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psnet.ahrq.gov/issue/war-two-fronts-cancer-care-time-covid-19
March 12, 2025 - A war on two fronts: cancer care in the time of COVID-19. … The authors discuss the need to balance delays in cancer diagnosis or treatment against the harm of COVID … March 12, 2025
Implementation of the I-PASS handoff program in diverse clinical environments … bridge to quality: an urgent call to integrate quality improvement and patient safety education with clinical … 2020
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See More About The Topic
Hospitals
Ambulatory Clinic or
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psnet.ahrq.gov/perspective/identifying-adverse-events-not-present-admission-can-we-do-it
October 01, 2008 - or more specialized care for those disorders. … to push the check box in front of the providers and make it very hard to move to the next stage of clinical … How do you plan to prepare your service and hospitalists or other physicians for the implications of … patient safety revolution was to get patient safety on the radar screen and to have it be part of the clinical … To me the fundamental reason that care is not nearly as safe as it should be is that up until 7 or 8
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psnet.ahrq.gov/issue/regional-variations-diagnostic-practices
July 15, 2020 - December 20, 2020
The safety of inpatient health care. … February 17, 2011
Implementation of the I-PASS handoff program in diverse clinical environments … Interview
In Conversation With...Amy Helwig about Health Plan … February 4, 2015
International Comparisons: A Focus on Quality of Care. … 2014
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Hospitals
Ambulatory Clinic or
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psnet.ahrq.gov/sites/default/files/2020-02/final_spotlight_opat_powerpoint_01102020_tocme.pdf
January 01, 2020 - with the help of
a family member, friend, or care provider … 13
Necessary Components of OPAT Plan:
• Care plan with discharge location
• IV antibiotic order … prior
to discharge
• Primary Care Provider
– Ensure appropriate follow-up care after discharge from … Norris AH, Shrestha NK, Allison GM, et. al, 2018 Infectious Diseases Society of America Clinical Practice … https://www.idsociety.org/globalassets/idsa/clinical-affairs/opat_epub_finalv3.pdf
5.
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psnet.ahrq.gov/issue/malpractice-liability-and-health-care-quality-review
April 13, 2011 - Malpractice liability and health care quality: A review . … The review found no evidence of association between liability risk and avoidable hospitalizations or … patient safety indicators or postoperative complications (2/6 studies). … Malpractice liability and health care quality: A review . … July 22, 2013
Clinical errors and medical negligence.
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psnet.ahrq.gov/node/49820/psn-pdf
February 01, 2018 - To develop a transition plan
of care addressing this broad array of needs, SNF nurses, social workers … and (ii) delineates the domains of a complete
transition plan of care, such as medications, advanced … A
common barrier to implementing transitional care in SNFs is the scarcity of clinical staff for delivering … for managing activities of daily living or medical
care at home. … The case did not include any details of discharge planning or transitional care provided in the
SNF.
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psnet.ahrq.gov/issue/deficiencies-emergent-and-outpatient-care-patient-alcohol-use-disorder-richard-l-roudebush-va
July 13, 2022 - at the Phoenix VA Health Care System in Arizona. … Louis Health Care System in Missouri. … September 6, 2023
Care Post-Roe: Documenting Cases of Poor-quality Care Since the Dobbs … March 1, 2023
Deficiencies in Care, Care Coordination, and Facility Response to a Patient … Public Health Professionals
General Public
Emergency Departments
Ambulatory Clinic or
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psnet.ahrq.gov/perspective/conversation-jack-westfall-md-mph
September 28, 2022 - I will talk to the patient, and we decided on a plan of action that included a blood test. … This relationship can enhance communication, manage clinical information, facilitate transitions in care … For example, if a patient receives the correct medications for a particular condition (effectiveness … Inadequate communication, poorly coordinated transitions between care settings, lack of current clinical … Laying ghost networks to rest: combatting deceptive health plan provider directories.
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psnet.ahrq.gov/node/33645/psn-pdf
February 01, 2007 - In this world, physicians would know the
prevalence of each possible condition under consideration, … Premature closure: Once a plausible condition is identified, other possibilities are not fully
considered … Improving patient care. The cognitive psychology of missed diagnoses. … 94%.
10% or more of autopsies disclose important
discrepancies that would have changed the
clinical … care or prognosis.(1) Studies looking at
specific clinical conditions find an error rate of
approximately
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psnet.ahrq.gov/node/866395/psn-pdf
July 23, 2024 - Failure to rescue
typically refers to a health system’s slow or ineffective response to clinical deterioration … resulting from an
underlying illness or a medical or surgical care complication. … , and overall patient
care processes with the goal of improving failure to rescue rates and overall … management of a common or esoteric surgical
condition. … Some
recommendations include the vice chair of surgical quality, or any surgeon, anesthesiologist, or
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psnet.ahrq.gov/node/850673/psn-pdf
June 14, 2023 - , and decision making; and collaboration at all levels of care, not
just in direct clinical care. … other families who may not understand hospital processes and the
important role that families can plan … in place for a patient or a resident in
long-term care to define their family or care partner, and how … Clinicians were having to treat patients, whether they had COVID or some
other serious condition, without … These senior leaders said they wanted to plan together with these advisors about how to respond to the
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psnet.ahrq.gov/issue/building-program-expanded-peer-support-entire-health-care-team-no-one-left-behind
May 26, 2021 - The most common event supported was inability to stop the progress of a medical condition, including … October 28, 2020
Diagnostic errors in hospitalized adults who died or were transferred … to intensive care. … January 10, 2024
In search of an international multidimensional action plan for second … August 31, 2022
Suicide risk, changing jobs, or leaving the nursing profession in the
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psnet.ahrq.gov/web-mm/adverse-event-during-intrahospital-transport
June 16, 2021 - In this commentary, we address these issues and provide potential solutions for clinical practice. … After the intrahospital transfer, the checklist may include reassessment of patient condition, a reminder … If the patient's condition requires it, the intrahospital transfer should be performed by qualified and … research has focused primarily on nurses and physicians, but failure to speak up is not limited to clinical … Clinical incidents that may or may not result in patient harm frequently occur during intrahospital transfer
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psnet.ahrq.gov/issue/potential-harms-resulting-patient-clinician-real-time-clinical-encounters-using-video-based
February 14, 2017 - Review
Potential harms resulting from patient–clinician real-time clinical encounters … Potential harms resulting from patient–clinician real-time clinical encounters using video-based telehealth … Potential harms resulting from patient–clinician real-time clinical encounters using video-based telehealth … , 2011
Impact of duty hour regulations on medical students' education: views of key clinical … Home Care
Medicine
Clinical Misdiagnosis
Telehealth
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psnet.ahrq.gov/web-mm/lp-or-not-lp
February 01, 2018 - To LP or Not LP
Citation Text:
Landrigan CP. To LP or Not LP. PSNet [internet]. … To LP or Not LP. PSNet [internet]. … The plan to refer the patient was sound, but the provider made errors in executing this plan, which facilitated … The combination of these failures left the family inappropriately responsible for conveying crucial clinical … February 1, 2018
Implementation of the I-PASS handoff program in diverse clinical
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psnet.ahrq.gov/node/865658/psn-pdf
April 24, 2024 - Another way that a facility can be cited or be required to implement a Plan of Correction is if it is … plan and the medication administration record. … , they are obligated to plan for that care to
include safe staffing levels. … Ron Ordona, DNP, FNP-BC, GS-C, WCC
Health Sciences Assistant Clinical Professor
Betty Irene Moore School … Bakerjian, PhD, APRN, FAANP, FGSA, FAAN
Co-Editor-in-Chief, AHRQ’s Patient Safety Network (PSNet)
Clinical
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psnet.ahrq.gov/issue/incivility-healthcare-impact-poor-communication
October 19, 2022 - Incivility hinders clinical performance , increases errors , and negatively impacts safety culture … October 19, 2022
Toward a responsible future: recommendations for AI-enabled clinical … Systems-Based Approaches to Improve Patient Safety by Improving Healthcare Worker Safety and Well-Being (R01 Clinical … October 25, 2023
In search of an international multidimensional action plan for second … Ambulatory Clinic or Office
Hospital Medicine
Nurse Care
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psnet.ahrq.gov/perspective/conversation-freya-spielberg-md-mph
September 28, 2022 - We had community health workers work with medical providers to come up with a care plan that they went … Once the individual is linked to primary care, the in-clinic staff can further implement the care plan … , while the community health workers can support adherence to the care plan in the community setting. … This relationship can enhance communication, manage clinical information, facilitate transitions in care … For example, if a patient receives the correct medications for a particular condition (effectiveness
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psnet.ahrq.gov/perspective/patient-and-family-roles-safety
June 14, 2023 - Families can then work collaboratively with nurses to ensure the plan of care is followed. … With the CARE Act, patients are asked to provide a family member or other care partner name for listing … , and decision making; and collaboration at all levels of care, not just in direct clinical care. … place for a patient or a resident in long-term care to define their family or care partner, and how … Clinicians were having to treat patients, whether they had COVID or some other serious condition, without
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psnet.ahrq.gov/issue/how-scale-quality-and-safety-program-home-care-accreditation
July 27, 2022 - Same Author(s)
From COVID-19 pandemic to patient safety: a new "spring" for telemedicine or … homes on care processes, safety climate and avoidable harms: evaluation of a care home quality improvement … Interview
In Conversation With...Amy Helwig about Health Plan … July 10, 2024
Perspectives on Safety
Health Plan … health record legal settlements in the US since the 2009 Health Information Technology for Economic and Clinical