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psnet.ahrq.gov/web-mm/low-totem-pole
October 01, 2003 - SPOTLIGHT CASE
Low on the Totem Pole
Citation Text:
Wachter R. Low on the Totem Pole. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2005.
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www.ahrq.gov/sites/default/files/wysiwyg/patient-safety/settings/hospitals/nicutoolkit.pdf
January 01, 2004 - Transitioning Newborns from NICU to Home: A Resource Toolkit
Transitioning Newborns
from NICU to Home:
A Resource Toolkit
Table of Contents
Overview: Improving the Quality of the Transition Home from the NICU............................1
Tools f…
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hcup-us.ahrq.gov/datainnovations/raceethnicitytoolkit/about_grants_re.jsp
July 01, 2016 - Race and Ethnicity Data Improvement Toolkit
An official website of the Department of Health & Human Services
Search All AHRQ Websites
Careers
Contact Us
Espanol
FAQs
Email U…
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psnet.ahrq.gov/node/49819/psn-pdf
February 01, 2018 - Signout Fallout
February 1, 2018
Starmer AJ, Landrigan CP. Signout Fallout. PSNet [internet]. 2018.
https://psnet.ahrq.gov/web-mm/signout-fallout
Case Objectives
Understand the role of communication failures in medical errors and preventable adverse events.
Review the evidence in support of handoff improvement pr…
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www.ahrq.gov/research/findings/final-reports/ssi/ssiapu.html
September 01, 2018 - Improving the Measurement of Surgical Site Infection Risk Stratification/Outcome Detection
Appendix U. Improving the Measurement of Surgical Site Infection (SSI) Risk Stratification and Outcome Detection
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Table of Contents
Improving the Measurement of Surgical Site Infection R…
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psnet.ahrq.gov/node/33643/psn-pdf
December 01, 2006 - In Conversation with...J. Bryan Sexton, PhD, MA
December 1, 2006
In Conversation with..J. Bryan Sexton, PhD, MA. PSNet [internet]. 2006.
https://psnet.ahrq.gov/perspective/conversation-withj-bryan-sexton-phd-ma
Editor's Note: J. Bryan Sexton, PhD, MA, is Assistant Professor, Department of Anesthesiology and
Critic…
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psnet.ahrq.gov/web-mm/complaints-safety-surveillance
May 05, 2021 - Complaints as Safety Surveillance
Citation Text:
Morris JL, Bismark M. Complaints as Safety Surveillance. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2016.
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www.ahrq.gov/sites/default/files/wysiwyg/cahps/news-and-events/podcasts/Teamwork_in_QI_2012_02_01_Transcript.pdf
January 01, 2012 - Teamwork in Quality Improvement
Teamwork in Quality Improvement
February 2012 Podcast
Speaker
Marjie Harbrecht, CEO, HealthTeamWorks
Moderator
Carla Zema, Consultant, CAHPS User Network; Assistant Professor of Economics and Health Policy,
Saint Vincent College
Presentation Available
https://www.ca…
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psnet.ahrq.gov/web-mm/mechanical-prosthetic-valve-thrombosis-thromboembolism
August 21, 2005 - Mechanical Prosthetic Valve Thrombosis with Thromboembolism.
Citation Text:
Hedayati N, White RO. Mechanical Prosthetic Valve Thrombosis with Thromboembolism.. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2022.
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psnet.ahrq.gov/web-mm/right-left-neither
November 16, 2022 - SPOTLIGHT CASE
Right? Left? Neither!
Citation Text:
Chassin MR, Howell EA. Right? Left? Neither!. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2006.
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psnet.ahrq.gov/node/847934/psn-pdf
April 26, 2023 - Patient Safety Indicators
April 26, 2023
Tokareva I, Romano P. Patient Safety Indicators. PSNet [internet]. 2023.
https://psnet.ahrq.gov/primer/patient-safety-indicators
Background
Over the past 25 years, policymakers and providers, payers, and purchasers of health care have
increasingly focused attention on pati…
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digital.ahrq.gov/ahrq-funded-projects/optimizing-value-patient-reported-outcome-measures-improving-care-delivery
January 01, 2024 - Optimizing the Value of Patient-Reported Outcome Measures in Improving Care Delivery through Health Information Technology
Project Final Report ( PDF , 473.77 KB) Disclaimer
Disclaimer
The findings and conclusions in this document are those of the author(s), who are responsible f…
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cdsic.ahrq.gov/sites/default/files/2025-06/TPC%20Topic%20Highlight%20Patient%20Preferences.pdf
January 01, 2025 - Incorporating Patient Preferences in Patient-Centered Clinical Decision Support
AHRQ Pub. No. 25-0055
June 2025
Incorporating Patient Preferences in
Patient-Centered Clinical Decision Support
Patient preferences can support a patient’s care experience and healthcare decision making. This
resource shows differe…
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www.ahrq.gov/sites/default/files/wysiwyg/cahps/surveys-guidance/helpful-resources/translating/translating-cahps-surveys.pdf
January 17, 2017 - Translating CAHPS Surveys
Translating CAHPS® Surveys
Contents
Purpose of this Document ............................................................................................................................. 1
Select Translation Team Members ...................................................................…
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psnet.ahrq.gov/curated-library/diagnostic-error
August 10, 2025 - Breadcrumb
Home
The PSNet Collection
Curated Libraries
Subscribed
Diagnostic Error
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Created By: Karen Cosby, AHRQ
Date Created: May 8, …
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cdsic.ahrq.gov/sites/default/files/2025-06/SRF%20Topic%20Highlight%20Patient%20App%20Interoperability.pdf
January 01, 2025 - Making Patient Apps Interoperable With the Health IT Ecosystem
AHRQ Pub. No. 25-0053
June 2025
Making Patient Apps Interoperable With
the Health IT Ecosystem
This resource for app developers explains considerations for developing patient-facing
applications (apps) that are interoperable with …
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www.uspreventiveservicestaskforce.org/uspstf/about-uspstf/methods-and-processes/current-processes-refining-evidence-based-recommendation-development
January 01, 2014 - Current Processes: Refining Evidence-based Recommendation Development
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Table of Contents
Preface
Introduction
Types of Recommendations
Types of Evidence Reviews
Co…
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www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-patient-role2.html
September 01, 2024 - The Patient’s Role in Diagnostic Safety and Excellence: From Passive Reception Toward Co-Design
The History of Patient Roles
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Table of Contents
The Patient’s Role in Diagnostic Safety and Excellence: From Passive Reception Toward Co-Design
Introduction
The History of Pat…
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psnet.ahrq.gov/web-mm/root-cause-analysis-gone-wrong
August 28, 2024 - Root Cause Analysis Gone Wrong
Citation Text:
Peerally MF, Dixon-Woods M. Root Cause Analysis Gone Wrong. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2018.
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www.ahrq.gov/cahps/quality-improvement/improvement-guide/6-strategies-for-improving/communication/strategy6kculturalcompetence.html
March 01, 2020 - Strategy 6K: Cultivating Cultural Competence
Contents
6.K.1. The Problem
6.K.2. Interventions
6.K.2.a. Maintaining Complete and Accurate Information on Enrollees
6.K.2.b. Building a Provider Network to Meet the Community’s Linguistic and Cultural Needs
6.K.2.c. Training Providers on Cultural…