerized Clinical Decision Support To Prevent Medication Errors and Adverse … Drug Events Report Protocol Failure To Rescue—Rapid Response Systems Report Protocol Prevention

83. Transforming Care for People Living with Multiple Chronic Conditions (pdf file)
    pcmh.ahrq.gov/sites/default/files/wysiwyg/patient-safety/settings/mcc-summit/mcc-summit-arlene.pdf
    November 17, 2020 - risk” will go on to develop MCC • Targeted interventions to improve health and reduce the risk of adverse … events and complications among those with multiple chronic conditions (e.g., diabetes, depression, … interventions for those who have complex management issues and who are at “high risk” for avoidable adverse … events, and require a focus on preventing decline, maximizing functioning, and improving quality of

84. Operational Measurement of Diagnostic Safety: State of the Science (pdf file)
    pcmh.ahrq.gov/sites/default/files/wysiwyg/patient-safety/reports/issue-briefs/state-of-science.pdf
    April 02, 2020 - Detecting adverse events for patient safety research: a review of current methodologies. … Measuring errors and adverse events in health care. … Lessons from a patient partnership intervention to prevent adverse drug events. … Computerized surveillance of adverse drug events in hospital patients. … Adverse events during hospitalization: results of a patient survey.

85. TeamSTEPPS®: Research/Evidence Base | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/teamstepps/evidence-base/labor-delivery.html
    July 01, 2015 - Effect of a comprehensive obstetric patient safety program on compensation payments and sentinel events … Effects of teamwork training on adverse outcomes and process of care in labor and delivery: a randomized … Impact of a comprehensive patient safety strategy on obstetric adverse events.

86. Changing the System To Improve Antibiotic Safety | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/antibiotic-use/long-term-care/safety/system-change.html
    June 01, 2021 - Improve Antibiotic Safety – Facilitator Guide (DOCX, 2.3 MB) Learning From Antibiotic-Associated Adverse … Events  (DOCX, 226.7 KB) Page last reviewed June 2021 Page originally

87. Patient Safety and Quality Areas | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/patient-safety/about/areas.html
    February 01, 2018 - Learn about Patient Safety Patient Safety and Quality Areas Patient Safety News and Events … Team Training Falls Pressure Ulcers Diagnostic Safety Blood Clot Prevention and Treatment Adverse … Drug Events AHRQ Quality Indicators (QIs) Page last reviewed February

88. Module 4: Event Reporting, Event Investigation and Analysis | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/patient-safety/settings/hospital/candor/modules/notes4.html
    August 01, 2022 - Do they believe the organization is aware of all the patient harm events? … Have they heard of events that should have been reported but were not reported? … Other methods of reporting CANDOR events may include in-person reporting. … The sole objective of the Event Investigation and Analysis of an adverse event or near miss is to prevent … future adverse events.

89. How To Use the Toolkit for Improving Perinatal Safety | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/how-to-use.html
    July 01, 2023 - Patients and Families About AHRQ's Quality & Patient Safety Work Patient Safety News and Events … team members how to apply the Comprehensive Unit-based Safety Program (CUSP) to prevent obstetrical adverse … events.

90. New Toolkit Can Improve Post-Surgery Complications and Enhance Patient Recovery | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/news/newsletters/e-newsletter/870.html
    June 01, 2023 - section News Newsroom Blog Newsletter AHRQ News Now Events … Researchers found that the interventions could prevent more than 3,100 ASCVD events over 10 years and … Walsh is working to prevent medication errors and adverse drug events among children, particularly those … Associated With Financial Distress An analysis of more than 132,000 individuals’ credit reports showed adverse … Racial, Ethnic, and Payer Disparities in Adverse Safety Events: Are there Differences across Leapfrog

91. Monitoring for Perinatal Safety: Electronic Fetal Monitoring: Facilitator Guide | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/modules/strategies/safe-electronic-fac-guide.html
    July 01, 2023 - Patients and Families About AHRQ's Quality & Patient Safety Work Patient Safety News and Events … 13: Key Safety Elements: Learn From Defects Say: A unit can decide its approach to debriefing events … Informal debriefings can be used by the clinical team immediately following a near miss or actual adverse … events. … Past adverse events related to EFM use.

92. AHRQ Research Inspires Efforts at Banner Desert To Reduce Drug Errors in E.D. Patients | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/news/newsroom/case-studies/201509.html
    January 01, 2018 - AHRQ Social Media AHRQ Stats Impact Case Studies Blog Newsletter Events … the technicians' work, the E.D. pharmacist can interpret the patient's medication history to look for adverse … events, one of the many reasons patients come to the E.D. … Study Identifier: 2015-09 AHRQ Product(s): Research Topic(s): Adverse … Drug Events (ADE), Outcomes, Patient Safety, Provider: Pharmacist Geographic

93. I-PASS: Integrating High Quality Handoffs into TeamSTEPPS and Hospital Care
    pcmh.ahrq.gov/sites/default/files/wysiwyg/teamstepps/webinars/2015-materials/teamstepps-monthly-webinar-may2015.pptx
    January 01, 2015 - Safety in the US: Ongoing Problems Institute of Medicine, 1999 44,000-98,000 deaths per year due to adverse … events Office of the Inspector General, 2010 180,000 deaths per year due to adverse events North Carolina … 05.2 Mod 1 05.2 Page ‹#› TeamSTEPPS® I-PASS Slide ‹#› Results: Medical Error and Preventable Adverse … JAMA 2013; 310: 2262-2270   Pre-RHB Post-RHB p-value Medical Errors 33.8 18.3 <0.001 Preventable Adverse … implementation associated with: Primary outcome A significant reduction in overall error rates and preventable adverse

94. Monitoring for Perinatal Safety: Electronic Fetal Monitoring: Slide Presentation | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/modules/strategies/safe-electronic-slides.html
    July 01, 2023 - Professional Liability EFM interpretation and management are a common issue in litigation involving adverse … Slide 13: Key Safety Elements: Learn From Defects Debrief and analyze near misses and adverse events … Have a process in place to review severe maternal or neonatal morbidity and mortality events. … Disclosing any unintended outcomes using unit policy for adverse events. … Past adverse events related to EFM use. Synergy with related or similar initiatives.

95. E-Fetal-Monitoring Facguide (doc file)
    pcmh.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/strategies/safe-electronic/e-fetal-monitoring_facguide.docx
    May 01, 2017 - individual staff skills with respect to EFM interpretation may not be enough to reduce perinatal safety events … Slide 12 SAY: A unit can decide its approach to debriefing events based on seriousness of event, expertise … Informal debriefings can be used by the clinical team immediately following a near miss or actual adverse … events. … events related to EFM use

96. Practice Improvement | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/practiceimprovement/index.html
    August 01, 2022 - Prevention Tools to assist nursing homes that have electronic medical record systems to prevent adverse … events. … Communication and Optimal Resolution (CANDOR) Toolkit Process for practitioners to use when unexpected events

97. Rapid Response for Perinatal Safety: Slide Presentation | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/modules/strategies/rapid-response/rapid-response-slides.html
    July 01, 2023 - Patients and Families About AHRQ's Quality & Patient Safety Work Patient Safety News and Events … Slide 14: Key Safety Elements: Learn From Defects Debrief and analyze near misses and adverse events … Have a process in place to review serious maternal or neonatal adverse outcomes. … Consider these factors: Unit data suggesting adverse events or near misses that may have been minimized … Debrief regularly after rapid response events, and solicit ongoing feedback from staff and patients to

98. First-of-its-Kind Study Examines Disparities in Healthcare Costs and Outcomes of Cigarette Smoking in the United States | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/news/newsroom/press-releases/smoking-cessation-disparities.html
    December 01, 2023 - AHRQ Social Media AHRQ Stats Impact Case Studies Blog Newsletter Events … policymakers conduct cost-benefit analyses that accurately reflect the burden of healthcare costs and adverse … “Disparities in medical spending, as well as adverse health outcomes, are continuing to increase over

99. TeamSTEPPS Additional Video: SBAR in Inpatient Medical Teams | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/teamstepps-program/resources/additional/sbar.html
    July 01, 2023 - how this technique, one tool in the TeamSTEPPS training program, can improve communication, reduce adverse … events, and improve care quality.

100. Patient Safety Organizations Program | Agency for Healthcare Research and Quality
     pcmh.ahrq.gov/cpi/about/otherwebsites/pso.ahrq.gov/index.html
     August 01, 2022 - the creation of PSOs and the development of Common Formats for uniform reporting of patient safety events … external experts who can assist providers in the collection, analysis, and aggregation of patient safety events … access to Common Formats (uniform definitions and reporting formats for collecting information about adverse … events).