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9921. 7.  Appendix C: Additional Tables by Topic Area | Agency for Healthcare Research and Quality
      www.ahrq.gov/ncepcr/reports/2024-annual-report/appendix-c.html
      May 01, 2024 - telemedicine visits on hospital admissions for ambulatory care-sensitive conditions (such as congestive heart failure … telemedicine visits on hospital admissions for ambulatory care-sensitive conditions (such as congestive heart failure

9922. Final Progress Report: Leveraging a Social Network of Elders and Families To Improve Medication Safety at Transitions of Care (pdf file)
      www.ahrq.gov/sites/default/files/2024-01/quintana-report.pdf
      January 01, 2024 - Each scenario consisted of multiple defined milestones to measure successful completion or failure. … Errors Observed in Scenarios 1-3 4.3 Usability Discussion The aggregated event timelines and success/failure … table highlighted specific areas of difficulty within the study scenarios and hint at a failure in … Pharmacist involvement at discharge with the joint commission heart failure core measure: challenges

9923. Final Progress Report: HIV/HCV Support Team to Improve Medication Safety and Engagement in Care (pdf file)
      www.ahrq.gov/sites/default/files/2024-02/berry-report.pdf
      January 01, 2024 - Unknown toxic potential Truvada (emtricitabine/tenofovir) maintained despite acute renal failure … Tenofovir is renally cleared and is nephrotoxic at supratherapeutic levels, resulting in compounded renal failure … patients, regardless of HST receipt, still faced risks of loss to follow-up after a kept appointment, ART failure … The second reason this study’s total sample was lower than hypothesized was a failure to capture most

9924. Bariatric Surgery in Women of Reproductive Age: Special Concerns for Pregnancy. Evidence Report/Technology Assessment, No. 169 (pdf file)
      www.ahrq.gov/downloads/pub/evidence/pdf/bariatricrep/barirep.pdf
      November 01, 2008 - It is not clear whether the failure rate of OCPs in this case series is significantly worse than expected … Based on this 5.0 percent failure rate, these authors advised the use of something other than OCP, and … called for a large RCT to determine the best method of contraception.38 Given that the failure rate … Failure of a nursing infant to thrive after the mother's gastric bypass for morbid obesity. … Steatohepatitis and fatal hepatic failure after biliopancreatic diversion.

9925. Improving Health Care and Palliative Care for Advanced and Serious Illness Disposition of Comments Report (pdf file)
      effectivehealthcare.ahrq.gov/sites/default/files/related_files/quality-gap-palliative-hospice_disposition-comments.pdf
      October 01, 2012 - limitations: “Few studies focused on specific non-cancer populations, such as patients with heart failure … limitations: “Few studies focused on specific non-cancer populations, such as patients with heart failure … literature: “Few studies focused on specific non-cancer populations, such as patients with heart failure … end of life", b) confusing Results organization, lack of reference from text to data tables, and failure … to provide citations so that statements are linked to specific groupings of studies, and c) failure

9926. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/33612/psn-pdf
      May 01, 2005 - Organizational Change in the Face of Highly Public Errors—I. The Dana-Farber Cancer Institute Experience May 1, 2005 Conway JB, Weingart SN. Organizational Change in the Face of Highly Public Errors—I. The Dana-Farber Cancer Institute Experience. PSNet [internet]. 2005. https://psnet.ahrq.gov/perspective/organizat…

9927. I. Introduction | Agency for Healthcare Research and Quality
      www.ahrq.gov/research/findings/final-reports/crctoolkit/crctoolkit1.html
      April 01, 2018 - Tracking and Improving Screening for Colorectal Cancer Intervention I. Introduction Previous Page Next Page Table of Contents Tracking and Improving Screening for Colorectal Cancer Intervention I. Introduction II. Background III. Intervention Steps and Tools IV. References 1.a-1 Informatio…

9928. TeamSTEPPS® Diagnosis Improvement: Team Assessment Tool (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/teamstepps-program/dx-improvement/dxsafety-team-assessment-tool.pdf
      February 01, 2022 - TeamSTEPPS® Diagnosis Improvement: Team Assessment Tool TeamSTEPPS® Team Assessment Tool for Improving Diagnosis – Instructions How to use this Team Assessment Tool This tool assesses the maturity level of your healthcare setting in five critical teamwork domains: Team Structure, Communication, Leadership, Situat…

9929. Prevent and Respond to Recurrence of Use | The Academy
      integrationacademy.ahrq.gov/products/playbooks/moud-playbook/implementing-treatment/prevent-and-respond-to-recurrence
      August 01, 2025 - 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…

9930. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/841306/psn-pdf
      December 14, 2022 - Resilient Healthcare and the Safety-I and Safety-II Frameworks December 14, 2022 Deutsch ES, Van CM, Mossburg SE. Resilient Healthcare and the Safety-I and Safety-II Frameworks. PSNet [internet]. 2022. https://psnet.ahrq.gov/perspective/resilient-healthcare-and-safety-i-and-safety-ii-frameworks Resilient healthca…

9931. Welcome Guide for Patients and Family Caregivers | Agency for Healthcare Research and Quality
      www.ahrq.gov/teamstepps-program/welcome-guides/caregivers.html
      July 01, 2023 - Welcome Guide for Patients and Family Caregivers Welcome to the TeamSTEPPS ® 3.0 curriculum. TeamSTEPPS (Team Strategies to Enhance Performance & Patient Safety) is a resource to equip members of healthcare teams to work effectively together to best meet the needs of patients and their family members, friend…

9932. References | Agency for Healthcare Research and Quality
      www.ahrq.gov/diagnostic-safety/resources/issue-briefs/leadership-6.html
      June 01, 2021 - Leadership To Improve Diagnosis: A Call to Action References Previous Page   Table of Contents Leadership To Improve Diagnosis: A Call to Action Diagnostic Safety as a Challenge for Healthcare Leadership Why Are Leaders Essential to Diagnostic Safety? How Can Leaders Drive Improvements in Diag…

9933. Science of Safety and Identifying Defects in Care of Mechanically Ventilated Patients: Facilitator Guide | Agency for Healthcare Research and Quality
      www.ahrq.gov/hai/tools/mvp/modules/cusp/science-of-safety-fac-guide.html
      February 01, 2017 - Science of Safety and Identifying Defects in Care of Mechanically Ventilated Patients: Facilitator Guide AHRQ Safety Program for Mechanically Ventilated Patients Slide 1: Science of Safety and Identifying Defects in Care of Mechanically Ventilated Patients Say: Today, we will give you an overview of the…

9934. Improving Patient Safety Through Simulation Research: Funded Projects (pdf file)
      www.ahrq.gov/sites/default/files/publications/files/simulproj11.pdf
      June 30, 2014 - Failure to recognize the early signs and symptoms of sepsis and institute aggressive management significantly

9935. New Mexico Race/Ethnicity Data Improvement Project Standardizing the Collection of Race, Ethnicity and Tribal Affiliation Data (pdf file)
      hcup-us.ahrq.gov/datainnovations/raceethnicitytoolkit/nm2.pdf
      June 01, 2011 - improvement interventions targeted to specific patient populations Disparities in care represent a failure

9936. Module 5: How To Measure Pressure Injury Rates and Prevention Practices | Agency for Healthcare Research and Quality
      www.ahrq.gov/patient-safety/settings/hospital/resource/pressureinjury/workshop/slides5.html
      October 01, 2017 - Usually when a deep pressure injury develops, it reflects a system failure.

9937. Back to Basics | PSNet
      psnet.ahrq.gov/web-mm/back-basics
      July 13, 2010 - Agonist-dependent failure of neutrophil function in diabetes correlates with extent of hyperglycemia.

9938. Statistical Brief #62: Characteristics of Persons Who Seldom or Never Wear Seat Belts, 2002 (pdf file)
      meps.ahrq.gov/data_files/publications/st62/stat62.pdf
      January 01, 2010 - includes a national commit­ ment to reducing injuries and deaths from motor vehicle crashes involving the failure

9939. Benefits vs. Risks of Intraosseous Vascular Access | PSNet
      psnet.ahrq.gov/web-mm/benefits-vs-risks-intraosseous-vascular-access
      September 01, 2005 - The Case A 72-year-old woman with a history of asthma, congestive heart failure, and medication noncompliance

9940. Engaging-Diverse-Patients-In-Hit-Use (pdf file)
      digital.ahrq.gov/sites/default/files/docs/survey/engaging-diverse-patients-in-hit-use.pdf
      January 01, 2004 - Heart Disease Diabetes High Blood Pressure Heart Failure Asthma or