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Total Results: 1,773 records

Showing results for "details".

261. Deficiencies in Facility Leaders' Response to Critical Surgical Events at the Michael E. DeBakey VA Medical Center in Houston, Texas. | PSNet
     psnet.ahrq.gov/issue/deficiencies-facility-leaders-response-critical-surgical-events-michael-e-debakey-va-medical
     November 29, 2023 - This report details five wrong-site surgeries and three instances of retained surgical items at one VA

262. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/42788/psn-pdf
     January 19, 2014 - This article details Johns Hopkins Hospital's efforts to exceed the Top Performer award thresholds on

263. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/39337/psn-pdf
     May 07, 2014 - Despite limitations in utilizing administrative data to draw clinical details, the findings are notable

264. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/39970/psn-pdf
     January 22, 2017 - This article details a checklist that hospital leadership can use to organize efforts to eliminate central

265. Microsoft PowerPoint - FINAL Feb 2021 Spotlight_Delay in Appropriate DX.pptx - Read-Only (pdf file)
     psnet.ahrq.gov/sites/default/files/2021-02/final_feb_2021_spotlight_delay_in_appropriate_dx.pdf
     January 01, 2021 - information led to missed diagnosis of submassive pulmonary embolism resulting in fatality 4 Case Details … chest radiograph • Patient was admitted to the hospital for acute asthma exacerbation 5 Case Details … tomography (CT) angiogram of the chest was obtained to rule out a pulmonary embolism (PE) 6 Case Details … conveyed to the primary team • The patient was started on a direct oral anticoagulant (DOAC) 7 Case Details … tachycardia • Bedside point-of-care ultrasound demonstrated marked right heart strain 8 Case Details

266. Improving resident handoffs for children transitioning from the intensive care unit. | PSNet
     psnet.ahrq.gov/issue/improving-resident-handoffs-children-transitioning-intensive-care-unit
     January 12, 2022 - This study details how improvement science methods were used to augment the quality of handoffs for

267. Patient and family engagement in incident investigations: exploring hospital manager and incident investigators' experiences and challenges. | PSNet
     psnet.ahrq.gov/issue/patient-and-family-engagement-incident-investigations-exploring-hospital-manager-and-incident
     November 04, 2020 - managers highlight two assets patients and families offer during incident investigations: they provide details

268. Improving resident physician participation in reporting patient safety and quality concerns. | PSNet
     psnet.ahrq.gov/issue/improving-resident-physician-participation-reporting-patient-safety-and-quality-concerns
     May 18, 2022 - This article details a quality and patient safety improvement project aimed at increasing reporting rates

269. A call to action: next steps to advance diagnosis education in the health professions. | PSNet
     psnet.ahrq.gov/issue/call-action-next-steps-advance-diagnosis-education-health-professions
     November 25, 2020 - This article details next steps for incorporating competencies into interprofessional health education

270. Quality framework for remote antenatal care: qualitative study with women, healthcare professionals and system-level stakeholders. | PSNet
     psnet.ahrq.gov/issue/quality-framework-remote-antenatal-care-qualitative-study-women-healthcare-professionals-and
     October 21, 2020 - This study with pregnant/recently pregnant women, maternity providers, and system-level stakeholders details

271. Patient–pharmacist communication during a post-discharge pharmacist home visit. | PSNet
     psnet.ahrq.gov/issue/patient-pharmacist-communication-during-post-discharge-pharmacist-home-visit
     May 28, 2015 - This qualitative study found that postdischarge home visits from pharmacists focused on the details

272. Drug Shortages: FDA's Ability to Respond Should Be Strengthened. | PSNet
     psnet.ahrq.gov/issue/drug-shortages-fdas-ability-respond-should-be-strengthened
     April 15, 2009 - This testimony details the US Food and Drug Administration (FDA) response to drug shortage trends and

273. Using a logic model to design and evaluate quality and patient safety improvement programs. | PSNet
     psnet.ahrq.gov/issue/using-logic-model-design-and-evaluate-quality-and-patient-safety-improvement-programs
     November 10, 2010 - management of a large-scale initiative to reduce health care–associated infections, this commentary details

274. Change in intern calls at night after a work hour restriction process change. | PSNet
     psnet.ahrq.gov/issue/change-intern-calls-night-after-work-hour-restriction-process-change
     September 01, 2017 - This study details the types of overnight calls received by cross-covering internal medicine night float

275. Necessity for a pathway for "high-alert" patients. | PSNet
     psnet.ahrq.gov/issue/necessity-pathway-high-alert-patients
     July 14, 2010 - commentary suggests engaging pharmacists in the transitions of care for these high-alert patients and details

276. Hand-off Communications. | PSNet
     psnet.ahrq.gov/issue/hand-communications
     January 04, 2017 - This article details the early progress of the Center's second major initiative, improving handoff communication

277. Implementing AORN recommended practices for transfer of patient care information. | PSNet
     psnet.ahrq.gov/issue/implementing-aorn-recommended-practices-transfer-patient-care-information
     October 07, 2013 - This commentary details how teamwork, effective communication, process documentation, policy adherence

278. Case-based learning for patient safety: the Lessons Learnt program for UK junior doctors. | PSNet
     psnet.ahrq.gov/issue/case-based-learning-patient-safety-lessons-learnt-program-uk-junior-doctors
     July 15, 2015 - This commentary details how a medical program implemented case-based learning (CBL) seminars and examines

279. Right medication, right dose, right patient, right time, and right route: how do we select the right patient-controlled analgesia (PCA) device? | PSNet
     psnet.ahrq.gov/issue/right-medication-right-dose-right-patient-right-time-and-right-route-how-do-we-select-right
     March 02, 2016 - This article details one teaching hospital's interdisciplinary approach to selecting a PCA device to

280. Training in quality and safety: the current landscape. | PSNet
     psnet.ahrq.gov/issue/training-quality-and-safety-current-landscape
     July 03, 2016 - offers information about educational opportunities for patient safety and quality improvement, including details