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psnet.ahrq.gov/node/49510/psn-pdf
May 01, 2006 - Cups of Error
May 1, 2006
Blegen MA, Pepper GA. Cups of Error. PSNet [internet]. 2006.
https://psnet.ahrq.gov/web-mm/cups-error
The Case
An 87-year-old man was 5 days postoperative from a decompressive laminectomy. Although he suffered
from dementia, he remained alert and oriented with only mild short-term memory…
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www.ahrq.gov/sites/default/files/wysiwyg/takeheart/training/module-2-implementation-guide.pdf
June 02, 2025 - Module 2 Implementation Guide: System Change: Laying the Foundation and Leadership
Implementation Guide - Module 2
System Change: Laying the Foundation and Leadership
Module Purpose
Following the call to action in Module 1, the purpose of this module is to lay the foundation for
systems change. Topics i…
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www.ahrq.gov/practiceimprovement/delivery-initiative/casalino/paper/idkeydsrapd.html
February 01, 2014 - Identifying Key Areas for Delivery System Research
Appendix D: Four Suggested Key Areas
Previous Page
Table of Contents
Identifying Key Areas for Delivery System Research
Executive Summary
Identifying Key Areas for Delivery System Research
Conclusion
References
Appendix A: Priority Topic…
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.314_slideshow.ppt
February 01, 2014 - PowerPoint Presentation
Spotlight Case
Multifactorial Medication Mishap
1
This presentation is based on the February 2014
AHRQ WebM&M Spotlight Case
See the full article at http://webmm.ahrq.gov
CME credit is available
Commentary by: Annie Yang, PharmD, BCPS
NYU Langone Medical Center
Editor, AHRQ WebM&M: Robe…
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psnet.ahrq.gov/node/33615/psn-pdf
June 01, 2005 - In Conversation with…Peter J. Pronovost, MD, PhD
June 1, 2005
In Conversation with…Peter J. Pronovost, MD, PhD. PSNet [internet]. 2005.
https://psnet.ahrq.gov/perspective/conversation-withpeter-j-pronovost-md-phd
Editor's Note: Peter J. Pronovost, MD, PhD, is Medical Director of the Johns Hopkins Center for
Innova…
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psnet.ahrq.gov/node/867980/psn-pdf
March 25, 2025 - Not All Headaches are Due to Migraine: Red Flags, Don’t
Miss Diagnoses, and Diagnostic Pitfalls
March 25, 2025
Olson APJ. Not All Headaches are Due to Migraine: Red Flags, Don’t Miss Diagnoses, and Diagnostic
Pitfalls. PSNet [internet]. 2025.
https://psnet.ahrq.gov/web-mm/not-all-headaches-are-due-migraine-red-fla…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/engagingfamilies/strategy3/Strat3_Tool_3_Pres_video_508.pdf
June 02, 2025 - Strategy 3: Bedside Shift Report (Tool 3)
Guide to Patient & Family Engagement
Insert hospital logo here
Nurse Bedside
Shift Report Training
[Hospital Name | Presenter name and title | Date of presentation]
Strategy 3: Nurse Bedside Shift Report (Tool 3)
Today’s session
• What is patient and famil…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-family-engagement/pfeprimarycare/beprepared_quickstartfull.pdf
January 01, 2015 - Implementation Quick Start Guide: Be Prepared to Be Engaged
Implementation
Quick Start Guide
Be Prepared
To Be Engaged
The Guide to Improving Patient Safety in Primary Care
Settings by Engaging Patients and Families
Table of Contents
What Is the Be Prepared To Be Engaged Strategy? .........................…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-family-engagement/pfeprimarycare/beprepared_quickstartbrochure.pdf
January 01, 2015 - Implementation Quick Start Guide: Be Prepared to Be Engaged (Half Page)
Implementation
Quick Start Guide
Be Prepared
To Be Engaged
The Guide to Improving Patient Safety
in Primary Care Settings by Engaging Patients
and Families
Table of Contents
What Is the Be Prepared To Be Engaged Strategy? ............…
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www.ahrq.gov/news/newsletters/e-newsletter/931.html
October 01, 2024 - Applicants Sought for National Coordinating Center and National Evaluation Center for State-Based Healthcare Extension Service
Issue Number
931
AHRQ News Now is a weekly newsletter that highlights agency research and program activities.
October 1, 2024
AHRQ Stats: Disparities in Sepsis-Related Hospitali…
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www.uspreventiveservicestaskforce.org/uspstf/about-uspstf/methods-and-processes/procedure-manual/procedure-manual-section-5-modeling
July 05, 2017 - Procedure Manual Section 5. Modeling
Share to Facebook
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Print
In addition to systematic reviews, the Task Force uses modeling to inform the recommendation process. The Task Force uses modeling only w…
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www.ahrq.gov/patient-safety/settings/hospital/candor/modules/notes2.html
August 01, 2022 - Module 2: Obtaining Organizational Buy-in and Support
AHRQ Communication and Optimal Resolution Toolkit
Facilitator Notes
Say:
Module 2 of the CANDOR Toolkit describes the importance of obtaining organizational support for CANDOR implementation. This module focuses on the role of organizational le…
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www.ahrq.gov/research/findings/final-reports/environmental-scan-programs/envscan-program1.html
April 01, 2018 - Environmental Scan of Patient Safety Education and Training Programs
Chapter 1. Environmental Scan
Previous Page Next Page
Table of Contents
Environmental Scan of Patient Safety Education and Training Programs
Introduction
Chapter 1. Environmental Scan
Chapter 2. Electronic Searchable Catalog …
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www.uspreventiveservicestaskforce.org/home/getfilebytoken/aRJ-3-AWuVvmC_kmoGCVHp
Evidence Gaps Research Taxonomy Table: Screening and Supplementation for Iron Deficiency and Iron Deficiency Anemia During Pregnancy
1
Evidence Gaps Research Taxonomy Table
Research to Address Evidence Gaps in Preventive Services for the USPSTF
Topic: Screening and Supplementation for Iron Deficiency a…
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www.uspreventiveservicestaskforce.org/home/getfilebytoken/kHT3WGUaG2wTz2pF_ke7bn
Evidence Gaps Research Taxonomy Table: Screening for Osteoporosis to Prevent Fractures
1
Evidence Gaps Research Taxonomy Table
Research to Address Evidence Gaps in Preventive Services for the USPSTF
Topic: Screening for Osteoporosis to Prevent Fractures
To fulfill its mission to improve health by making…
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psnet.ahrq.gov/node/866265/psn-pdf
July 31, 2024 - Misplaced Vial: Medication Kit Variability Contributes to
Medication Error During Patient Transport
July 31, 2024
MacDowell P, McGee E. Misplaced Vial: Medication Kit Variability Contributes to Medication Error During
Patient Transport. PSNet [internet]. 2024.
https://psnet.ahrq.gov/web-mm/misplaced-vial-medicatio…
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digital.ahrq.gov/ahrq-funded-projects/partnership-clinician-electronic-health-record-ehr-use-and-quality-care
January 01, 2023 - A Partnership for Clinician Electronic Health Record (EHR) Use and Quality of Care
Project Final Report ( PDF , 812.92 KB) Disclaimer
Disclaimer
The findings and conclusions in this document are those of the author(s), who are responsible for its content, and do not necessarily…
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www.ahrq.gov/sites/default/files/wysiwyg/cahps/quality-improvement/improvement-guide/1-about/cahps-ambulatory-care-guide-section-1.pdf
May 01, 2017 - About the CAHPS Ambulatory Care Improvement Guide
The CAHPS Ambulatory Care
Improvement Guide
Practical Strategies for Improving Patient Experience
Section 1: About the CAHPS Ambulatory Care Improvement
Guide
Visit the AHRQ Website for the full Guide.
May 2017 (updated)
https://www.ahrq.gov/cahps/quality-im…
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www.uspreventiveservicestaskforce.org/home/getfilebytoken/d8DVjQhw6JgjWaBtED97s6
Evidence Gaps Research Taxonomy Table: Research Gaps for Interventions for High Body Mass Index in Children and Adolescents
1
Evidence Gaps Research Taxonomy Table
Topic: Research Gaps for Interventions for High Body Mass Index in Children and Adolescents
To fulfill its mission to improve health by making …
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psnet.ahrq.gov/perspective/soil-not-seed-real-problem-root-cause-analysis
March 01, 2007 - The Soil, Not the Seed: The Real Problem with Root Cause Analysis
Patrice Spath, BA, RHIT, and William Minogue, MD | July 1, 2008
View more articles from the same authors.
Citation Text:
Spath P, Minogue W. The Soil, Not the Seed: The Real Problem with Root Cause …