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psnet.ahrq.gov/node/861778/psn-pdf
January 31, 2024 - Care Deficiencies and Leaders' Inadequate Reviews of a
Patient Who Died at the Lt. Col. Luke Weathers, Jr. VA
Medical Center in Memphis, Tennessee.
January 31, 2024
Washington, DC: The Veterans Affairs Inspector General; January 10, 2024. Report No. 23-00777-52.
https://psnet.ahrq.gov/issue/care-deficiencies-and-l…
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psnet.ahrq.gov/node/47450/psn-pdf
March 27, 2019 - A qualitative evaluation of healthcare professionals'
perceptions of adverse events focusing on
communication and teamwork in maternity care.
March 27, 2019
Rönnerhag M, Severinsson E, Haruna M, et al. A qualitative evaluation of healthcare professionals'
perceptions of adverse events focusing on communication and…
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psnet.ahrq.gov/node/37294/psn-pdf
May 21, 2013 - Improving Hand-Off Communication.
May 21, 2013
Oakbrook Terrace lL: Joint Commission Resources; 2007. ISBN 9781599400907.
https://psnet.ahrq.gov/issue/improving-hand-communication
The process of transferring primary responsibility for patient care is commonly referred to as a handoff.
Handoffs are inherently dange…
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psnet.ahrq.gov/node/46421/psn-pdf
November 08, 2017 - A novel ICU hand-over tool: the glass door of the patient
room.
November 8, 2017
Wessman BT, Sona C, Schallom M. A Novel ICU Hand-Over Tool: The Glass Door of the Patient Room. J
Intensive Care Med. 2017;32(8):514-519. doi:10.1177/0885066616653947.
https://psnet.ahrq.gov/issue/novel-icu-hand-over-tool-glass-door-p…
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psnet.ahrq.gov/node/44393/psn-pdf
August 12, 2015 - FDA Drug Safety Communication: FDA warns about
prescribing and dispensing errors resulting from brand
name confusion with antidepressant Brintellix
(vortioxetine) and antiplatelet Brilinta (ticagrelor).
August 12, 2015
MedWatch Safety Alert. Silver Spring, MD: US Food and Drug Administration; July 30, 2015.
https…
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psnet.ahrq.gov/perspective/how-identify-and-manage-problem-behaviors
December 01, 2009 - Nurse–physician communications: the impact of disruptive behaviors of factors affecting decision making
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www.ahrq.gov/sites/default/files/wysiwyg/teamstepps-program/dx-improvement/module5-situation-monitoring.pptx
January 10, 2022 - Module 5: Situation Monitoring
Module 5
Situation Monitoring To Improve Diagnosis
TeamSTEPPS® for Diagnosis Improvement
Welcome to the TeamSTEPPS for Diagnosis Improvement Course. This presentation will cover Module 5, Situation Monitoring To Improve Diagnosis, that you will review as the facilitator.
Individual…
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www.ahrq.gov/sites/default/files/wysiwyg/teamstepps-program/dx-improvement/module5-presenters-notes.pdf
January 10, 2022 - TeamSTEPPS® Diagnosis Improvement: Module 5 Situation Monitoring To Improve Diagnosis - Facilitator’s Notes
Slide 1
TeamSTEPPS® for Diagnosis
Improvement
…
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psnet.ahrq.gov/node/50612/psn-pdf
October 30, 2019 - The Safety Challenges of Supervision and Night Coverage
in Academic Residency
October 30, 2019
Raffel K. The Safety Challenges of Supervision and Night Coverage in Academic Residency. PSNet
[internet]. 2019.
https://psnet.ahrq.gov/web-mm/safety-challenges-supervision-and-night-coverage-academic-residency
The Case…
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www.ahrq.gov/sites/default/files/wysiwyg/pqmp/toolkits/questionnaire-overview.pdf
March 20, 2017 - CAHPS Child Hospital Survey: Overview of the Questionnaire
CAHPS® Child Hospital Survey and Instructions
CAHPS Child Hospital Survey: Overview of the Questionnaire
Document No. 950
Updated 3/20/2017
CAHPS® Child Hospital Survey:
Overview of the Questionnaire
Introduction..............................…
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www.ahrq.gov/ncepcr/care/coordination/atlas/chapter6m.html
June 01, 2014 - Care Coordination Measures Atlas Update
Chapter 6. Measure Maps and Profiles (continued, 14)
Previous Page Next Page
Table of Contents
Care Coordination Measures Atlas Update
Chapter 1: Background
Chapter 2. What is Care Coordination?
Chapter 3. Care Coordination Measurement Framework
Chapte…
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effectivehealthcare.ahrq.gov/sites/default/files/related_files/clinical-care-rapid-review-appendix-c.xlsx
January 01, 2018 - List of Evidence Tables
Category Evidence Table
Characteristics Evidence Table C-1. Study characteristics of included primary studies
Evidence Table C-2. Intervention characteristics of included primary studies
Evidence Table C-3. Population characteristics of included primary studies
Event reporting Evidence Ta…
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effectivehealthcare.ahrq.gov/sites/default/files/s23.pdf
October 01, 2007 - ORIGINAL ARTICLE
Improving Depiction of Benefits and Harms
Analyses of Studies of Well-Known Therapeutics and Review of
High-Impact Medical Journals
Artyom Sedrakyan, MD, PhD,*†‡ and Chuck Shih, MHS*
Abstract: The issues of weighing benefits and harms and of shared
decision-making have become increasingly important…
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effectivehealthcare.ahrq.gov/sites/default/files/related_files/clinical-care-protocol.pdf
January 01, 2024 - Making Healthcare Safer IV: Programs for Responding to Harms Experienced by Patients during Clinical Care
Evidence-based Practice Center Rapid Review Protocol
Project Title: Making Healthcare Safer IV: Programs for Responding to
Harms Experienced by Patients during Clinical Care
Review Question…
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psnet.ahrq.gov/node/867676/psn-pdf
February 26, 2025 - Responding to Patient Safety Events
February 26, 2025
Shaikh U. Responding to Patient Safety Events. PSNet [internet]. 2025.
https://psnet.ahrq.gov/primer/responding-patient-safety-events
Background
Patient safety events that occur in health care facilities require prompt action to ensure that further harm is
mit…
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digital.ahrq.gov/ahrq-funded-projects/accessibility-and-beyond-designing-consumer-health-it-disabled-individuals
January 01, 2023 - Accessibility and Beyond: Designing Consumer Health IT for Disabled Individuals
Project Final Report ( PDF , 423.59 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 re…
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psnet.ahrq.gov/node/49536/psn-pdf
May 01, 2007 - On the Other Hand
May 1, 2007
Henneman EA. On the Other Hand. PSNet [internet]. 2007.
https://psnet.ahrq.gov/web-mm/other-hand
The Case
A young woman with Takayasu's arteritis presented to the hospital with severe abdominal pain. The patient
had been diagnosed with Takayasu's a decade earlier. The disease results…
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www.ahrq.gov/teamstepps-program/curriculum/intro/explain.html
July 01, 2023 - Section 2: Explanation and Value of the TeamSTEPPS Curriculum
This section contains explanations and illustrations to help you better understand and appreciate the structure and importance of the TeamSTEPPS curriculum and its key concepts. If you teach this content or want additional insights into how the mate…
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www.ahrq.gov/hai/tools/ambulatory-surgery/sections/implementation/training-tools/pf-engagement-slides.html
May 01, 2017 - Patient and Family Engagement in the Surgical Environment Module
Slide 1: Patient and Family Engagement in the Surgical Environment Module
Slide 2: Learning Objectives
Image: Learning objectives are presented in a series of steps:
Define patient and family engagement.
Explain the importance of engagin…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/quality-resources/tools/cauti-ltc/modules/implementation/long-term-modules/module1/facilitator-notes.docx
March 01, 2017 - Facilitator Notes
SAY:
The Comprehensive LTC Safety Modules assist users with how to apply safety principles. This overview module explains the purpose of the toolkit and how it can be used in your facility’s quality improvement initiatives.
SLIDE 1
SAY:
The objectives of this module are to—
· Describe the purpo…