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  1. www.ahrq.gov/sites/default/files/wysiwyg/research/findings/nhqrdr/qdr-data-spotlight-heart-failure-hospital.pdf
    July 01, 2023 - Hospital Deaths for Common Heart Conditions Increased While Hospitalizations Decreased During the First Year of COVID-19 1 Hospital Deaths for Common Heart Conditions Increased While Hospitalizations Decreased During the First Year of COVID-19 Deaths From Heart Disease Increased in 2020 Heart disease is the mo…
  2. www.ahrq.gov/patient-safety/settings/hospital/vtguide/appb.html
    October 01, 2022 - Preventing Hospital-Associated Venous Thromboembolism Appendix B: Risk Assessment Models, Protocols, and Order Sets Previous Page Next Page Table of Contents Preventing Hospital-Associated Venous Thromboembolism Preface Executive Summary Chapter 1. The Framework for Improvement Chapter 2. An…
  3. www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/mrsa-surgery/105-what-are-the-4-es-notes.docx
    April 01, 2025 - AHRQ Safety Program for MRSA Prevention: Targeting SSI What Are the 4 Es? Surgical Services For: Cardiac, Hip and Knee Joint Replacement, and Spinal Fusion Surgeries Slide Title and Commentary Slide Number and Slide What Are the 4 Es? SAY: This presentation reviews the 4 Es, a framework to guide the implementation…
  4. www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/mrsa-2/015-ss-hand-hygiene-periop-fg.docx
    April 01, 2025 - AHRQ Safety Program for MRSA Prevention: Targeting SSI Hand Hygiene in the Perioperative Setting Surgical Services For: Cardiac, Hip and Knee Joint Replacement, and Spinal Fusion Surgeries Slide Title and Commentary Slide Number and Slide Hand Hygiene in the Perioperative Setting SAY: Welcome to this presentatio…
  5. www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol3/Davis.pdf
    February 12, 2004 - Implementation of a Data-based Medical Event Reporting System in the U.S. Department of Defense 235 Implementation of a Data-based Medical Event Reporting System in the U.S. Department of Defense Mary Ann Davis, Geoffrey W. Rake Abstract Objective: As a result of the Institute of Medicine (IOM) report, To…
  6. www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol4/Kizer1.pdf
    April 01, 2004 - Safe Practices for Better Health Care 23 Safe Practices for Better Health Care Kenneth W. Kizer, Laura N. Blum Abstract Modern health care is highly complex, high risk, and error prone. Not surprisingly, health care errors and consequent adverse events are a leading cause of death and injury, even though wel…
  7. www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol1/Advances-Pronovost_95.pdf
    June 12, 2008 - Improving the Value of Patient Safety Reporting Systems Improving the Value of Patient Safety Reporting Systems Peter J. Pronovost, MD, PhD; Laura L. Morlock, PhD; J. Bryan Sexton, PhD; Marlene R. Miller, MD, MSc; Christine G. Holzmueller, BLA; David A. Thompson, DNSc, MS; Lisa H. Lubomski, PhD; Albert W. Wu, M…
  8. www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol3/Advances-Perry_49.pdf
    March 27, 2008 - High-Hanging Fruit: Improving Transitions in Health Care High-Hanging Fruit: Improving Transitions in Health Care Shawna J. Perry, MD; Robert L. Wears, MD, MS; Emily S. Patterson, PhD Abstract Discussions about enhancing the safety of transitions in health care have been disjointed. Respected health care …
  9. www.ahrq.gov/ncepcr/reports/2024-annual-report/recent-grants-improvement.html
    May 01, 2024 - Investments in Primary Care Research for 2021 and 2022 Practice and Quality Improvement Previous Page Next Page Table of Contents Investments in Primary Care Research for 2021 and 2022 Acknowledgments and Authors Message from the Acting Director of AHRQ's National Center for Excellence in Primar…
  10. Imp-Handouts (pdf file)

    www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/long-term-care/resources/ontime/prevhosp/imp-handouts.pdf
    June 02, 2025 - AHRQ’s Safety Program for Nursing Homes: On-Time Preventable Hospital and ED Visits 1 On-Time Preventable Hospital and ED Visits: Implementation On-Time Preventable Hospital and ED Visits Self-Assessment Scripted Exercise Team consists of:  Facilitator [Tom]  Program Champion (Quality Assessment and…
  11. www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/nicu_toolkit/nicupacket-apb.pdf
    June 02, 2025 - Transitioning Newborns from NICU to Home: Family Information Packet, Appendix B Appendix B: Clinical Materials to Share With Primary Care Providers Diagnoses and Conditions ■ Anemia of Prematurity ■ Apnea of Prematurity ■ Bronchopulmonary Dysplasia ■ Gastroesophageal Reflux ■ Nephrocalcinosis ■ Patent D…
  12. www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/surgery/modules/implementation/imp_learn_from_defects.pptx
    December 01, 2017 - PowerPoint Presentation: Learn From Defects Through Sensemaking Learning From Defects Through Sensemaking AHRQ Safety Program for Surgery Implementation AHRQ Pub. No. 16(18)-0004-15-EF December 2017 AHRQ Safety Program For Surgery – Implementation This module focuses on the process of Learning from Defects throug…
  13. www.ahrq.gov/sites/default/files/wysiwyg/diagnostic/resources/issue-briefs/dxsafety-cognitive-load-theory.pdf
    May 01, 2024 - Cognitive Load Theory and Its Impact on Diagnostic Accuracy: Issue Brief PATIENT SAFETY e Issue Brief 17 Cognitive Load Theory and Its Impact on Diagnostic Accuracy This page intentionally left blank. e Issue Brief 17 Cognitive Load Theory and Its Impact on Diagnostic Accuracy Prepared for: Agency for…
  14. www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-228-fullreport.pdf
    February 01, 2018 - Protocol for Identifying and Treating Children With Sepsis Syndrome in the Emergency Department 1 Protocol for Identifying and Treating Children with Sepsis Syndrome in the Emergency Department Section 1. Basic Measure Information 1.A. Measure Name Protocol for Identifying and Treating Children with Sepsis Syn…
  15. www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-117-fullreport.pdf
    October 18, 2017 - groups, New York Medicaid, and others to inform our measure development with the intelligence and experiences
  16. www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/chronic/chipra-088-fullreport.pdf
    January 05, 2017 - Accurate ADHD Diagnosis Accurate ADHD Diagnosis Section 1. Basic Measure Information 1.A. Measure Name Accurate ADHD Diagnosis 1.B. Measure Number 0088 1.C. Measure Description Please provide a non-technical description of the measure that conveys what it measures to a broad audience. Percentage of patien…
  17. www.ahrq.gov/sites/default/files/wysiwyg/research/findings/ta/topicrefinement/liquid-biopsy-topicrefinement.pdf
    July 29, 2021 - Final Topic Refinement Document - Role of Liquid Biopsy in Detection and Management of Cancer in the Medicare Population 1 Final Topic Refinement Document Role of Liquid Biopsy in Detection and Management of Cancer in the Medicare Population ID: MYOE58 Agency for Healthcare Research and Quality Te…
  18. www.ahrq.gov/sites/default/files/wysiwyg/sops/surveys/hospital/hospital-user-guide.pdf
    July 01, 2018 - For example, if you are administering the survey to 800 staff and your hospital typically experiences
  19. www.ahrq.gov/sites/default/files/wysiwyg/evidencenow/tools-and-materials/skills-qi-heart-health.docx
    February 01, 2016 - Implementing Heart Health Practice Self-Assessment Implementing Heart Health Practice Self-Assessment February 1, 2016 Implementing Heart Health Practice Self-Assessment – February 1, 2016 pg. 1 Preface This document presents a Practice Strategy Toolkit for the Heart of Virginia Healthcare (HVH) Cooperative. T…
  20. www.ahrq.gov/patient-safety/settings/hospital/resource/pressureulcer/tool/pu3.html
    October 01, 2014 - Preventing Pressure Ulcers in Hospitals 3. What are the best practices in pressure ulcer prevention that we want to use? Previous Page Next Page Table of Contents Preventing Pressure Ulcers in Hospitals Overview Key Subject Area Index 1. Are we ready for this change? 2. How will we manage ch…

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