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www.ahrq.gov/sites/default/files/wysiwyg/action-alliance/progress-update-2024-slides.pdf
January 01, 2024 - Slide Presentation - Progress Update: The National Action Alliance for Patient and Workforce Safety—What, Why and How?
The National Action Alliance for Patient and Workforce
Safety - What, Why, and How?
NATIONAL WEBINAR
April 23, 2024
Housekeeping Notes
• This webinar will be recorded and available for viewing…
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psnet.ahrq.gov/node/836841/psn-pdf
June 01, 2020 - The Cleveland Clinic Pairs Advanced Practice Registered
Nurses and Paramedics To Provide Home Visits to
Recently Discharged Patients at Highest Risk for Hospital
Readmission
April 7, 2022
https://psnet.ahrq.gov/innovation/cleveland-clinic-pairs-advanced-practice-registered-nurses-and-
paramedics-provide-home
Sum…
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psnet.ahrq.gov/node/33654/psn-pdf
August 01, 2007 - In Conversation with...James L. Reinertsen, MD
August 1, 2007
In Conversation with..James L. Reinertsen, MD. PSNet [internet]. 2007.
https://psnet.ahrq.gov/perspective/conversation-withjames-l-reinertsen-md
Editor's Note: James L. Reinertsen, MD, heads the Reinertsen Group, a prominent health care consulting
firm …
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psnet.ahrq.gov/node/33635/psn-pdf
July 01, 2006 - In Conversation with...Allan Frankel, MD
July 1, 2006
In Conversation with..Allan Frankel, MD. PSNet [internet]. 2006.
https://psnet.ahrq.gov/perspective/conversation-withallan-frankel-md
Dr. Robert Wachter, Editor, AHRQ WebM&M: Tell us a little bit about how you became interested in this
kind of work.
Dr. Allan …
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psnet.ahrq.gov/node/33865/psn-pdf
September 01, 2018 - In Conversation With… Rebecca Lawton, PhD
September 1, 2018
In Conversation With… Rebecca Lawton, PhD. PSNet [internet]. 2018.
https://psnet.ahrq.gov/perspective/conversation-rebecca-lawton-phd
Editor's note: Rebecca Lawton, a Professor in the Psychology of Healthcare at the University of Leeds, is
a health psycho…
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psnet.ahrq.gov/node/49642/psn-pdf
December 01, 2011 - Order Interrupted by Text: Multitasking Mishap
December 1, 2011
Halamka J. Order Interrupted by Text: Multitasking Mishap. PSNet [internet]. 2011.
https://psnet.ahrq.gov/web-mm/order-interrupted-text-multitasking-mishap
Case Objectives
State the prevalence of mobile devices among clinicians and their common health…
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psnet.ahrq.gov/sites/default/files/2023-03/challenging_case_of_multiple_suicide_attempts_in_a_complex_patient_with_psychiatric_comorbidities.pdf
January 01, 2023 - Microsoft PowerPoint - Spotlight Case_Suicide Attempts_03.17.2023 FINAL.pptx
Spotlight
Challenging Case of Multiple Suicide Attempts in a
Complex Patient with Psychiatric Comorbidities
Source and Credits
• This presentation is based on the March 2023 AHRQ WebM&M
Spotlight Case
o See the full article at https://…
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www.ahrq.gov/es/patient-safety/settings/hospital/resource/pressureulcer/tool/put5.html
October 01, 2014 - Preventing Pressure Ulcers in Hospitals
5. How do we measure our pressure ulcer rates and practices?
Previous Page Next Page
Table of Contents
Preventing Pressure Ulcers in Hospitals
Overview
Key Subject Area Index
1. Are we ready for this change?
2. How will we manage change?
3. What are …
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psnet.ahrq.gov/node/49573/psn-pdf
January 01, 2009 - Dangerous Shift
November 1, 2008
Patterson ES. Dangerous Shift. PSNet [internet]. 2008.
https://psnet.ahrq.gov/web-mm/dangerous-shift
Case Objectives
Review the evidence base on erroneous actions related to shift changes.
Understand the limits of standardizing handoffs in preventing errors at shift change.
Expla…
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www.ahrq.gov/research/findings/making-healthcare-safer/comparison.html
June 01, 2025 - Comparison Tables for Making Healthcare Safer Reports
The tables below compare all editions of the Agency for Healthcare Research and Quality’s Making Health Care Safer report . The first edition , published in 2001, was developed following the 1999 publication of To Err is Human: Building a Safer Health Sys…
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psnet.ahrq.gov/web-mm/consequences-miscommunication-regarding-possible-artifact
May 11, 2019 - SPOTLIGHT CASE
The Consequences of Miscommunication Regarding a Possible Artifact
Citation Text:
Gwal K. The Consequences of Miscommunication Regarding a Possible Artifact. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 20…
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psnet.ahrq.gov/web-mm/coming-undone-failure-closure-device
April 01, 2006 - Coming Undone: Failure of Closure Device
Citation Text:
Baez-Escudero JL, Levine GN. Coming Undone: Failure of Closure Device. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2007.
Copy Citation
Format:
Google Scholar Bi…
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psnet.ahrq.gov/web-mm/failure-latch
November 27, 2012 - Failure to Latch
Citation Text:
Rodriguez M, Mannel R, Frye DR. Failure to Latch. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2008.
Copy Citation
Format:
Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tag…
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effectivehealthcare.ahrq.gov/sites/default/files/worker-health_executive.pdf
April 01, 2016 - Finally, we searched for harms
associated with TWH interventions, such as increased
barriers to reporting … We found no information
pertaining to increased barriers to reporting work-
related injuries or illnesses … Randomized trials are not always feasible because
of barriers associated with studying populations of
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www.ahrq.gov/sites/default/files/2025-03/walsh-kirkendall-report.pdf
January 01, 2025 - For the
PRISM survey, items with mean scores >2 were counted as self-management barriers.29 Scores for … elements of people, tasks, tools and technologies,
organization and environmental components, and notes barriers … Development and validation of PRISM: A survey tool to identify
diabetes self-management barriers.
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www.uspreventiveservicestaskforce.org/uspstf/recommendation/cervical-cancer-screening
August 21, 2018 - especially those who have recently immigrated to the United States and may have language or cultural barriers … contributing to higher incidence and mortality rates include financial, geographic, and language or cultural barriers … to screening; barriers to follow-up; unequal treatment; and difference in cancer types, all of which
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www.ahrq.gov/sites/default/files/2025-03/isbell-boudreaux-report.pdf
January 01, 2025 - Identify factors that serve as barriers to and facilitators of diagnostic reasoning in
emergency medicine … Identify factors that serve as barriers to and facilitators of diagnostic reasoning in
emergency medicine … Identify factors that serve as barriers to and facilitators of diagnostic reasoning in
emergency medicine
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qualityindicators.ahrq.gov/Downloads/Resources/Publications/2012/Appendix_1A_Details_of_literature_review.pdf
January 01, 2012 - However, barriers to care include the “attitudes of medical
practitioners” and potential underdetection … Barriers to clinicians’ reporting of abuse and neglect include
lack of knowledge of laws regarding abuse … Reducing barriers to participation in prevention strategies in
older adults is important in preventing … Barriers include having no prior history of
falls, stigma of aging/frailty, inaccessible information
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www.uspreventiveservicestaskforce.org/uspstf/document/evidence-summary-screening-for-women-and-elderly-adults/intimate-partner-violence-and-elderly-abuse-screening-2004
March 08, 2004 - health care settings requires evaluations that consider costs, time, resources, clinician consistency, barriers … The impact of perceived barriers on primary care physicians' screening practices for female partner abuse … Barriers to domestic violence screening in the pediatric setting.
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www.uspreventiveservicestaskforce.org/uspstf/document/evidence-summary/intimate-partner-violence-and-abuse-of-elderly-and-vulnerable-adults-screening
June 24, 2025 - Specific groups, including Asian, Black, and minority ethnic and immigrant women, may experience barriers … due to institutional racism, cultural norms, and factors associated with immigration (eg, language barriers … Intimate partner violence and barriers to help-seeking among Black, Asian, minority ethnic and immigrant