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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/836850/psn-pdf
    March 31, 2022 - Annual Perspective: Topics in Medication Safety March 31, 2022 Harris IB, Dowell P, Mossburg SE. Annual Perspective: Topics in Medication Safety. PSNet [internet]. 2022. https://psnet.ahrq.gov/perspective/annual-perspective-topics-medication-safety Introduction Issues with medication management and errors in medi…
  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/851971/psn-pdf
    July 31, 2023 - Failure to Adhere to Dietary Restrictions Leading to Complications and Poor Follow-up July 31, 2023 Bohringer C, Bourgeois J, Xiong G, et al. Failure to adhere to dietary restrictions leading to complications and poor follow-up. PSNet [internet]. 2023. https://psnet.ahrq.gov/web-mm/failure-adhere-dietary-restricti…
  3. psnet.ahrq.gov/web-mm/spotlight-mistaken-attribution-diagnostic-misstep
    July 01, 2011 - SPOTLIGHT CASE Spotlight: Mistaken Attribution, Diagnostic Misstep Citation Text: Kreider TR, Young JQ. Spotlight: Mistaken Attribution, Diagnostic Misstep. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2019. Copy Citat…
  4. digital.ahrq.gov/sites/default/files/docs/citation/r36hs022201-yuan-final-report-2015.pdf
    January 01, 2015 - Understanding How Social Influence and Social Networks Affect Electronic Medical Record Implementation - Final Report 1 Understanding how social influence and social networks influence EMR implementation Principal Investigator: Christina T. Yuan, MPH Research Team: Ingrid M. Nembhard, Ph.D. (Dissertation Co…
  5. effectivehealthcare.ahrq.gov/sites/default/files/pdf/atypical-antipsychotics-off-label-update_research-protocol.pdf
    May 19, 2010 - Evidence Report on the Source: www.effectivehealthcare.ahrq.gov Published Online: May 19, 2010 Evidence-based Practice Center Systematic Review Protocol Project Title: Efficacy and Comparative Effectiveness of Off-Label Use of Atypical Antipsychotics – Update I. Background and Objectives for the Sys…
  6. effectivehealthcare.ahrq.gov/sites/default/files/suppl-2-user-guide-to-ocer_130129.pdf
    January 01, 2011 - 177 Abstract This supplement describes how counterfactual theory is used to define causal effects and the conditions in which observed data can be used to estimate counterfactual-based causal effects. Basic definitions and language used in causal graph theory are then presented. The graphical separation rules linki…
  7. psnet.ahrq.gov/web-mm/missed-connection-case-inadequate-ecg-oversight-cardiac-surgery
    March 25, 2020 - SPOTLIGHT CASE Missed Connection: A Case of Inadequate ECG Oversight in Cardiac Surgery Citation Text: Bohringer C, Fierro M, Venugopal S. Missed Connection: A Case of Inadequate ECG Oversight in Cardiac Surgery. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Dep…
  8. psnet.ahrq.gov/perspective/conversation-wanda-pratt-phd
    November 01, 2017 - In Conversation With… Wanda Pratt, PhD November 1, 2017  Also Read an Essay Citation Text: In Conversation With… Wanda Pratt, PhD. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2017. Cop…
  9. www.ahrq.gov/sites/default/files/2024-09/segall-report.pdf
    January 01, 2024 - Final Progress Report: Workload effects on response time to life-threatening arrhythmias Workload effects on response time to life-threatening arrhythmias Principal investigator: Noa Segall, PhD Team members: Christopher Granger, MD Melanie Wright, PhD Gene Hobbs, CHT Alberto Bonifacio, RN, BSN, MHA, CEN Jeffr…
  10. www.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/demoeval/what-we-learned/highlight11.pdf
    September 08, 2015 - How are CHIPRA quality demonstration States using quality reports to drive heatlh care improvements for children? Evaluation Highlight No. 11 The CHIPRA Quality Demonstration Grant Program In February 2010, the Centers for Medicare & Medicaid Services (CMS) awarded 10 grants, funding 18 States, to improve the qu…
  11. www.ahrq.gov/sites/default/files/wysiwyg/pqmp/lessons/lessons-performance-comparisons.pdf
    October 01, 2019 - Lessons from the Field: Making Performance Comparisons Lessons from the Field: Making Performance Comparisons Prepared for the Agency for Healthcare Research and Quality by L&M Policy Research, LLC with guidance from the Pediatric Quality Measure Program (PQMP) Grantees i Table of Contents List o…
  12. www.ahrq.gov/diagnostic-safety/resources/issue-briefs/education-dx-outcomes-7.html
    March 01, 2022 - Improving Education—A Key to Better Diagnostic Outcomes References Previous Page   Table of Contents Improving Education—A Key to Better Diagnostic Outcomes Introduction Foundations of Diagnosis Education Current State of Diagnosis Education Competencies To Improve Diagnosis in Health Profes…
  13. www.ahrq.gov/ncepcr/tools/case-studies/health-team-works.html
    August 01, 2014 - Case Studies of Exemplary Primary Care Practice Facilitation Training Programs Training Program Summary: HealthTeamWorks’ Coach University Previous Page Next Page Table of Contents Case Studies of Exemplary Primary Care Practice Facilitation Training Programs Overview Training Program Summary: H…
  14. psnet.ahrq.gov/sites/default/files/2024-05/spotlight_case_hindsight_is_2020_slides_final_revised_05.03.2024.pdf
    January 01, 2024 - Spotlight Hindsight is 20/20: Thrombolytics for Alcohol Intoxication Source and Credits • This presentation is based on the April 2024 AHRQ WebM&M Spotlight Case o See the full article at https://psnet.ahrq.gov/webmm o CME credit is available o Commentary by: Eric Signoff, MD, Noelle Boctor, MD, and David K. B…
  15. www.ahrq.gov/sites/default/files/2024-11/blumenthal-report.pdf
    January 01, 2024 - Final Progress Report: Validation of an Innovative Approach to Error Reduction Final Progress Report Validation of an Innovative Approach To Error Reduction Principal Investigator: David Blumenthal, MD, MPP Team Members: Carlos A. Camargo, Jr., MD, DrPH (Massachusetts General Hospital) Paul D. Cleary, PhD (Yale…
  16. www.ahrq.gov/sites/default/files/2024-10/sirio2-report.pdf
    January 01, 2024 - Final Progress Report: Systems Approach for Improving Region-Wide Patient Safety FINAL PROGRESS REPORT Systems Approach for Improving Region-Wide Patient Safety Carl A. Sirio, MD (Principal Investigator) Rober Weber, RPh Carlene Muto, MD Donna Keyser, PhD Jan Pringle, PhD Rangaraj Ramanujam, PhD John Jernig…
  17. Faclearncusp (doc file)

    www.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/cusptoolkit/modules/learn/faclearncusp.docx
    January 01, 2009 - SAY: The “Learn About CUSP” module of the Comprehensive Unit-based Safety Program (or CUSP) Toolkit introduces CUSP and provides an overview of resources to use when applying the CUSP model. Slide 1 SAY: This module offers an outline and brief history of the CUSP model, summarizes the CUSP Toolkit modules, and expl…
  18. www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/surgery/modules/sustainability/sustainability_learn_from_defects_facnotes.docx
    December 01, 2017 - Accessible Facilitator Guide: Learn From Defects for Sustainability Slide Title and Commentary Slide Number and Slide Sustainability: Learning From Defects SAY: This module will review some concepts from Learning From Defects Through Sensemaking. It will also cover the Learning From Defects process from the per…
  19. www.ahrq.gov/hai/tools/surgery/modules/sustainability/learn-from-defects-fac-notes.html
    December 01, 2017 - Sustainability: Learning From Defects: Facilitator Notes AHRQ Safety Program for Surgery Slide 1: Sustainability: Learning From Defects Say: This module will review some concepts from Learning From Defects Through Sensemaking. It will also cover the Learning From Defects process from the perspective of …
  20. www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/perinatal-care-2/hypertension_6-coaching.pptx
    July 01, 2023 - PowerPoint Presentation Coaching Module 6 of 8 SPPC-II Toolkit AHRQ Pub. No. 23-0046 July 2023 Hospital AIM Team Leads SPPC-II SCRIPT Welcome to Module 6 of the SPPC-II Teamwork Toolkit. In this module, we’ll learn some tactics for coaching your frontline providers on using the teamwork tools. 1 Coaching Involve…