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  1. The Nursing Home Expert Panel’s Falls Investigation Guide Toolkit: How-To Guide. | PSNet

    psnet.ahrq.gov/issue/nursing-home-expert-panels-falls-investigation-guide-toolkit-how-guide
    January 09, 2025 - Tools/Toolkit The Nursing Home Expert Panel’s Falls Investigation Guide Toolkit: How-To Guide. Citation Text: The Nursing Home Expert Panel’s Falls Investigation Guide Toolkit: How-To Guide. Portland, OR: Oregon Patient Safety Commission; 2022.  Copy Citation Sav…

  2. Patient monitoring alarms in the ICU and in the operating room. | PSNet

    psnet.ahrq.gov/issue/patient-monitoring-alarms-icu-and-operating-room
    May 26, 2021 - Review Patient monitoring alarms in the ICU and in the operating room. Citation Text: Schmid F, Goepfert MS, Reuter DA. Patient monitoring alarms in the ICU and in the operating room. Crit Care. 2013;17(2):216. doi:10.1186/cc12525. Copy Citation Format: DOI Google Scholar…

  3. The Threats to Australian Patient Safety (TAPS) study: incidence of reported errors in general practice. | PSNet

    psnet.ahrq.gov/issue/threats-australian-patient-safety-taps-study-incidence-reported-errors-general-practice
    March 05, 2008 - Study The Threats to Australian Patient Safety (TAPS) study: incidence of reported errors in general practice. Citation Text: Makeham MAB, Kidd MR, Saltman DC, et al. The Threats to Australian Patient Safety (TAPS) study: incidence of reported errors in general practice. Med J Aust. 20…

  4. Systems approaches to surgical quality and safety: from concept to measurement. | PSNet

    psnet.ahrq.gov/issue/systems-approaches-surgical-quality-and-safety-concept-measurement
    January 19, 2016 - Review Systems approaches to surgical quality and safety: from concept to measurement. Citation Text: Vincent CA, Moorthy K, Sarker SK, et al. Systems approaches to surgical quality and safety: from concept to measurement. Ann Surg. 2004;239(4):475-82. Copy Citation Format: …

  5. Patients' perspectives of surgical safety: do they feel safe? | PSNet

    psnet.ahrq.gov/issue/patients-perspectives-surgical-safety-do-they-feel-safe
    November 18, 2013 - Study Patients' perspectives of surgical safety: do they feel safe? Citation Text: Dixon JL, Tillman MM, Wehbe-Janek H, et al. Patients' Perspectives of Surgical Safety: Do They Feel Safe? The Ochsner J. 2015;15(2):143-148. Copy Citation Format: Google Scholar PubMed BibTeX…

  6. Improving patient safety using interactive, evidence-based decision support tools. | PSNet

    psnet.ahrq.gov/issue/improving-patient-safety-using-interactive-evidence-based-decision-support-tools
    September 14, 2022 - Commentary Improving patient safety using interactive, evidence-based decision support tools. Citation Text: Quinn MM, Mannion J. Improving patient safety using interactive, evidence-based decision support tools. Jt Comm J Qual Patient Saf. 2005;31(12):678-683. Copy Citation Form…

  7. Managing medication errors—a qualitative study. | PSNet

    psnet.ahrq.gov/issue/managing-medication-errors-qualitative-study
    December 06, 2023 - Study Managing medication errors—a qualitative study. Citation Text: Stetina P, Groves M, Pafford L. Managing medication errors--a qualitative study. Medsurg Nurs. 2005;14(3):174-8. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML Endnote tag…

  8. Tune-in and time-out: toward surgeon-led prevention of "never" events. | PSNet

    psnet.ahrq.gov/issue/tune-and-time-out-toward-surgeon-led-prevention-never-events
    July 24, 2024 - Study Tune-in and time-out: toward surgeon-led prevention of "never" events. Citation Text: Jones N. Tune-In and Time-Out: Toward Surgeon-Led Prevention of "Never" Events. J Patient Saf. 2019;15(4):e36-e39. doi:10.1097/PTS.0000000000000259. Copy Citation Format: DOI Google …

  9. Pediatric medication errors in the postanesthesia care unit: analysis of MEDMARX data. | PSNet

    psnet.ahrq.gov/issue/pediatric-medication-errors-postanesthesia-care-unit-analysis-medmarx-data
    January 06, 2017 - Study Pediatric medication errors in the postanesthesia care unit: analysis of MEDMARX data. Citation Text: Payne CH, Smith CR, Newkirk LE, et al. Pediatric medication errors in the postanesthesia care unit: analysis of MEDMARX data. AORN J. 2007;85(4):731-40; quiz 741-4. Copy Citati…

  10. Geometric probability distribution for modeling of error risk during prescription dispensing. | PSNet

    psnet.ahrq.gov/issue/geometric-probability-distribution-modeling-error-risk-during-prescription-dispensing
    December 24, 2008 - Study Geometric probability distribution for modeling of error risk during prescription dispensing. Citation Text: Carnahan BJ, Maghsoodloo S, Flynn EA, et al. Geometric probability distribution for modeling of error risk during prescription dispensing. Am J Health Syst Pharm. 2006;63(…

  11. Implementing a nurse-shadowing program for first-year medical students to improve interprofessional collaborations on health care teams. | PSNet

    psnet.ahrq.gov/issue/implementing-nurse-shadowing-program-first-year-medical-students-improve-interprofessional
    January 15, 2025 - Commentary Implementing a nurse-shadowing program for first-year medical students to improve interprofessional collaborations on health care teams. Citation Text: Jain A, Luo E, Yang J, et al. Implementing a nurse-shadowing program for first-year medical students to improve interprofessi…

  12. Impact of organizations on healthcare-associated infections. | PSNet

    psnet.ahrq.gov/issue/impact-organizations-healthcare-associated-infections
    December 11, 2024 - Commentary Impact of organizations on healthcare-associated infections. Citation Text: Castro-Sánchez E, Holmes AH. Impact of organizations on healthcare-associated infections. J Hosp Infect. 2015;89(4):346-50. doi:10.1016/j.jhin.2015.01.012. Copy Citation Format: DOI Googl…

  13. Prioritizing threats to patient safety in rural primary care. | PSNet

    psnet.ahrq.gov/issue/prioritizing-threats-patient-safety-rural-primary-care
    April 23, 2014 - Study Prioritizing threats to patient safety in rural primary care. Citation Text: Singh R, Singh A, Servoss TJ, et al. Prioritizing threats to patient safety in rural primary care. J Rural Health. 2007;23(2):173-8. Copy Citation Format: Google Scholar PubMed BibTeX EndNo…

  14. Inpatient notes: reducing diagnostic error—a new horizon of opportunities for hospital medicine. | PSNet

    psnet.ahrq.gov/issue/inpatient-notes-reducing-diagnostic-error-new-horizon-opportunities-hospital-medicine
    February 24, 2021 - Commentary Inpatient notes: reducing diagnostic error—a new horizon of opportunities for hospital medicine. Citation Text: Singh H, Zwaan L. Web Exclusives. Annals for Hospitalists Inpatient Notes - Reducing Diagnostic Error-A New Horizon of Opportunities for Hospital Medicine. Ann Inter…

  15. Module 6: Laying the Groundwork for Care Coordination | Agency for Healthcare Research and Quality

    www.ahrq.gov/takeheart/training/module-6/index.html
    December 01, 2022 - Module 6: Laying the Groundwork for Care Coordination   YouTube embedded video: https://www.youtube-nocookie.com/embed/Zvp6SFaH-8g Video: Laying the Groundwork for Care Coordination (1:00:12) Slides: Laying the Groundwork for Effective Care Coordination (PDF, 1.4 MB) Implementation Guide:  Laying th…

  16. Data Query Tools

    hcup-us.ahrq.gov/dataquerytools.jsp
    February 01, 2023 - Data Query Tools An official website of the Department of Health & Human Services Search All AHRQ Websites Careers Contact Us Espanol FAQs Email Updates …

  17. Reports Archive

    hcup-us.ahrq.gov/reports/reports_archive.jsp
    April 01, 2022 - Reports Archive An official website of the Department of Health & Human Services Search All AHRQ Websites Careers Contact Us Espanol FAQs Email Updates …

  18. The problem with incident reporting. | PSNet

    psnet.ahrq.gov/issue/problem-incident-reporting
    February 28, 2024 - Commentary The problem with incident reporting. Citation Text: Macrae C. The problem with incident reporting. BMJ Qual Saf. 2016;25(2):71-75. doi:10.1136/bmjqs-2015-004732. Copy Citation Format: DOI Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged Pu…

  19. Iowa’s Waverly Health Center Uses AHRQ Tools to Improve Patient Safety | Agency for Healthcare Research and Quality

    www.ahrq.gov/news/newsroom/case-studies/201526.html
    January 01, 2018 - Iowa’s Waverly Health Center Uses AHRQ Tools to Improve Patient Safety Search All Impact Case Studies September 2015 Waverly Health Center, a critical access hospital in Waverly, Iowa, has used three AHRQ resources to improve communication, teamwork, and leadership engagement as part of ongoing efforts to i…

  20. More Opioid-Related Emergency Visits, No Change in Illicit Drug Use Treatment

    hcup-us.ahrq.gov/reports/infographics/SAMSHA_opioids.jsp
    January 01, 2022 - More Opioid-Related Emergency Visits, No Change in Illicit Drug Use Treatment An official website of the Department of Health & Human Services Search All AHRQ Websites Careers Contact Us …
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