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Showing results for "failures".

  1. Appendix B: Risk Assessment Models, Protocols, and Order Sets (continued) | Agency for Healthcare Research and Quality

    www.ahrq.gov/patient-safety/settings/hospital/vtguide/appb2.html
    January 01, 2020 - Preventing Hospital-Associated Venous Thromboembolism Appendix B: Risk Assessment Models, Protocols, and Order Sets (continued) Previous Page Next Page Table of Contents Preventing Hospital-Associated Venous Thromboembolism Preface Executive Summary Chapter 1. The Framework for Improvement C…

  2. Appendix B: Risk Assessment Models, Protocols, and Order Sets (continued) | Agency for Healthcare Research and Quality

    www.ahrq.gov/es/patient-safety/settings/hospital/vtguide/appb2.html
    January 01, 2020 - Preventing Hospital-Associated Venous Thromboembolism Appendix B: Risk Assessment Models, Protocols, and Order Sets (continued) Previous Page Next Page Table of Contents Preventing Hospital-Associated Venous Thromboembolism Preface Executive Summary Chapter 1. The Framework for Improvement C…

  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49478/psn-pdf
    April 01, 2005 - Compare and Contrast April 1, 2005 Cho KC, Chertow GM. Compare and Contrast. PSNet [internet]. 2005. https://psnet.ahrq.gov/web-mm/compare-and-contrast Case Objectives Define contrast nephropathy (CN) List risk factors for CN Implement pharmacologic strategies for CN prophylaxis Follow an algorithm for CN risk …

  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49527/psn-pdf
    December 01, 2006 - Right Patient, Wrong Sample December 1, 2006 Astion ML. Right Patient, Wrong Sample. PSNet [internet]. 2006. https://psnet.ahrq.gov/web-mm/right-patient-wrong-sample The Case A 54-year-old man was admitted to the hospital for preoperative evaluation and elective knee surgery. On the morning of surgery, the patien…

  5. Statistical Brief #151: Trends in Potentially Preventable Hospital Admissions among Adults and Children, 2005-2010 (pdf file)

    hcup-us.ahrq.gov/reports/statbriefs/sb151.pdf
    August 01, 2011 - Statistical Brief #151: Trends in Potentially Preventable Hospital Admissions among Adults and Children, 2005-2010 1 March 2013 Trends in Potentially Preventable Hospital Admissions among Adults and Children, 2005–2010 Celeste M. Torio, Ph.D., M.P.H., Anne Elixhauser, Ph.D., and Roxanne …

  6. Statistical Brief #70: Hospitalizations for Eating Disorders from 1999 to 2006 (pdf file)

    hcup-us.ahrq.gov/reports/statbriefs/sb70.pdf
    April 01, 2009 - Statistical Brief #70: Hospitalizations for Eating Disorders from 1999 to 2006 HEALTHCARE COST AND UTILIZATION PROJECT Agency for Healthcare Research and Quality STATISTICAL BRIEF #70 April 2009 Highlights Eating disorder related hospitalizations increased 18 percent from 1999−2000 to …

  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/866995/psn-pdf
    October 30, 2024 - A Cognitive and Communication Blind Spot Contributes to Permanent Paralysis October 30, 2024 Utter GH. A Cognitive and Communication Blind Spot Contributes to Permanent Paralysis. PSNet [internet]. 2024. https://psnet.ahrq.gov/web-mm/cognitive-and-communication-blind-spot-contributes-permanent-paralysis Disclosur…

  8. Slide 1

    www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/cauti-tools/archived-webinars/cauti-sustainability.pptx
    December 01, 2015 - However, employees often only hear about this feedback when failures occur or performance falls below … Culture of Confidence. 39 To turn around a failure cycle can be tough, particularly when successive failures

  9. Final Progress Report: Risk-Informed Clinical Network for Safe Pediatric Emergency Transfers (pdf file)

    www.ahrq.gov/sites/default/files/2025-02/woods-report.pdf
    January 01, 2025 - Each of the above failures has been shown to exist in each of these processes. … Communication failures in the operating room: an observational classification of recurrent types and … Communication failures inpatient sign- out and suggestions for improvement: a critical incident analysis

  10. Final Progress Report: Shared Decision Making in Surgery To Improve Patient Safety and Reduce Liability (pdf file)

    www.ahrq.gov/sites/default/files/2024-07/domino-report.pdf
    January 01, 2024 - As communication failures between patients and healthcare providers are at the root of systems failures … In contrast, the nature of most errors was equipment injuries (23%), diagnostic delays or failures (

  11. In Situ Simulation: Challenges and Results (pdf file)

    www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol3/Advances-Patterson_48.pdf
    May 05, 2008 - Sustaining motivation to participate in in situ exercises over time requires feedback that system failures … Active failures by clinicians due to knowledge deficits and technical incompetence were also readily … Analysis of tracheal intubation attempts and failures in a pediatric ICU.

  12. Facts and Figures 2005

    hcup-us.ahrq.gov/reports/factsandfigures/facts_figures_2005.jsp
    January 01, 2005 - Facts and Figures 2005 An official website of the Department of Health & Human Services Search All AHRQ Websites Careers Contact Us Espanol FAQs Email Updates …

  13. Trends in Hospital Readmissions for Four High-Volume Conditions, 2009-2013 (pdf file)

    hcup-us.ahrq.gov/reports/statbriefs/sb196-Readmissions-Trends-High-Volume-Conditions.pdf
    December 01, 2014 - Trends in Hospital Readmissions for Four High-Volume Conditions, 2009-2013 1 November 2015 Trends in Hospital Readmissions for Four High-Volume Conditions, 2009–2013 Kathryn Fingar, Ph.D., M.P.H., and Raynard Washington, Ph.D. Introduction Hospital readmissions can have negative cons…

  14. Comparative Effectiveness of Beta-Adrenergic Antagonists on the Risk of Rehospitalization in Adults with Heart Failure | Effective Health Care (EHC) Program

    effectivehealthcare.ahrq.gov/products/heart-failure-rehospitalization/research

  15. Making Healthcare Safer IV: Patient Monitoring Systems To Prevent Failure To Rescue | Effective Health Care (EHC) Program

    effectivehealthcare.ahrq.gov/products/patient-monitoring-systems/rapid-research

  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/866868/psn-pdf
    October 02, 2024 - Integrating Safety-I and Safety-II conceptual frameworks to enhance safety measurement and management. October 2, 2024 Lounsbury O, Brant K, Stockwell DC. Integrating Safety-I and Safety-II conceptual frameworks to enhance safety measurement and management. J Patient Saf Risk Manag. 2024;29(3):128-130. doi:10.1177…

  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/72635/psn-pdf
    January 13, 2021 - Conducting safety research safely: a policy-based approach for conducting research with peer review protected material. January 13, 2021 Myers LC, Blumenthal K, Phadke NA, et al. Conducting Safety Research Safely: A Policy-Based Approach for Conducting Research with Peer Review Protected Material. Jt Comm J Qual P…

  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42252/psn-pdf
    May 08, 2013 - Patient safety in orthopedic surgery: prioritizing key areas of iatrogenic harm through an analysis of 48,095 incidents reported to a national database of errors. May 8, 2013 Panesar S, Carson-Stevens A, Salvilla SA, et al. Patient safety in orthopedic surgery: prioritizing key areas of iatrogenic harm through an …

  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/74758/psn-pdf
    February 09, 2022 - Emotional harm in the radiology department: analysis of an underrecognized preventable error. February 9, 2022 Siewert B, Swedeen S, Brook OR, et al. Emotional harm in the radiology department: analysis of an underrecognized preventable error. Radiology. 2022;302(3):613-619. doi:10.1148/radiol.2021211846. https://…

  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/46654/psn-pdf
    December 13, 2017 - Organisational paradoxes in speaking up for safety: implications for the interprofessional field. December 13, 2017 Rowland P. Organisational paradoxes in speaking up for safety: Implications for the interprofessional field. J Interprof Care. 2017;31(5):553-556. doi:10.1080/13561820.2017.1321305. https://psnet.ahr…
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