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8121. New York City Uses AHRQ's TeamSTEPPS®, Other AHRQ Resources to Advance Patient Safety | Agency for Healthcare Research and Quality
      www.ahrq.gov/news/newsroom/case-studies/201518.html
      July 01, 2015 - New York City Uses AHRQ's TeamSTEPPS®, Other AHRQ Resources to Advance Patient Safety Search All Impact Case Studies July 2015 Description New York City Health and Hospitals Corporation (HHC), the nation’s largest municipal health care delivery system, uses several AHRQ resources to improve patient care…

8122. Potentially severe incidents during interhospital transport of critically ill patients, frequently occurring but rarely reported: a prospective study. | PSNet
      psnet.ahrq.gov/issue/potentially-severe-incidents-during-interhospital-transport-critically-ill-patients
      October 26, 2022 - Study Potentially severe incidents during interhospital transport of critically ill patients, frequently occurring but rarely reported: a prospective study. Citation Text: Eiding H, Røise O, Kongsgaard UE. Potentially severe incidents during interhospital transport of critically ill pati…

8123. Introduction | Agency for Healthcare Research and Quality
      www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-ai-wave1.html
      July 01, 2025 - Understanding the AI Wave: Foundational Knowledge for Improving Diagnosis and Beyond Introduction Previous Page Next Page Table of Contents Understanding the AI Wave: Foundational Knowledge for Improving Diagnosis and Beyond Introduction Understanding the AI Wave—What Is AI? Understanding AI’s…

8124. Patient readmissions, emergency visits, and adverse events after software-assisted discharge from hospital: cluster randomized trial. | PSNet
      psnet.ahrq.gov/issue/patient-readmissions-emergency-visits-and-adverse-events-after-software-assisted-discharge
      November 16, 2022 - Study Patient readmissions, emergency visits, and adverse events after software-assisted discharge from hospital: cluster randomized trial. Citation Text: Graumlich JF, Novotny NL, Nace S, et al. Patient readmissions, emergency visits, and adverse events after software-assisted dischar…

8125. Conclusions | Agency for Healthcare Research and Quality
      www.ahrq.gov/hai/cusp/clabsi-hpwpreport/clabsi-hpwp4.html
      August 01, 2015 - High-Performance Work Practices in CLABSI Prevention Interventions Conclusions Previous Page Next Page Table of Contents High-Performance Work Practices in CLABSI Prevention Interventions Case Studies Key Findings Conclusions References Table 1. Case Study Sites Table 2. Summary of Key …

8126. Implementing a robust process improvement program in the neonatal intensive care unit to reduce harm. | PSNet
      psnet.ahrq.gov/issue/implementing-robust-process-improvement-program-neonatal-intensive-care-unit-reduce-harm
      March 23, 2022 - Study Implementing a robust process improvement program in the neonatal intensive care unit to reduce harm. Citation Text: Nether KG, Thomas EJ, Khan A, et al. Implementing a robust process improvement program in the neonatal intensive care unit to reduce harm. J Healthc Qual. 2022;44(1)…

8127. Vital signs: maternity care experiences — United States, April 2023. | PSNet
      psnet.ahrq.gov/issue/vital-signs-maternity-care-experiences-united-states-april-2023
      July 19, 2023 - Study Vital signs: maternity care experiences — United States, April 2023. Citation Text: Mohamoud YA, Cassidy E, Fuchs E, et al. Vital Signs: Maternity Care Experiences — United States, April 2023. MMWR Morb Mortal Wkly Rep. 2023;72(35):961–967. doi:10.15585/mmwr.mm7235e1. Copy Citati…

8128. Safran, Charles | Digital Healthcare Research
      digital.ahrq.gov/principal-investigator/safran-charles
      July 17, 2017 - Safran, Charles InfoSAGE: usage pattern of a family-centric care coordination online platform. Citation Quintana Y, Henao J, Kaldany E, Gorenbeg M, Chen YP, Adra M, Lipsitzc L, Safran C. InfoSAGE: usage pattern of a family-centric care coordination online platform. Stud Health…

8129. Diagnostic uncertainty among critically ill children admitted to the PICU: a multicenter study. | PSNet
      psnet.ahrq.gov/issue/diagnostic-uncertainty-among-critically-ill-children-admitted-picu-multicenter-study
      June 14, 2023 - Study Diagnostic uncertainty among critically ill children admitted to the PICU: a multicenter study. Citation Text: Cifra CL, Custer JW, Smith CM, et al. Diagnostic uncertainty among critically ill children admitted to the PICU: a multicenter study. Crit Care Med. 2025;53(2):e294-e307. …

8130. Latent safety threats and countermeasures in the operating theater: a national in situ simulation-based observational study. | PSNet
      psnet.ahrq.gov/issue/latent-safety-threats-and-countermeasures-operating-theater-national-situ-simulation-based
      February 22, 2023 - Study Latent safety threats and countermeasures in the operating theater: a national in situ simulation-based observational study. Citation Text: Long JA, Webster CS, Holliday T, et al. Latent safety threats and countermeasures in the operating theater: a national in situ simulation-base…

8131. Available Comprehensive Quality Improvement Guides (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/g1_combo_availablecomprehensiveqiguides.pdf
      June 02, 2025 - Available Comprehensive Quality Improvement Guides Toolkit for Using the AHRQ Quality Indicators How To Improve Hospital Quality and Safety Available Comprehensive Quality Improvement Guides What is the purpose of this tool? This tool provides information on oth…

8132. What Is Patient Safety Culture? | Agency for Healthcare Research and Quality
      www.ahrq.gov/sops/about/patient-safety-culture.html
      June 01, 2024 - What Is Patient Safety Culture? Patient Safety Culture Defined Patient safety culture is the extent to which an organization's culture supports and promotes patient safety. It refers to the values, beliefs, and norms that are shared by healthcare practitioners and other staff throughout the organization that in…

8133. The influence of professional identity on how the receiver receives and responds to a speaking up message: a cross-sectional study. | PSNet
      psnet.ahrq.gov/issue/influence-professional-identity-how-receiver-receives-and-responds-speaking-message-cross
      August 10, 2022 - Study The influence of professional identity on how the receiver receives and responds to a speaking up message: a cross-sectional study. Citation Text: Barlow M, Watson B, Jones EW, et al. The influence of professional identity on how the receiver receives and responds to a speaking up …

8134. Helping healthcare teams to debrief effectively: associations of debriefers' actions and participants' reflections during team debriefings. | PSNet
      psnet.ahrq.gov/issue/helping-healthcare-teams-debrief-effectively-associations-debriefers-actions-and-participants
      February 02, 2022 - Study Helping healthcare teams to debrief effectively: associations of debriefers' actions and participants' reflections during team debriefings. Citation Text: Kolbe M, Grande B, Lehmann-Willenbrock N, et al. Helping healthcare teams to debrief effectively: associations of debriefers’ a…

8135. Using Health Information Technology in Practice Redesign: Impact of Health Information Technology on Workflow | Digital Healthcare Research
      digital.ahrq.gov/ahrq-funded-projects/using-health-information-technology-practice-redesign-impact-health-information-technology-on-workflow-ma
      January 01, 2023 - Using Health Information Technology in Practice Redesign: Impact of Health Information Technology on Workflow Project Final Report ( PDF , 3.82 MB) × Disclaimer Disclaimer details Close Project Description Annual Summaries Publications …

8136. Clinical Case Scenarios | Agency for Healthcare Research and Quality
      www.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care-2/clinical-case-scenarios.html
      July 01, 2023 - Clinical Case Scenarios AHRQ Safety Program for Perinatal Care, Phase 2 The two clinical case scenarios below illustrate 10 teamwork tools and strategies for improving perinatal care. One scenario focuses on obstetric hemorrhage, and the other scenario focuses on severe hypertension in pregnancy. Both scena…

8137. Disclosure of medical errors: what factors influence how patients respond? | PSNet
      psnet.ahrq.gov/issue/disclosure-medical-errors-what-factors-influence-how-patients-respond
      December 23, 2008 - Study Classic Disclosure of medical errors: what factors influence how patients respond? Citation Text: Mazor KM, Reed G, Yood RA, et al. Disclosure of medical errors: what factors influence how patients respond? J Gen Intern Med. 2006;21(7):704-10. Copy Cit…

8138. Understanding User Needs and Context to Inform Consumer Health Information Technology (IT) Design (R01) | Digital Healthcare Research
      digital.ahrq.gov/funding-mechanism/understanding-user-needs-and-context-inform-consumer-health-information-technology
      January 01, 2023 - Understanding User Needs and Context to Inform Consumer Health Information Technology (IT) Design (R01) Patient portal use and experience among older adults: systematic review. Citation Sakaguchi-Tang DK, Bosold AL, Choi YK, et al. Patient portal use and experience among olde…

8139. Individuals with End-of-Life Care Needs | Digital Healthcare Research
      digital.ahrq.gov/population/individuals-end-life-care-needs
      January 01, 2023 - Individuals with End-of-Life Care Needs A Demonstration Project: Assessing the Significance and Impact of Utilizing a Novel Telemedicine Application in the Delivery of Community-Based Palliative Care in a Rural Seriously Ill Population - Final Report Citation Bull J. A Demonst…

8140. Lifetime prevalence and correlates of patient-perceived medical errors experienced in the U.S. ambulatory setting: a population-based study. | PSNet
      psnet.ahrq.gov/issue/lifetime-prevalence-and-correlates-patient-perceived-medical-errors-experienced-us-ambulatory
      June 09, 2021 - Study Lifetime prevalence and correlates of patient-perceived medical errors experienced in the U.S. ambulatory setting: a population-based study. Citation Text: Sundwall DN, Munger MA, Tak CR, et al. Lifetime prevalence and correlates of patient-perceived medical errors experienced in t…