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psnet.ahrq.gov/perspective/conversation-jessica-behrhorst-about-evolution-root-cause-analysis
February 26, 2025 - that we conduct root cause analysis on sentinel events , which are serious events that cause harm or death … could be secretive and confidential because we are dealing with sensitive events, like causing harm or death
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www.uspreventiveservicestaskforce.org/home/getfilebytoken/oo3XPmknWkhsBbAuYZQyQw
November 24, 2020 - Task Force
Summary of Recommendation
Importance
Cardiovascular disease (CVD) is the leading cause of death … blood pressure, those with dyslipidemia,
IMPORTANCE Cardiovascular disease (CVD) is a leading cause of death
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psnet.ahrq.gov/perspective/evolution-root-cause-analysis
February 26, 2025 - that we conduct root cause analysis on sentinel events , which are serious events that cause harm or death … could be secretive and confidential because we are dealing with sensitive events, like causing harm or death
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol1/Tuinen.pdf
March 01, 2004 - location of injury,1 injury severity,2, 3
disease severity,4 comorbidity severity,5 the likelihood of death … Harm was defined as death, prolonged hospital stay, or temporary or
permanent impairment of bodily function
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effectivehealthcare.ahrq.gov/sites/default/files/related_files/anal-cancer-protocol.pdf
September 26, 2023 - fluorouracil/ or Immune Checkpoint Inhibitors/ or
Mitomycin/ or Nivolumab/ or Paclitaxel/ or Programmed Cell Death … checkpoint inhibitor* or Mitomycin or Nivolumab or Paclitaxel or
Pembrolizumab or programmed cell death
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hcup-us.ahrq.gov/reports/statbriefs/sb173-Childbirth-Delivery-Complications.jsp
May 01, 2014 - known or suspected fetal and placental
Fetal distress
0.9
2.3
1.0
2.2
Intrauterine death … fetal and placental problems affecting management of mother
656.3 fetal distress
656.4 intrauterine death
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psnet.ahrq.gov/sites/default/files/2024-06/spotlight_case_hemorrhagic_shock_slides_final.pptx
January 01, 2024 - This approach was not adequate and led to continued postoperative bleeding and eventual death from untreated
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psnet.ahrq.gov/node/841469/psn-pdf
December 14, 2022 - Diagnostic delays can significantly increase the risk of
death.
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psnet.ahrq.gov/node/60952/psn-pdf
September 30, 2020 - have not definitively shown to improve patient outcomes
such as electrolyte repletion and avoidable death
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/cusp/engaging-srexec-facguide.docx
January 01, 2017 - Still, despite that wakeup call, preventable harm is the third leading cause of death in the United States
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/assess-resident-UTI-facilitator-guide.docx
June 01, 2021 - It does not lead to increased risk of infection or death.
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/technical/measuredesc-dailyearlymobility-facguide.docx
January 01, 2017 - There are 25 event codes all together, ranging from endotracheal tube dislodgement to death.
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/safety/improvement-facilitator-guide.pdf
November 01, 2019 - meta-analysis shows that patients who undergo
antibiotic de-escalation have a 28 percent reduced risk
of death
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psnet.ahrq.gov/node/33656/psn-pdf
September 01, 2007 - bypass surgeries that in the last decade have exploded in number and have caused unacceptable rates of
death
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psnet.ahrq.gov/node/49513/psn-pdf
July 01, 2006 - A root cause analysis later attributed the death, at least in part, to inadequate delivery of
supplemental
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www.ahrq.gov/es/patient-safety/settings/hospital/vtguide/guide3.html
February 01, 2016 - Embolism Prevention trial. 17 This trial was designed to investigate the effect of ASA on vascular death
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www.ahrq.gov/patient-safety/settings/hospital/vtguide/guide3.html
February 01, 2016 - Embolism Prevention trial. 17 This trial was designed to investigate the effect of ASA on vascular death
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hcup-us.ahrq.gov/reports/statbriefs/sb152.pdf
March 08, 2013 - Causes
of death in homeless adults in Boston. … Risk factors for death in homeless adults in Boston.
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integrationacademy.ahrq.gov/products/playbooks/opioid-use-disorder/plan-integrate-mat-for-oud/understanding-components-of-mat
February 01, 2025 - Use Harm Reduction Strategies
Opioid use can cause serious health effects, including death, so
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integrationacademy.ahrq.gov/products/playbooks/opioid-use-disorder/implement-mat-for-oud/pharmacotherapy
January 01, 2018 - Discontinuing medications can increase a patient’s risk of relapse, overdose, and death. 1