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psnet.ahrq.gov/issue/effects-online-personal-health-record-medication-accuracy-and-safety-cluster-randomized-trial
March 04, 2015 - Study
Effects of an online personal health record on medication accuracy and safety: a cluster-randomized trial.
Citation Text:
Schnipper JL, Gandhi TK, Wald JS, et al. Effects of an online personal health record on medication accuracy and safety: a cluster-randomized trial. J Am Med Inf…
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psnet.ahrq.gov/issue/central-venous-catheter-guidewire-retention-lessons-englands-never-event-database
September 15, 2021 - Study
Central venous catheter guidewire retention: lessons from England's never event database.
Citation Text:
Mariyaselvam MZA, Patel V, Young HE, et al. Central venous catheter guidewire retention: lessons from England's never event database. J Patient Saf. 2022;18(2):e387-e392. doi:10…
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psnet.ahrq.gov/issue/frequency-missed-test-results-and-associated-treatment-delays-highly-computerized-health
July 22, 2009 - Study
The frequency of missed test results and associated treatment delays in a highly computerized health system.
Citation Text:
Wahls TL, Cram PM. The frequency of missed test results and associated treatment delays in a highly computerized health system. BMC Fam Pract. 2007;8:32.
…
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psnet.ahrq.gov/issue/mandatory-provider-review-and-pain-clinic-laws-reduce-amounts-opioids-prescribed-and-overdose
August 02, 2017 - Study
Mandatory provider review and pain clinic laws reduce the amounts of opioids prescribed and overdose death rates.
Citation Text:
Dowell D, Zhang K, Noonan RK, et al. Mandatory Provider Review And Pain Clinic Laws Reduce The Amounts Of Opioids Prescribed And Overdose Death Rates. He…
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psnet.ahrq.gov/issue/interns-compliance-accreditation-council-graduate-medical-education-work-hour-limits
January 07, 2011 - Study
Interns' compliance with Accreditation Council for Graduate Medical Education work-hour limits.
Citation Text:
Landrigan CP, Barger LK, Cade BE, et al. Interns' compliance with accreditation council for graduate medical education work-hour limits. JAMA. 2006;296(9):1063-70.
Cop…
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psnet.ahrq.gov/issue/factors-influencing-nurses-decision-question-medication-administration-neonatal-clinical-care
April 21, 2021 - Study
Factors influencing a nurse's decision to question medication administration in a neonatal clinical care unit.
Citation Text:
Aydon L, Hauck Y, Zimmer M, et al. Factors influencing a nurse's decision to question medication administration in a neonatal clinical care unit. J Clin Nur…
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www.ahrq.gov/es/tools/index.html?page=4
October 01, 2024 - Comprehensive Unit-based Safety Program (CUSP) The CUSP toolkit includes training tools to make care safer. More
The SHARE Approach Five-step process for clinicians and their patients More
EvidenceNOW Tools for Change Helping practices implement evidence More
Tools
The …
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psnet.ahrq.gov/issue/electromagnetic-interference-radio-frequency-identification-inducing-potentially-hazardous
February 14, 2024 - Study
Electromagnetic interference from radio frequency identification inducing potentially hazardous incidents in critical care medical equipment.
Citation Text:
van der Togt R, van Lieshout EJ, Hensbroek R, et al. Electromagnetic interference from radio frequency identification indu…
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psnet.ahrq.gov/issue/monitoring-harm-associated-use-anticoagulants-pediatric-populations-through-trigger-based
November 11, 2015 - Study
Monitoring the harm associated with use of anticoagulants in pediatric populations through trigger-based automated adverse-event detection.
Citation Text:
Patregnani JT, Spaeder MC, Lemon V, et al. Monitoring the harm associated with use of anticoagulants in pediatric populations t…
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psnet.ahrq.gov/issue/developing-and-evaluating-automated-all-cause-harm-trigger-system
July 31, 2013 - Study
Developing and evaluating an automated all-cause harm trigger system.
Citation Text:
Sammer C, Miller S, Jones C, et al. Developing and Evaluating an Automated All-Cause Harm Trigger System. Jt Comm J Qual Patient Saf. 2017;43(4):155-165. doi:10.1016/j.jcjq.2017.01.004.
Copy Cita…
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psnet.ahrq.gov/issue/strength-improvement-recommendations-injurious-fall-investigations-retrospective-multi
August 17, 2022 - Study
Strength of improvement recommendations from injurious fall investigations: a retrospective multi-incident analysis.
Citation Text:
Paulik O, Hallen J, Lapkin S, et al. Strength of improvement recommendations from injurious fall investigations: a retrospective multi-incident analys…
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www.ahrq.gov/es/tools/index.html?page=0
December 01, 2015 - Comprehensive Unit-based Safety Program (CUSP) The CUSP toolkit includes training tools to make care safer. More
The SHARE Approach Five-step process for clinicians and their patients More
EvidenceNOW Tools for Change Helping practices implement evidence More
Tools
The …
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psnet.ahrq.gov/issue/wrong-site-surgery-pennsylvania-during-2015-2019-study-variables-associated-368-events-178
October 09, 2024 - Study
Wrong-site surgery in Pennsylvania during 2015–2019: a study of variables associated with 368 events from 178 facilities.
Citation Text:
Yonash RA, Taylor M. Wrong-Site Surgery in Pennsylvania During 2015–2019: A Study of Variables Associated With 368 Events From 178 Facilities. …
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www.ahrq.gov/news/blog/ahrqviews/eliminate-diagnostic-errors.html
August 01, 2022 - AHRQ Views: Blog posts from AHRQ leaders
AHRQ Expands Its Repertoire to Eliminate Diagnostic Errors
AUG
22
2022
By
Robert Otto
Valdez,
Ph.D., M.H.S.A.
R. Valdez, Ph.D., M.H.S.A.
Too many Americans have experienced the health-related consequences and anxieties that f…
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psnet.ahrq.gov/issue/exploring-health-care-professionals-perceptions-incidents-and-incident-reporting
August 28, 2013 - Study
Exploring health care professionals' perceptions of incidents and incident reporting in rehabilitation settings.
Citation Text:
Espin S, Carter C, Janes N, et al. Exploring Health Care Professionals' Perceptions of Incidents and Incident Reporting in Rehabilitation Settings. J Pati…
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www.ahrq.gov/sites/default/files/wysiwyg/ncepcr/resources/job-aid-joy-in-work.pdf
June 02, 2025 - Job Aid: Joy in Work
Primary Care Practice Facilitator
Training Series
1
Job Aid: Joy in Work
Joy in work is one of three categories of common goals practices
have for improvement. Joy in work is central to good patient
care and in recognition of this, the national triple aim has been
expanded to…
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psnet.ahrq.gov/issue/medication-reconciliation-during-hospitalization-and-hospital-home-interface-observational
June 16, 2021 - Study
Medication reconciliation during hospitalization and in hospital-home interface: an observational retrospective study.
Citation Text:
Volpi E, Giannelli A, Toccafondi G, et al. Medication reconciliation during hospitalization and in hospital-home interface: an observational retrosp…
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www.ahrq.gov/teamstepps-program/curriculum/mutual/tools/index.html
June 01, 2023 - Section 2: Explanation of Mutual Support Key Concepts and Tools
This section contains explanations and illustrations to help you better understand and appreciate the importance of TeamSTEPPS mutual support concepts and tools. If you teach this content or want additional insights into how the material can be mor…
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www.ahrq.gov/ecareplan/past-contributors/index.html
August 01, 2024 - eCare Plan Past Contributors
Technical Expert Panels The Technical Expert Panels (TEP) were created to identify data elements important for care for people with Long COVID, type 2 diabetes, chronic pain and opioid use, cardiovascular diseases, and chronic kidney disease—especially in the context of multiple chr…
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psnet.ahrq.gov/issue/randomized-controlled-trial-evaluating-impact-computerized-rounding-and-sign-out-system
July 14, 2010 - Study
Classic
A randomized, controlled trial evaluating the impact of a computerized rounding and sign-out system on continuity of care and resident work hours.
Citation Text:
Van Eaton EG, Horvath KD, Lober WB, et al. A randomized, controlled trial evaluating…