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psnet.ahrq.gov/web-mm/no-news-may-not-be-good-news
December 07, 2009 - .( 1,2 ) In fact, the fastest growing area of malpractice litigation involves failures or delays in diagnosis … Missed and delayed diagnoses in the ambulatory setting: a study of closed malpractice claims. … Missed hypothyroidism diagnosis uncovered by linking laboratory and pharmacy data.
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psnet.ahrq.gov/innovation/project-boost-increases-patient-understanding-treatment-and-follow-care
February 26, 2025 - of the program found that it significantly increased patients' understanding and knowledge of their diagnoses … Many patients lack understanding of their hospitalization diagnosis and treatment plans, 9 resulting … factors for readmission (8Ps) include (1) problems with medications, (2) psychological, (3) principal diagnosis
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.233_slideshow.ppt
February 01, 2011 - Spotlight Case July 2008
Spotlight Case
One Toxic Drug Is Not Like Another
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*
Source and Credits
This presentation is based on the February 2011
AHRQ WebM&M Spotlight Case
See the full article at http://webmm.ahrq.gov
CME credit is available
Commentary by: Eric S. Holmboe, MD, American Board of Internal…
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.293_slideshow.ppt
March 01, 2013 - Spotlight Case July 2008
Spotlight Case
A Weighty Mistake
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*
Source and Credits
This presentation is based on the March 2013
AHRQ WebM&M Spotlight Case
See the full article at http://webmm.ahrq.gov
CME credit is available
Commentary by: Seth J. Bokser, MD, MPH, Associate Professor of Pediatrics & Medical…
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psnet.ahrq.gov/perspective/new-insights-safety-and-health-it
August 01, 2015 - talk to the patient about the things that the physician uniquely can do—complicated decisions, complex diagnoses … March 5, 2025
Documenting Diagnosis: Exploring the Impact of Electronic Health Records … Patient Safety Innovations
Ambulatory Safety Nets to Reduce Missed and Delayed Diagnoses
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psnet.ahrq.gov/node/49748/psn-pdf
December 01, 2015 - In the ED, his working diagnosis was acute decompensation of cirrhosis
without a clear etiology. … paracentesis
and sending the fluid for culture should be very low, as the consequences of missing the diagnosis … It is unclear in this case whether a
diagnosis of SBP was present or excluded, but the evaluation for
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psnet.ahrq.gov/web-mm/rapid-mis-strep
February 01, 2004 - The child was given a diagnosis of viral syndrome and dehydration, and the father was reassured. … The clinical diagnosis of streptococcal pharyngitis is frequently difficult, in part because patients … Practice guidelines for the diagnosis and management of group A streptococcal pharyngitis. … Perplexity and precision in the diagnosis of streptococcal pharyngitis. … Laboratory Diagnosis of Group A Streptococcal Infections: A Laboratory Manual.
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psnet.ahrq.gov/node/49537/psn-pdf
June 01, 2007 - When told of his diagnosis of metastatic cancer, the patient immediately said that he
wished he had
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psnet.ahrq.gov/web-mm/dying-hospital-advanced-dementia
November 01, 2016 - for Americans age 65 and older, and 1 in 3 seniors die with dementia.( 1 ) The median survival from diagnosis
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psnet.ahrq.gov/node/843736/psn-pdf
February 01, 2023 - pulmonary hypertension are generally counseled
against pregnancy, many patients are unaware of their diagnosis
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psnet.ahrq.gov/node/846564/psn-pdf
March 29, 2023 - Technology as a Tool for Improving Patient Safety
March 29, 2023
Holmgren AJ, McBride S, Gale B, et al. Technology as a Tool for Improving Patient Safety . PSNet
[internet]. 2023.
https://psnet.ahrq.gov/perspective/technology-tool-improving-patient-safety
Introduction
In the past several decades, technological a…
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psnet.ahrq.gov/node/867357/psn-pdf
December 18, 2024 - Hypoxemia after Emergency Intubation
December 18, 2024
Bohringer C, Liu H. Hypoxemia after Emergency Intubation. PSNet [internet]. 2024.
https://psnet.ahrq.gov/web-mm/hypoxemia-after-emergency-intubation
The Case
A 19-month-old child was brought to the emergency department (ED) via ambulance after drowning in a
p…
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psnet.ahrq.gov/classics
August 01, 2023 - Popular Classics
Classic
Missed diagnoses of acute cardiac … Missed or delayed diagnosis of cardiovascular disease can lead to adverse patient outcomes. … commentary discussed how improved teamwork and shared decision-making might have prevented a missed diagnosis … Artificial intelligence (AI) has the potential to enhance safety and improve diagnosis, but its use is … Clinical decision support (CDS) systems are intended to support diagnosis and therapeutic processes of
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psnet.ahrq.gov/web-mm/do-not-disturb
February 03, 2011 - Since physicians have ultimate responsibility for diagnosis and treatment decisions, other team members … February 3, 2011
Measurement is essential for improving diagnosis and reducing diagnostic … February 23, 2018
Ten principles for more conservative, care-full diagnosis. … October 10, 2018
Bringing diagnosis into the quality and safety equations. … Patient Safety Innovations
Ambulatory Safety Nets to Reduce Missed and Delayed Diagnoses
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psnet.ahrq.gov/web-mm/mismanagement-acute-decompensated-heart-failure-hypertensive-emergency
May 01, 2018 - After these results, the working diagnosis changed to acute heart failure exacerbation and the patient … Syncope is a common ED presentation with a broad differential diagnosis that includes multiple potential … should consider implementing policies and procedures that direct patients with high-risk admitting diagnoses … July 24, 2024
Documenting Diagnosis: Exploring the Impact of Electronic Health Records … Related Resources
WebM&M Cases
Under Pressure: Delayed Diagnosis
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psnet.ahrq.gov/node/49631/psn-pdf
July 01, 2011 - patient-safety-and-adherence-self-administered-medications
The Case
A 30-year-old man, with HIV and a recent diagnosis … toxoplasmosis or another brain disease,
and transferred him to the university hospital where the original diagnosis
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psnet.ahrq.gov/node/33835/psn-pdf
June 01, 2017 - We looked at 4 million
emergency admissions in the United Kingdom, and we looked at 50 different diagnosis … We adjusted for age, sex, economic deprivation, comorbidities, and the
admitting diagnosis.
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psnet.ahrq.gov/perspective/patient-advocacy-patient-safety-have-things-changed
June 01, 2014 - Patient Advocacy in Patient Safety: Have Things Changed?
Helen Haskell, MA | June 1, 2014
Also Read a Conversation
View more articles from the same authors.
Citation Text:
Haskell H. Patient Advocacy in Patient Safety: Have Things Changed?. PSNet [internet]. Ro…
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psnet.ahrq.gov/web-mm/missing-large-vessel-occlusion-stroke-patient-history-seizures
August 31, 2022 - Due to the delayed diagnosis of left MCA stroke, it was too late to perform any neurovascular intervention … However, premature closure on this diagnosis contributed to this missed opportunity to recognize … Emergency care providers should only make other diagnoses, such as postictal deficits or complex migraines … The therapeutic time window for acute ischemic stroke is relatively narrow, and any delays in diagnosis … If the diagnosis of ischemic stroke had been established in a timely manner, close monitoring for signs
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psnet.ahrq.gov/sites/default/files/2022-05/final_cme_reviewed_-_spotlight_missing_a_large_vessel_occlusion_stroke_04.14.2022_-_copy.pdf
January 01, 2022 - use medical history
and neurological examination to localize lesions and generate a
differential diagnosis … • Emergency care providers should only make other diagnoses,
such as postictal deficits or complex … • The therapeutic time window for acute ischemic stroke is relatively
narrow, and any delays in diagnosis … COMMUNICATION AND HANDOFFS
30
Communication and Handoffs (1)
31
• The delayed diagnosis of LVO … – If the diagnosis of ischemic stroke had been established in a timely
manner, close monitoring for