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4801. Improving America's Hospitals: The Joint Commission's Annual Report on Quality and Safety 2012. | PSNet
      psnet.ahrq.gov/issue/improving-americas-hospitals-joint-commissions-annual-report-quality-and-safety-2012
      November 02, 2012 - Book/Report Improving America's Hospitals: The Joint Commission's Annual Report on Quality and Safety 2012. Citation Text: Improving America's Hospitals: The Joint Commission's Annual Report on Quality and Safety 2012. Oakbrook Terrace, IL: The Joint Commission; September 2012. C…

4802. Evidence Brief: Implementation of High Reliability Organization Principles. | PSNet
      psnet.ahrq.gov/issue/evidence-brief-implementation-high-reliability-organization-principles
      November 11, 2020 - Book/Report Evidence Brief: Implementation of High Reliability Organization Principles. Citation Text: Evidence Brief: Implementation of High Reliability Organization Principles. Veazie S, Peterson K, Bourne D. Washington DC: United States Department of Veterans Affairs; May 2019. …

4803. Is Our Pharmacy Meeting Patients' Needs? A Pharmacy Health Literacy Assessment Tool User's Guide. | PSNet
      psnet.ahrq.gov/issue/our-pharmacy-meeting-patients-needs-pharmacy-health-literacy-assessment-tool-users-guide
      December 24, 2008 - Measurement Tool/Indicator Is Our Pharmacy Meeting Patients' Needs? A Pharmacy Health Literacy Assessment Tool User's Guide. Citation Text: Is Our Pharmacy Meeting Patients' Needs? A Pharmacy Health Literacy Assessment Tool User's Guide. Jacobson KL, Gazmararian JA, Kripalani S, et a…

4804. Preventing unintended retained foreign objects. | PSNet
      psnet.ahrq.gov/issue/preventing-unintended-retained-foreign-objects
      January 25, 2023 - Sentinel Event Alerts Preventing unintended retained foreign objects. Citation Text: Preventing unintended retained foreign objects. Sentinel event alert. 2013;(51):1-5. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId …

4805. Hoch I et al. 2003 "Countrywide computer alerts to community physicians improve potassium testing in patients receiving diuretics." | Digital Healthcare Research
      digital.ahrq.gov/health-it-tools-and-resources/workflow-assessment-health-it-toolkit/research/hoch-i-et-al-2003
      January 01, 2003 - Hoch I et al. 2003 "Countrywide computer alerts to community physicians improve potassium testing in patients receiving diuretics." Reference Hoch I, Heymann AD, Kurman I, et al. Countrywide computer alerts to community physicians improve potassium testing in patients receiving diuretics. J Am Med Inf…

4806. Medical Harm: Historical, Conceptual, and Ethical Dimensions of Iatrogenic Illness. | PSNet
      psnet.ahrq.gov/issue/medical-harm-historical-conceptual-and-ethical-dimensions-iatrogenic-illness
      May 13, 2020 - Book/Report Classic Medical Harm: Historical, Conceptual, and Ethical Dimensions of Iatrogenic Illness. Citation Text: Medical Harm: Historical, Conceptual, and Ethical Dimensions of Iatrogenic Illness. Sharpe VA, Faden AI. Cambridge NY; Cambridge University…

4807. Bad stars or guiding lights? Learning from disasters to improve patient safety. | PSNet
      psnet.ahrq.gov/issue/bad-stars-or-guiding-lights-learning-disasters-improve-patient-safety
      June 08, 2011 - Commentary Bad stars or guiding lights? Learning from disasters to improve patient safety. Citation Text: Hughes C, Travaglia JF, Braithwaite J. Bad stars or guiding lights? Learning from disasters to improve patient safety. Qual Saf Health Care. 2010;19(4):332-6. doi:10.1136/qshc.2008…

4808. AHRQ-Funded Patient Safety Project Highlights: Improving Healthcare Safety by Engaging Patients and Families. | PSNet
      psnet.ahrq.gov/issue/ahrq-funded-patient-safety-project-highlights-improving-healthcare-safety-engaging-patients
      March 22, 2024 - Book/Report AHRQ-Funded Patient Safety Project Highlights: Improving Healthcare Safety by Engaging Patients and Families. Citation Text: AHRQ-Funded Patient Safety Project Highlights: Improving Healthcare Safety by Engaging Patients and Families. Rockville, MD: Agency for Healthcare Rese…

4809. National Healthcare Quality and Disparities Report Chartbook on Patient Safety. | PSNet
      psnet.ahrq.gov/issue/national-healthcare-quality-and-disparities-report-chartbook-patient-safety-0
      May 02, 2017 - Book/Report National Healthcare Quality and Disparities Report Chartbook on Patient Safety. Citation Text: National Healthcare Quality and Disparities Report Chartbook on Patient Safety. Rockville, MD: Agency for Healthcare Research and Quality; March 2024. AHRQ Pub. No. 23-0046. Cop…

4810. Effective Health Care (pdf file)
      effectivehealthcare.ahrq.gov/sites/default/files/pdf/TND_0265_02-29-2008.pdf
      January 01, 2008 - Effective Health Care Topic Number(s): 0074 Document Completion Date: 12-01-09 1 Results of Topic Selection Process & Next Steps  Multimodal pain management for post-hip surgery will go forward for refinement as a comparative effectiveness or effectiveness review. The scope of this topic, in…

4811. Framing diagnostic error: an epidemiological perspective. | PSNet
      psnet.ahrq.gov/issue/framing-diagnostic-error-epidemiological-perspective
      January 12, 2022 - Review Framing diagnostic error: an epidemiological perspective. Citation Text: Hunter MK, Singareddy C, Mundt KA. Framing diagnostic error: an epidemiological perspective. Front Public Health. 2024;12:1479750. doi:10.3389/fpubh.2024.1479750. Copy Citation Format: DOI Googl…

4812. Ambulatory medication errors and adverse events involved in medicine-related malpractice cases from 2011 to 2021. | PSNet
      psnet.ahrq.gov/issue/ambulatory-medication-errors-and-adverse-events-involved-medicine-related-malpractice-cases
      November 18, 2016 - Study Ambulatory medication errors and adverse events involved in medicine-related malpractice cases from 2011 to 2021. Citation Text: Boisvert S, Nelson M, Ross J. Ambulatory medication errors and adverse events involved in medicine-related malpractice cases from 2011 to 2021. J Patient…

4813. A Patient-Facing App to Improve Care Transitions from Hospital to Home | Digital Healthcare Research
      digital.ahrq.gov/program-overview/research-stories/patient-facing-app-improve-care-transitions-hospital-home
      January 01, 2023 - A Patient-Facing App to Improve Care Transitions from Hospital to Home Theme: Engaging and Empowering Patients and Caregivers Subtheme: Using Digital Healthcare Tools in Chronic Disease Self-Management A patient-facing app simplifying the information patients and caregivers receive has the…

4814. State-Based Healthcare Extension Cooperatives - NOFO Released by AHRQ | The Academy
      integrationacademy.ahrq.gov/news-and-events/news/state-based-healthcare-extension-cooperatives-nofo-released-ahrq
      September 13, 2024 - An official website of the Department of Health & Human Services Search All AHRQ Sites Careers Contact Us Español FAQs Email Updates The Academy Integrating Behavioral Health & Primary Care Expand Navi…

4815. AHRQ Sitemap | Agency for Healthcare Research and Quality
      www.ahrq.gov/sitemap.html
      August 11, 2025 - AHRQ Main Site Topics Priority Populations About Priority Populations Children/Adolescents Elderly Low-Income Racial/Ethnic Minorities Rural/Inner-City Residents Special Healthcare Needs Women Information in Spanish Programs Rese…

4816. A recurring call to action: every healthcare organization needs a medication safety officer! | PSNet
      psnet.ahrq.gov/issue/recurring-call-action-every-healthcare-organization-needs-medication-safety-officer
      March 03, 2021 - Newspaper/Magazine Article A recurring call to action: every healthcare organization needs a medication safety officer! Citation Text: A recurring call to action: every healthcare organization needs a medication safety officer! ISMP Medication Safety Alert! Acute care edition. February…

4817. Project Charter (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d2_combo_projectcharter.pdf
      December 23, 2009 - Project Charter Toolkit for Using the AHRQ Quality Indicators How To Improve Hospital Quality and Safety i Tool D.2 Project Charter What is the purpose of this tool? The purpose of the project charter is to describe the performance improvement rationale, goals, barriers, and anticipated resources to which the…

4818. D2 Combo Projectcharter (doc file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d2_combo_projectcharter.docx
      December 23, 2009 - Project Charter What is the purpose of this tool? The purpose of the project charter is to describe the performance improvement rationale, goals, barriers, and anticipated resources to which the team will commit. Who are the target audiences? Staff members directly involved in the improvement project. Consider adding …

4819. Reimagining Healthcare Teams: Leveraging the Patient-Clinician-AI Triad To Improve Diagnostic Safety. | PSNet
      psnet.ahrq.gov/issue/reimagining-healthcare-teams-leveraging-patient-clinician-ai-triad-improve-diagnostic-safety
      September 13, 2023 - Book/Report Reimagining Healthcare Teams: Leveraging the Patient-Clinician-AI Triad To Improve Diagnostic Safety. Citation Text: Reimagining Healthcare Teams: Leveraging the Patient-Clinician-AI Triad To Improve Diagnostic Safety. James C, Singh K, Valley TS, et al. Rockville, MD; Agency…

4820. Documenting Diagnosis: Exploring the Impact of Electronic Health Records on Diagnostic Safety. | PSNet
      psnet.ahrq.gov/issue/documenting-diagnosis-exploring-impact-electronic-health-records-diagnostic-safety
      August 16, 2023 - Book/Report Documenting Diagnosis: Exploring the Impact of Electronic Health Records on Diagnostic Safety. Citation Text: Miller K, Ratwani R, Hose B-Z, et al. Documenting Diagnosis: Exploring The Impact Of Electronic Health Records On Diagnostic Safety. Rockville, MD: Agency for Healthc…