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psnet.ahrq.gov/issue/reasons-repeat-rapid-response-team-calls-and-associations-hospital-mortality
March 03, 2020 - Study
Reasons for repeat rapid response team calls, and associations with in-hospital mortality.
Citation Text:
Chalwin R, Giles L, Salter A, et al. Reasons for Repeat Rapid Response Team Calls, and Associations with In-Hospital Mortality. Jt Comm J Qual Patient Saf. 2019;45(4):268-275. …
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www.ahrq.gov/news/newsroom/case-studies/201520.html
July 01, 2015 - Wisconsin Critical Access Hospital Sees Big Results with AHRQ’s CUSP, RED and TeamSTEPPS®
Search All Impact Case Studies
July 2015
Amery Hospital & Clinic, a 25-bed acute care critical access hospital in rural Wisconsin, used AHRQ’s Comprehensive Unit-based Safety Program (CUSP) to reduce surgical site in…
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psnet.ahrq.gov/issue/impact-diagnostic-checklists-interpretation-normal-and-abnormal-electrocardiograms
September 14, 2022 - Study
Impact of diagnostic checklists on the interpretation of normal and abnormal electrocardiograms.
Citation Text:
Staal J, Zegers R, Caljouw-Vos J, et al. Impact of diagnostic checklists on the interpretation of normal and abnormal electrocardiograms. Diagnosis (Berl). 2022;10(2):121…
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psnet.ahrq.gov/issue/risks-complications-attending-physicians-after-performing-nighttime-procedures
February 14, 2018 - Study
Classic
Risks of complications by attending physicians after performing nighttime procedures.
Citation Text:
Rothschild JM. Risks of Complications by Attending Physicians After Performing Nighttime Procedures. JAMA. 2009;302(14):1565-1572. doi:10.1001/ja…
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psnet.ahrq.gov/issue/unit-based-care-teams-and-frequency-and-quality-physician-nurse-communications
November 16, 2022 - Study
Unit-based care teams and the frequency and quality of physician–nurse communications.
Citation Text:
Gordon M, Melvin P, Graham DA, et al. Unit-based care teams and the frequency and quality of physician-nurse communications. Arch Pediatr Adolesc Med. 2011;165(5):424-8. doi:10.100…
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psnet.ahrq.gov/issue/healthy-life-years-lost-and-excess-bed-days-due-6-patient-safety-incidents-empirical-evidence
May 18, 2022 - Study
Healthy life-years lost and excess bed-days due to 6 patient safety incidents: empirical evidence from English hospitals.
Citation Text:
Hauck KD, Wang S, Vincent CA, et al. Healthy Life-Years Lost and Excess Bed-Days Due to 6 Patient Safety Incidents: Empirical Evidence From Engli…
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meps.ahrq.gov/data_files/publications/st8/stat08.pdf
February 27, 2025 - Statistical Brief #8: Access to Urgent Medical Care: 2001
Statistical Brief # 8
Access to Urgent Medical Care: 2001
By: Janet Greenblatt, MPH
The quality of the health care received by Americans is an issue of public policy concern for
several reasons. First, the level of quality of the health care delivery …
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psnet.ahrq.gov/issue/organizational-response-known-medical-errors-does-peer-review-protection-impede-improvement
April 24, 2018 - Commentary
Organizational response to known medical errors: does peer review protection impede improvement?
Citation Text:
Wenner WJ, Choi SW. Organizational Response to Known Medical Errors: Does Peer Review Protection Impede Improvement? Am J Med Qual. 2018;33(5):552-553. doi:10.1177/1…
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psnet.ahrq.gov/issue/second-victims-need-emotional-support-after-adverse-events-even-just-safety-culture
April 12, 2023 - Commentary
Second victims need emotional support after adverse events: even in a just safety culture.
Citation Text:
Schrøder K, Lamont RF, Jørgensen JS, et al. Second victims need emotional support after adverse events: even in a just safety culture. BJOG. 2019;126(4):440-442. doi:10.11…
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psnet.ahrq.gov/issue/older-adults-awareness-deprescribing-population-based-survey
June 22, 2009 - Study
Older adults' awareness of deprescribing: a population-based survey.
Citation Text:
Turner JP, Tannenbaum C. Older adults' awareness of deprescribing: a population-based survey. J Am Geriatr Soc. 2017;65(12):2691-2696. doi:10.1111/jgs.15079.
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DOI …
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psnet.ahrq.gov/issue/five-topics-health-care-simulation-can-address-improve-patient-safety-results-consensus
June 28, 2023 - Study
Five topics health care simulation can address to improve patient safety: results from a consensus process.
Citation Text:
Sollid SJM, Dieckman P, Aase K, et al. Five Topics Health Care Simulation Can Address to Improve Patient Safety: Results From a Consensus Process. J Patient Sa…
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psnet.ahrq.gov/issue/problem-based-training-improves-recognition-patient-hazards-advanced-medical-students-during
September 11, 2024 - Study
Problem-based training improves recognition of patient hazards by advanced medical students during chart review: a randomized controlled crossover study.
Citation Text:
Holderried F, Heine D, Wagner R, et al. Problem-based training improves recognition of patient hazards by advance…
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psnet.ahrq.gov/issue/theoretical-model-flow-disruptions-anesthesia-team-during-cardiovascular-surgery
July 21, 2021 - Study
A theoretical model of flow disruptions for the anesthesia team during cardiovascular surgery.
Citation Text:
Boquet A, Cohen T, Diljohn F, et al. A theoretical model of flow disruptions for the anesthesia team during cardiovascular surgery. J Patient Saf. 2021;17(6):e534-e539. doi…
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psnet.ahrq.gov/issue/novel-method-reproducibly-measuring-effects-interventions-improve-emotional-climate-indices
March 16, 2011 - Study
A novel method for reproducibly measuring the effects of interventions to improve emotional climate, indices of team skills and communication, and threat to patient outcome in a high-volume thoracic surgery center.
Citation Text:
Nurok M, Lipsitz S, Satwicz P, et al. A novel me…
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psnet.ahrq.gov/issue/patient-safety-approach-setting-passfail-standards-basic-procedural-skills-checklists
July 28, 2010 - Commentary
A patient safety approach to setting pass/fail standards for basic procedural skills checklists.
Citation Text:
Yudkowsky R, Tumuluru S, Casey P, et al. A patient safety approach to setting pass/fail standards for basic procedural skills checklists. Simul Healthc. 2014;9(5):27…
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psnet.ahrq.gov/issue/medication-errors-caregivers-home-neonates-discharged-neonatal-intensive-care-unit
June 07, 2023 - Study
Medication errors by caregivers at home in neonates discharged from the neonatal intensive care unit.
Citation Text:
Solanki R, Mondal N, Mahalakshmy T, et al. Medication errors by caregivers at home in neonates discharged from the neonatal intensive care unit. Arch Dis Child. 2017…
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psnet.ahrq.gov/issue/nighttime-cross-coverage-associated-decreased-intensive-care-unit-mortality-single-center
March 07, 2012 - Study
Nighttime cross-coverage is associated with decreased intensive care unit mortality. A single-center study.
Citation Text:
Amaral ACK-B, Barros BS, Barros CCPP, et al. Nighttime cross-coverage is associated with decreased intensive care unit mortality. A single-center study. Am J R…
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psnet.ahrq.gov/issue/hospital-covid-19-burden-and-adverse-event-rates
June 22, 2022 - Study
Hospital COVID-19 burden and adverse event rates.
Citation Text:
Metersky ML, Rodrick D, Ho S-Y, et al. Hospital COVID-19 burden and adverse event rates. JAMA Netw Open. 2024;7(11):e2442936. doi:10.1001/jamanetworkopen.2024.42936.
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psnet.ahrq.gov/issue/direct-reporting-laboratory-test-results-patients-mail-enhance-patient-safety
February 15, 2011 - Study
Direct reporting of laboratory test results to patients by mail to enhance patient safety.
Citation Text:
Sung S, Forman-Hoffman VL, Wilson MC, et al. Direct reporting of laboratory test results to patients by mail to enhance patient safety. J Gen Intern Med. 2006;21(10):1075-8. …
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psnet.ahrq.gov/issue/human-errors-emergency-medical-services-qualitative-analysis-contributing-factors
July 07, 2021 - Study
Human errors in emergency medical services: a qualitative analysis of contributing factors.
Citation Text:
Poranen A, Kouvonen A, Nordquist H. Human errors in emergency medical services: a qualitative analysis of contributing factors. Scand J Trauma Resusc Emerg Med. 2024;32(1):78.…