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psnet.ahrq.gov/issue/wrong-patient-ordering-errors-peripartum-mother-newborn-pairs-unique-patient-safety-challenge
July 28, 2021 - February 15, 2023
Society for Maternal-Fetal Medicine Special Statement: cognitive bias … experience of obstetric patients and health care workers after implementation of universal SARS-CoV-2 testing
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psnet.ahrq.gov/issue/perfect-storm-exam-medical-error-and-factors-contributing-its-possible-escalation
October 20, 2021 - November 16, 2022
Development and usability testing of the Agency for Healthcare Research … View More
Related Resources
WebM&M Cases
A Cognitive
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www.ahrq.gov/sites/default/files/wysiwyg/opioids/compendium/opioids-case-study-ehr-oud.pdf
April 07, 2025 - evaluating effectiveness and potential adverse effects of opioid use in older adults: misuse, falls, and cognitive … the Opioid Use in Older Adults Compendium,
developed by Abt Associates through the Identifying and Testing … resources,
(2) input from experts in quality improvement, geriatrics, and pain management, and
(3) testing
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digital.ahrq.gov/sites/default/files/docs/publication/r18hs017186-nebeker-final-report-2011.pdf
January 01, 2011 - Identify cognitive components of providers’ therapeutic decision making in the field.
Aim 2. … COCOM is a phenomenological description of behavior from Cognitive Systems
Engineering. … Higher modes of control are typically associated with higher cognitive
effort. … Theoretical testing was limited by lack of a validated measurement model. … The stratification reduced the power for hypothesis testing and impaired the
ability to determine clear
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www.ahrq.gov/sites/default/files/publications2/files/distributed-cognition-er-nurses_0.pdf
August 01, 2022 - Traditionally, the diagnostic process has been viewed as an individual cognitive activity of information … Using cognitive artifacts to understand distributed
cognition. … The hidden lives of nurses’ cognitive artifacts. … ‘More than words’ - Interpersonal communication, cognitive bias,
and diagnostic errors. … The importance of cognitive errors in diagnosis and strategies to minimize them.
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digital.ahrq.gov/technology/natural-language-processing-system
January 01, 2024 - Emergency Department Overcrowding Problems
Improving Patient Safety and Clinician Cognitive … Improving Patient Safety and Clinician Cognitive Support Through eMAR Redesign – Final Report. … Hettinger, Aaron Zachary
Project Name
Improving Patient Safety and Clinician Cognitive Support … Project Name
Improving Patient Safety and Clinician Cognitive Support Through eMAR Redesign
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cdsic.ahrq.gov/sites/default/files/2023-06/InnovationCenterQ12023ProgressReportDraft.pdf
January 01, 2023 - Data visualization techniques can lead to a more effective
decision-making process by reducing cognitive … and availability, the design of visualizations, level of user experience and expertise, individual cognitive … This testing was done according to Nielson’s 10 usability heuristics: 1) Visibility of system
status … After completing heuristic testing, the team presented a demonstration of the prototypes to AHRQ and … The
team will ultimately develop a report describing the findings from the testing.
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digital.ahrq.gov/sites/default/files/docs/citation/u19hs021093-lambert-final-report-2017.pdf
January 01, 2017 - After training, each resident independently completed 10 training and, subsequently, 5
testing trials … Develop, demonstrate and disseminate a standard protocol for pre-approval testing of drug names,
including … These experimental designs and analytic methods should
be useful in the preapproval testing of proposed … One obstacle to the acceptance
of these pre-approval testing methods has been the absence of validated … 9/30/16-9/29/21
AHRQ
Goal is to improve patient safety and the quality of care by developing and testing
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psnet.ahrq.gov/node/854973/psn-pdf
October 31, 2023 - communication technologies to find, evaluate, create, and communicate information, requiring both
cognitive … Transactional literacy is the highest cognitive level of eHealth literacy, meaning it
is informed and … displaying content clearly on the page, organizing content and
simplifying navigation, engaging users, and testing
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psnet.ahrq.gov/web-mm/do-not-miss-sepsis-needles-viral-haystacks
March 27, 2024 - Laboratory testing showed a normal white blood cell count of 8,500, but with 1.6% abnormal metamyelocytes … Believing in overcoming cognitive biases . … The impact of cognitive and implicit bias on patient safety and quality. … Six cognitive challenges of evidence-based approaches. … Cognitive forcing strategies in clinical decisionmaking.
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digital.ahrq.gov/sites/default/files/docs/citation/r21hs025238-xie-final-report-2020.pdf
January 01, 2020 - Objective: The proposed project aims to (1) examine individual and team cognitive work associated with … work of individual providers, but also the teamwork or
distributed cognitive work8-10 of providers … To examine individual and team cognitive work associated with obtaining a blood culture;
2. … Journal of Cognitive Engineering and Decision Making.
Xie, A, Koontz, D. … Using cognitive artifacts to understand
distributed cognition.
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digital.ahrq.gov/sites/default/files/docs/page/Tennessee%204-VI.ppt
August 18, 2004 - Usability (focus groups in ED)
1 month and 1 year after go-live
Barriers to implementing infrastructure (cognitive … Organizational development
Equipment
Software development
Site-specific customizations and costs
Cognitive … 08-18-04-Working-Group
08-18-04-Working-Group
System Usability
Will conduct usability testing … 18-04-Working-Group
ED Administrative Outcomes
Reduce inpatient admissions
Decreased duplicate testing … from SPL patient enrollment
Data from site provider enrollment
Downtime logs
Help desk logs
Other cognitive
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digital.ahrq.gov/sites/default/files/docs/page/Johnson%205-V.ppt
August 18, 2004 - Usability (focus groups in ED)
1 month and 1 year after go-live
Barriers to implementing infrastructure (cognitive … Organizational development
Equipment
Software development
Site-specific customizations and costs
Cognitive … 08-18-04-Working-Group
08-18-04-Working-Group
System Usability
Will conduct usability testing … 18-04-Working-Group
ED Administrative Outcomes
Reduce inpatient admissions
Decreased duplicate testing … from SPL patient enrollment
Data from site provider enrollment
Downtime logs
Help desk logs
Other cognitive
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digital.ahrq.gov/sites/default/files/docs/publication/r18hs017308-samore-final-report-2011.pdf
January 01, 2011 - Key Words: patient-centered care; personal health records; shared decision-making; cognitive
support … the interfaces flexible, intuitive, and smart.
3
We designed our technology to provide cognitive … Methods and Results for Aim 2
Usability Testing
The primary goal of usability testing was to elicit … This “think
aloud” technique permits understanding the cognitive process of the user during the session … Usability Testing in a Resource Stressed Environment: A
model for Public Health System Testing. 2009
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psnet.ahrq.gov/issue/demonstrating-value-postgraduate-fellowships-physicians-quality-improvement-and-patient
November 04, 2015 - September 15, 2011
Developing and testing a tool to measure nurse/physician communication … January 9, 2014
Teaching about how doctors think: a longitudinal curriculum in cognitive
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psnet.ahrq.gov/issue/checklist-identify-inpatient-suicide-hazards-veterans-affairs-hospitals
April 20, 2011 - September 19, 2016
Awareness and use of a cognitive aid for anesthesiology. … October 23, 2018
Academic detailing to improve laboratory testing among outpatient medication
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psnet.ahrq.gov/issue/nursing-practice-hospitalised-older-people-safety-and-harm
April 24, 2018 - June 4, 2014
Development and testing of tools to detect ambulatory surgical adverse events … Journal Article
Study
Demonstrating the value of a standardized cognitive
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psnet.ahrq.gov/issue/listen-whispers-they-become-screams-addressing-black-maternal-morbidity-and-mortality-united
December 05, 2012 - October 20, 2021
Development and testing of an objective structured clinical exam (OSCE … August 31, 2022
Society for Maternal-Fetal Medicine Special Statement: cognitive bias
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digital.ahrq.gov/sites/default/files/docs/citation/AHRQ_Personal_Health_InfoFinalReport_FINAL508compliant.pdf
March 01, 2010 - User capacities (e.g., cognitive, physical, health literacy). … benefit from newly developed health IT
systems, industry developers need to conduct more efficacy testing … of those systems, and
industry incentives may need to be enacted to promote more widespread testing … Beyond this step, preliminary testing on actual prototypes is also important. … The procedures
used in Phase I and II clinical trials can serve as one model for testing a product prior
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www.uspreventiveservicestaskforce.org/uspstf/recommendation/iron-deficiency-anemia-in-young-children-screening
September 07, 2015 - screening for iron deficiency anemia in asymptomatic children ages 6 to 24 months on growth or child cognitive … the effects of treatment of iron deficiency anemia in children ages 6 to 24 months on growth or child cognitive … for iron deficiency anemia in asymptomatic children ages 6 to 24 months to prevent adverse growth, cognitive … childhood may be associated with neurodevelopmental and behavioral delays and poorer performance on cognitive … Cognitive and behavioral delays in children have also been found to be associated with iron deficiency