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psnet.ahrq.gov/issue/ongoing-preventable-fatal-events-fentanyl-transdermal-patches-are-alarming
May 07, 2018 - Newspaper/Magazine Article
Ongoing, preventable fatal events with fentanyl transdermal patches are alarming!
Citation Text:
Ongoing, preventable fatal events with fentanyl transdermal patches are alarming! ISMP Medication Safety Alert! Acute Care Edition. June 28, 2007;12:1-3.
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/ambulatory-surgery/safetransitions/safetrans_checklist.pdf
December 01, 2017 - Checklist to Prepare Patients for New Appointments
Checklist to Prepare Patients for
New Appointments
Once the team knows a patient has a new health care appointment, the checklist can be used to prompt team
members to reinforce key steps that promote patient engagement and preparation. This checklist includes ref…
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psnet.ahrq.gov/issue/fda-begins-inquiry-after-death-and-illness-saline-bags-meant-training
October 17, 2012 - Newspaper/Magazine Article
FDA begins inquiry after death and illness from saline bags meant for training.
Citation Text:
FDA begins inquiry after death and illness from saline bags meant for training. Tavernise S. New York Times. January 15, 2015.
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www.ahrq.gov/sites/default/files/wysiwyg/cahps/news-and-events/events/webinars/hcbs-webcast-051623-woodward.pdf
June 02, 2025 - HCBS CAHPS Survey Database: What You Need to Know - WOODWARD
HCBS CAHPS Technical
Assistance
Kathleen Woodward, MSPH
Managing Director
The Lewin Group
19
Helpful Resources
• AHRQ CAHPS Guidance: https://www.ahrq.gov/cahps/surveys-
guidance/hcbs/index.html
• AHRQ Guide to Quality Improvement: https://www.Agency…
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/four-moments/poster-three-options.pdf
November 01, 2019 - Pocket Cards_4 Moments
Th
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Fo
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M
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M
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AHRQ Pub. No. 17(20)-0028-EF
November 2019
Moment 1 occurs at the time that initiation of antibiotic
therapy is being considered. Ask, “Does my patient have an
infection that requires antibiotics?”
Mome…
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psnet.ahrq.gov/issue/hamilton-father-misdiagnosed-lung-cancer-demands-answers
September 13, 2017 - Newspaper/Magazine Article
Hamilton father misdiagnosed with lung cancer demands answers.
Citation Text:
Hamilton father misdiagnosed with lung cancer demands answers. Carville O. The Star. November 14, 2014.
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psnet.ahrq.gov/issue/designing-safer-rotas-junior-doctors-48-hour-week
August 01, 2018 - Book/Report
Designing Safer Rotas for Junior Doctors in the 48-Hour Week.
Citation Text:
Designing Safer Rotas for Junior Doctors in the 48-Hour Week. Horrocks N, Pounder R. London, UK: Royal College of Physicians of London; 2006.
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psnet.ahrq.gov/issue/educating-safety
December 09, 2020 - Special or Theme Issue
Educating for Safety.
Citation Text:
Educating for Safety. Am J Pharm Edu. 2011;75(7):e140-e143.
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psnet.ahrq.gov/issue/disclosure-medical-errors-involving-gametes-and-embryos
April 22, 2020 - Commentary
Disclosure of medical errors involving gametes and embryos.
Citation Text:
Disclosure of medical errors involving gametes and embryos. Ethics Committee of the American Society for Reproductive Medicine. Fertil Steril. 2016;106:59-63.
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psnet.ahrq.gov/issue/lost-voice
March 21, 2007 - Newspaper/Magazine Article
A lost voice.
Citation Text:
A lost voice. Baker M. Seattle Times. February 10, 2017.
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psnet.ahrq.gov/issue/human-costs-training-doctors
December 17, 2014 - Newspaper/Magazine Article
Human costs of training doctors.
Citation Text:
Human costs of training doctors. Dunklin R; Goetinck Ambrose S; Egerton B.
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www.ahrq.gov/patient-safety/reports/engage/appe.html
March 01, 2017 - Guide to Improving Patient Safety in Primary Care Settings by Engaging Patients and Families
Appendix E. Category Definitions
Previous Page Next Page
Table of Contents
Guide to Improving Patient Safety in Primary Care Settings by Engaging Patients and Families
Executive Summary
Introduction
…
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www.ahrq.gov/hai/quality/tools/cauti-ltc/modules/implementation/long-term-modules/module5/engage-checklist.html
March 01, 2017 - Resident and Family Engagement Checklist
AHRQ Safety Program for Long-Term Care: HAIs/CAUTI
Purpose: To provide leaders and staff a checklist to help plan, implement, and evaluate resident and family engagement in safety projects in a long-term care facility.
Who should use this tool? Leaders …
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www.ahrq.gov/hai/quality/tools/cauti-ltc/modules/implementation/education-bundles/urine-culturing/antibiotic-stewardship/case-study-key.html
March 01, 2017 - Antibiotic Stewardship: Case Study Facilitator Key
AHRQ Safety Program for Long-Term Care: HAIs/CAUTI
Instructions:
Divide into small groups of two to three people.
Ask each group to work through each part of the case scenario, pausing for discussion before moving to the next section.
Us…
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meps.ahrq.gov/mepsweb/about_meps/index_policymaker.jsp
Medical Expenditure Panel Survey Policymaker Information
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An official website of the Department of Health & Human Services
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psnet.ahrq.gov/issue/case-medication-safety-officers-mso
April 30, 2019 - Book/Report
The Case for Medication Safety Officers (MSO).
Citation Text:
The Case for Medication Safety Officers (MSO). Horsham, PA: Institute for Safe Medication Practices; 2018.
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psnet.ahrq.gov/issue/safety-i-and-safety-ii-past-and-future-safety-management
July 22, 2019 - Book/Report
Classic
Safety-I and Safety-II: The Past and Future of Safety Management.
Citation Text:
Safety-I and Safety-II: The Past and Future of Safety Management. Hollnagel E. Aldershot, Hampshire, England: Ashgate; 2014. ISBN: 9781472423085.
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meps.ahrq.gov/mepsweb/survey_comp/mpc.jsp
August 23, 2017 - Medical Expenditure Panel Survey Medical Provider Component Overview
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An official website of the Department of Health & Human Services
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psnet.ahrq.gov/issue/principles-risk-management-and-patient-safety
March 27, 2005 - Book/Report
Principles of Risk Management and Patient Safety.
Citation Text:
Principles of Risk Management and Patient Safety. Youngberg BJ, ed. Sudbury, MA: Jones Bartlett; 2011. ISBN: 9780763774059.
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digital.ahrq.gov/2019-year-review/research-summary/emerging-innovative-newly-funded-research/how-you-feel-important-making-pros-meaningful
January 01, 2019 - How You Feel Is Important: Making PROs Meaningful
A tool to collect and share PROs in a primary care setting for a diverse patient population with multiple chronic conditions can potentially improve the patient-clinician relationship and improve patients’ quality of life.
Principal Investigator:…