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141. Microsoft PowerPoint - FINAL June-Spotlight Case Slides_06.12.2020.pptx (pdf file)
     psnet.ahrq.gov/sites/default/files/2020-06/final_june-spotlight_case_slides_06.12.2020.pdf
     January 01, 2020 - Microsoft PowerPoint - FINAL June-Spotlight Case Slides_06.12.2020.pptx Spotlight When the Indications … Administration Blur Source and Credits • This presentation is based on the June 2020 AHRQ WebM&M Spotlight Case … activity, participants should be able to: • Discuss five patient safety targets associated with this case … documentation and communication, and the impact of limited resources during the night shift 4 Case … anxiety, resulting in a total of 4 doses (16 mg) of IV lorazepam over the course of 12-hours 6 Case

142. Committed to Safety: Ten Case Studies on Reducing Harm to Patients. | PSNet
     psnet.ahrq.gov/issue/committed-safety-ten-case-studies-reducing-harm-patients
     July 31, 2012 - Book/Report Committed to Safety: Ten Case Studies on Reducing Harm to Patients. … Citation Text: Committed to Safety: Ten Case Studies on Reducing Harm to Patients. … This report presents ten case studies to illustrate interventions that address prominent and targeted … The authors also published an article about case studies in safety improvement. … July 31, 2012 Stories from the sharp end: case studies in safety improvement.

143. Case Study Webinar Series on Clinician Burnout: The Ohio State University | PSNet
     psnet.ahrq.gov/issue/case-study-webinar-series-clinician-burnout-ohio-state-university
     September 28, 2022 - Webinar Case Study Webinar Series on Clinician Burnout: The Ohio State University … Citation Text: Case Study Webinar Series on Clinician Burnout: The Ohio State University … Case Study Webinar Series on Clinician Burnout: The Ohio State University. … Case Study Webinar Series on Clinician Burnout: The Ohio State University. … Case Study Webinar Series on Clinician Burnout: The Ohio State University.

144. The Case for Investing in Patient Safety in Canada. | PSNet
     psnet.ahrq.gov/issue/case-investing-patient-safety-canada
     October 05, 2021 - Book/Report The Case for Investing in Patient Safety in Canada. … Citation Text: The Case for Investing in Patient Safety in Canada. RiskAnalytica. … Linkedin Copy URL Cite Citation Citation Text: The Case

145. Burnout in healthcare: the case for organisational change. | PSNet
     psnet.ahrq.gov/issue/burnout-healthcare-case-organisational-change
     September 28, 2022 - Commentary Classic Burnout in healthcare: the case for … Burnout in healthcare: the case for organisational change. … Burnout in healthcare: the case for organisational change.

146. Stories from the sharp end: case studies in safety improvement. | PSNet
     psnet.ahrq.gov/issue/stories-sharp-end-case-studies-safety-improvement
     October 07, 2008 - Study Stories from the sharp end: case studies in safety improvement. … Citation Text: Stories from the sharp end: case studies in safety improvement. … definitions, attributes, and strategies to approach the issue, and present a detailed account of each case … Cite Citation Citation Text: Stories from the sharp end: case … the Breadth and Depth of Relationships through National Quantitative Surveys and In-depth Qualitative Case

147. Add-on Case and the Missing Checklist | PSNet
     psnet.ahrq.gov/web-mm/add-case-and-missing-checklist
     September 01, 2012 - Add-on Case and the Missing Checklist Citation Text: Catchpole K. … Add-on Case and the Missing Checklist. PSNet [internet]. … Add-on Case and the Missing Checklist. PSNet [internet]. … The next day, the patient was scheduled for an EGD as an add-on case. … Add-on Case and the Missing Checklist. PSNet [internet].

148. The impact of the 80-hour work week on appropriate resident case coverage. | PSNet
     psnet.ahrq.gov/issue/impact-80-hour-work-week-appropriate-resident-case-coverage
     June 18, 2008 - Study The impact of the 80-hour work week on appropriate resident case coverage. … The Impact of the 80-Hour Work Week on Appropriate Resident Case Coverage. … However, this study found that surgical residents maintained an adequate operative case volume over the … The Impact of the 80-Hour Work Week on Appropriate Resident Case Coverage. … Related Resources From the Same Author(s) Effect of the 80-hour work week on resident case

149. Preventable deaths due to problems in care in English acute hospitals: a retrospective case record review study. | PSNet
     psnet.ahrq.gov/issue/preventable-deaths-due-problems-care-english-acute-hospitals-retrospective-case-record-review
     July 20, 2022 - Preventable deaths due to problems in care in English acute hospitals: a retrospective case … Preventable deaths due to problems in care in English acute hospitals: a retrospective case record review … Preventable deaths due to problems in care in English acute hospitals: a retrospective case record review … February 10, 2021 Collaborative case review: a systems-based approach to patient safety … September 12, 2016 A structured judgement method to enhance mortality case note review

150. Think twice: effects on diagnostic accuracy of returning to the case to reflect upon the initial diagnosis. | PSNet
     psnet.ahrq.gov/issue/think-twice-effects-diagnostic-accuracy-returning-case-reflect-upon-initial-diagnosis
     June 08, 2022 - Study Think twice: effects on diagnostic accuracy of returning to the case to reflect … Think twice: effects on diagnostic accuracy of returning to the case to reflect upon the initial diagnosis … Think twice: effects on diagnostic accuracy of returning to the case to reflect upon the initial diagnosis … Using the NAM diagnostic process framework to teach clinical reasoning in computerized case … January 26, 2022 How physicians think: a case-based diagnostic simulation exercise.

151. Safety shortcomings spotted in Sunrise catheter case. | PSNet
     psnet.ahrq.gov/issue/safety-shortcomings-spotted-sunrise-catheter-case
     September 01, 2011 - Newspaper/Magazine Article Safety shortcomings spotted in Sunrise catheter case. … Citation Text: Safety shortcomings spotted in Sunrise catheter case. Harasim P. … Cite Citation Citation Text: Safety shortcomings spotted in Sunrise catheter case

152. Leading quality and safety on the frontline - a case study of department leaders in nursing homes. | PSNet
     psnet.ahrq.gov/issue/leading-quality-and-safety-frontline-case-study-department-leaders-nursing-homes
     February 28, 2024 - Study Leading quality and safety on the frontline - a case study of department leaders … Leading quality and safety on the frontline - a case study of department leaders in nursing homes. … Leading quality and safety on the frontline - a case study of department leaders in nursing homes. … support-systems and requirements for complying with quality and safety regulation in nursing homes - a case … Tools for establishing a sustainable safety culture within maternity services: a retrospective case

153. Spotlight Case Hindsight Is 2020 Slides Final Revised 05.03.2024 (pdf file)
     psnet.ahrq.gov/sites/default/files/2024-05/spotlight_case_hindsight_is_2020_slides_final_revised_05.03.2024.pdf
     January 01, 2024 - Intoxication Source and Credits • This presentation is based on the April 2024 AHRQ WebM&M Spotlight Case … aid in “stroke mimic” diagnosis 3 HINDSIGHT IS 20/20: THROMBOLYTICS FOR ALCOHOL INTOXICATION A case … facial droop, but facial symmetry was difficult to assess as he would not follow instructions. 5 Case … these findings represented a National Institutes of Health Stroke Scale (NIHSS) value of 6. 6 Case … • But what led to the diagnostic error in this case?

154. Alcoholism and American healthcare: the case for a patient safety approach. | PSNet
     psnet.ahrq.gov/issue/alcoholism-and-american-healthcare-case-patient-safety-approach
     March 30, 2022 - Review Alcoholism and American healthcare: the case for a patient safety approach … Alcoholism and American healthcare: the case for a patient safety approach. … Alcoholism and American healthcare: the case for a patient safety approach. … January 19, 2022 Medication-related medical emergency team activations: a case review … Incidence, nature and causes of avoidable significant harm in primary care in England: retrospective case

155. Early warning scores to predict noncritical events overnight in hospitalized medical patients: a prospective case cohort study. | PSNet
     psnet.ahrq.gov/issue/early-warning-scores-predict-noncritical-events-overnight-hospitalized-medical-patients
     March 30, 2022 - warning scores to predict noncritical events overnight in hospitalized medical patients: a prospective case … warning scores to predict noncritical events overnight in hospitalized medical patients: a prospective case … March 2, 2022 Investigating hospital supervision: a case study of regulatory inspectors … Preventable deaths due to problems in care in English acute hospitals: a retrospective case … April 5, 2013 Medication-related medical emergency team activations: a case review study

156. Healthcare leaders' and elected politicians' approach to support-systems and requirements for complying with quality and safety regulation in nursing homes - a case study. | PSNet
     psnet.ahrq.gov/issue/healthcare-leaders-and-elected-politicians-approach-support-systems-and-requirements
     February 28, 2024 - support-systems and requirements for complying with quality and safety regulation in nursing homes - a case … support-systems and requirements for complying with quality and safety regulation in nursing homes – a case … February 28, 2024 Leading quality and safety on the frontline - a case study of department … May 15, 2024 Investigating hospital supervision: a case study of regulatory inspectors … Tools for establishing a sustainable safety culture within maternity services: a retrospective case

157. Tools for establishing a sustainable safety culture within maternity services: a retrospective case study. | PSNet
     psnet.ahrq.gov/issue/tools-establishing-sustainable-safety-culture-within-maternity-services-retrospective-case
     February 28, 2024 - Tools for establishing a sustainable safety culture within maternity services: a retrospective case … Tools for establishing a sustainable safety culture within maternity services: a retrospective case study … Tools for establishing a sustainable safety culture within maternity services: a retrospective case study … February 28, 2024 Leading quality and safety on the frontline - a case study of department … May 15, 2024 Investigating hospital supervision: a case study of regulatory inspectors

158. Care quality, patient safety, and nurse outcomes at hospitals serving economically disadvantaged patients: a case for investment in nursing. | PSNet
     psnet.ahrq.gov/issue/care-quality-patient-safety-and-nurse-outcomes-hospitals-serving-economically-disadvantaged
     December 09, 2020 - quality, patient safety, and nurse outcomes at hospitals serving economically disadvantaged patients: a case … quality, patient safety, and nurse outcomes at hospitals serving economically disadvantaged patients: a case … 2020 Patient-related factors associated with an increased risk of being a reported case … of preventable harm in first-line health care: a case-control study March 11, 2020 … September 30, 2020 Collaborative case review: a systems-based approach to patient safety

159. Managing patient safety and staff safety in nursing homes: exploring how leaders of nursing homes negotiate their dual responsibilities- a case study. | PSNet
     psnet.ahrq.gov/issue/managing-patient-safety-and-staff-safety-nursing-homes-exploring-how-leaders-nursing-homes
     September 13, 2023 - safety in nursing homes: exploring how leaders of nursing homes negotiate their dual responsibilities- a case … safety in nursing homes: exploring how leaders of nursing homes negotiate their dual responsibilities—a case … support-systems and requirements for complying with quality and safety regulation in nursing homes - a case … May 15, 2024 Investigating hospital supervision: a case study of regulatory inspectors … Tools for establishing a sustainable safety culture within maternity services: a retrospective case

160. Investigating hospital supervision: a case study of regulatory inspectors' roles as potential co-creators of resilience. | PSNet
     psnet.ahrq.gov/issue/investigating-hospital-supervision-case-study-regulatory-inspectors-roles-potential-co
     September 23, 2020 - Study Investigating hospital supervision: a case study of regulatory inspectors' … Investigating Hospital Supervision: A Case Study of Regulatory Inspectors’ Roles as Potential Co-creators … Investigating Hospital Supervision: A Case Study of Regulatory Inspectors’ Roles as Potential Co-creators … April 5, 2023 Collaborative case review: a systems-based approach to patient safety event … September 23, 2020 Medication-related medical emergency team activations: a case review