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www.ahrq.gov/research/findings/nhqrdr/chartbooks/intro.html
June 01, 2018 - These measures generally represent rates of adverse events or deaths.
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www.ahrq.gov/sites/default/files/wysiwyg/patient-safety/settings/ambulatory/6bb-toolkit-fasttrack.pdf
January 12, 2021 - Any patient using LtOT, regardless of dose, has a risk of adverse events, including overdose;
2.
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www.ahrq.gov/sites/default/files/wysiwyg/topics/pridx-framework.pdf
July 05, 2023 - Diagnostic Excellence, Mea-
sure Dx: A Resource To Identify, Analyze, and Learn From
Diagnostic Safety Events … If incentives are too
detailed, prescriptive, or misaligned, they may have adverse
effects on clinician
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www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/availability/chipra-0123-fullreport.pdf
November 01, 2019 - respiratory), obstetric
shock, pulmonary embolism, amniotic embolism, eclampsia, septicemia, cardiac events … Additional studies suggest
that on the continuum of care to adverse pregnancy outcomes, there are a … Inadequate physician supervision is an important cause of adverse events around
delivery.
-
www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/availability/chipra-0121-fullreport.pdf
October 01, 2019 - respiratory), obstetric shock, pulmonary
embolism, amniotic embolism, eclampsia, septicemia, cardiac events … Additional studies suggest that on
the continuum of care to adverse pregnancy outcomes, there are a … Inadequate physician supervision is an important cause
of adverse events around delivery.
-
www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/availability/chipra-0120-fullreport.pdf
May 01, 2018 - respiratory), obstetric shock, pulmonary
embolism, amniotic embolism, eclampsia, septicemia, cardiac events … Additional
studies suggest that on the continuum of care to adverse pregnancy outcomes, there are a … Inadequate physician supervision is an important cause of adverse events around delivery.
-
www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/availability/chipra-0122-fullreport.pdf
September 01, 2019 - respiratory), obstetric
shock, pulmonary embolism, amniotic embolism, eclampsia, septicemia, cardiac events … Additional studies suggest
that on the continuum of care to adverse pregnancy outcomes, there are a … Inadequate physician supervision is an important cause of adverse events around
delivery.
-
www.ahrq.gov/data/infographics/hac-rates-decline.html
August 01, 2018 - Declines in Hospital-Acquired Conditions from 2014 to 2016
Declines in Hospital-Acquired Conditions from 2014 to 2016 (PDF, 6.9 MB)
Source: AHRQ National Scorecard on Rates of Hospital-Acquired Conditions .
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www.ahrq.gov/research/findings/final-reports/crcscreeningrpt/crcscreen3.html
April 01, 2018 - achieve its intended (positive) impact without additionally causing (negative) unintended effects or adverse … Prevailing conditions and events occurring in the external environment that could affect the implementation
-
www.ahrq.gov/sites/default/files/2025-02/shapiro-report.pdf
January 01, 2025 - The
association between emergency department crowding and adverse cardiovascular
outcomes in patients
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol3/Vane.pdf
February 01, 2005 - Behind the Scenes: Patient Safety in the Operating Room and Central Materiel Service During Deployments
469
Behind the Scenes: Patient Safety in
the Operating Room and Central
Materiel Service During Deployments
Elizabeth A. P. Vane, Edward Drost, Daryl Elder, Yvonne Heib
Abstract
The United States Army per…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/engagingfamilies/strategy1/Strat1_Implement_Hndbook_508_v2.pdf
January 28, 2011 - to longer-term benefits including:1
• Better health outcomes for patients
• Reduced errors and adverse … events
• Increased patient loyalty
• Reduced risk of malpractice
• Increased employee satisfaction … The
object is to promote learning
from these types of events
with the goal of identifying
opportunities … When patients and
families serve as advisors, there may be events or circumstances that prevent them … Many hospitals use a process called root-cause analysis to illuminate the
events and decisions that
-
www.ahrq.gov/sites/default/files/wysiwyg/research/findings/final-reports/16651-Weinger-draft-1.pdf
February 02, 2010 - Study Rationale
Communication failures continue to be the most frequently cited “root cause” of adverse … events
reported to The Joint Commission (personal communication, Margaret VanAmringe, February 2, … accurately
and consistently portray the clinical role and also respond appropriately to unexpected turns of events
-
www.ahrq.gov/sites/default/files/wysiwyg/research/findings/final-reports/bolton-report.pdf
October 22, 2019 - time was explicitly
represented by a clock and simulation steps had to account for the number of time events … states, the model computes a set of
T discrete times based on the total number of times when change events … probability that
medical practitioners will hear the alarms, respond to them appropriately, and thus avoid adverse
-
www.ahrq.gov/sites/default/files/2024-01/bolton-report.pdf
January 01, 2024 - time was explicitly
represented by a clock and simulation steps had to account for the number of time events … states, the model computes a set of
T discrete times based on the total number of times when change events … probability that
medical practitioners will hear the alarms, respond to them appropriately, and thus avoid adverse
-
www.ahrq.gov/sites/default/files/2024-01/weinger-report.pdf
January 01, 2024 - Study Rationale
Communication failures continue to be the most frequently cited “root cause” of adverse … events
reported to The Joint Commission (personal communication, Margaret VanAmringe, February 2, … accurately
and consistently portray the clinical role and also respond appropriately to unexpected turns of events
-
www.ahrq.gov/research/findings/final-reports/stpra/stpraapd.html
April 01, 2018 - Intake information collected: antibiotics taken, previous anesthesia experiences, allergies, recent events
-
www.ahrq.gov/sites/default/files/wysiwyg/diagnostic/resources/issue-briefs/dx-safety-rural-healthcare.pdf
July 01, 2024 - these errors contribute to
approximately 10 percent of patient deaths and 6-17 percent of hospital adverse … events.4
The National Academy of Medicine (NAM) defines diagnostic errors as the failure to establish … Serious misdiagnosis-related harms in malpractice claims: the “Big
Three”–vascular events, infections
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/technical/ltvv-litreview.docx
January 01, 2017 - findings, the authors could not conclude that protective mechanical ventilation prevents some of the adverse … There was no evidence that protective mechanical ventilation prevents some of the adverse effects of
-
www.ahrq.gov/sites/default/files/wysiwyg/research/findings/nhqrdr/nhqdr16/2016qdrintromethods.pdf
July 01, 2017 - These measures generally represent rates of adverse events or deaths.