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Showing results for "failures".

  1. Primary Care Interventions to Prevent Child Maltreatment (pdf file)

    www.uspreventiveservicestaskforce.org/Home/GetFileByToken/otgsgT2HpLH5gbn4sFN3hw
    June 01, 2013 - Primary Care Interventions to Prevent Child Maltreatment June 2013 Task Force FINAL Recommendation | 1 Understanding Task Force Recommendations Primary Care Interventions to Prevent Child Maltreatment The U.S. Preventive Services Task Force (Task Force) has issued a final recommendation statement on Primary C…

  2. Table 8B: Dually Eligible HCBS Participants | Agency for Healthcare Research and Quality

    www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/findings/tab8b.html
    February 01, 2023 - Assessing the Health and Welfare of the HCBS Population Table 8B: Dually Eligible HCBS Participants Previous Page Next Page Table of Contents Assessing the Health and Welfare of the HCBS Population Introduction HCBS Population Availability and Use of State Medicaid HCBS Outcome Indicators fo…

  3. Table 8C: Medicaid-Only HCBS Participants | Agency for Healthcare Research and Quality

    www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/findings/tab8c.html
    February 01, 2023 - Assessing the Health and Welfare of the HCBS Population Table 8C: Medicaid-Only HCBS Participants Previous Page Next Page Table of Contents Assessing the Health and Welfare of the HCBS Population Introduction HCBS Population Availability and Use of State Medicaid HCBS Outcome Indicators for …

  4. Table 8E: Serious Mental Illness Subpopulation | Agency for Healthcare Research and Quality

    www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/findings/tab8e.html
    February 01, 2023 - Assessing the Health and Welfare of the HCBS Population Table 8E: Serious Mental Illness Subpopulation Previous Page Next Page Table of Contents Assessing the Health and Welfare of the HCBS Population Introduction HCBS Population Availability and Use of State Medicaid HCBS Outcome Indicators…

  5. Table 8G: HCBS Population Age 65 | Agency for Healthcare Research and Quality

    www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/findings/tab8g.html
    February 01, 2023 - Assessing the Health and Welfare of the HCBS Population Table 8G: HCBS Population Age 65+ Previous Page Next Page Table of Contents Assessing the Health and Welfare of the HCBS Population Introduction HCBS Population Availability and Use of State Medicaid HCBS Outcome Indicators for the HCBS…

  6. Table 8A: National HCBS Population | Agency for Healthcare Research and Quality

    www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/findings/tab8.html
    February 01, 2023 - Assessing the Health and Welfare of the HCBS Population Table 8A: National HCBS Population Previous Page Next Page Table of Contents Assessing the Health and Welfare of the HCBS Population Introduction HCBS Population Availability and Use of State Medicaid HCBS Outcome Indicators for the HCB…

  7. Table 8D: Intellectual/Developmental Disabilities Subpopulation | Agency for Healthcare Research and Quality

    www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/findings/tab8d.html
    February 01, 2023 - Assessing the Health and Welfare of the HCBS Population Table 8D: Intellectual/Developmental Disabilities Subpopulation Previous Page Next Page Table of Contents Assessing the Health and Welfare of the HCBS Population Introduction HCBS Population Availability and Use of State Medicaid HCBS O…

  8. Table 8F: HCBS Population Ages 18-64 Without Intellectual/Developmental Disabilities or Serious Mental Illness | Agency for Healthcare Research and Quality

    www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/findings/tab8f.html
    February 01, 2023 - Assessing the Health and Welfare of the HCBS Population Table 8F: HCBS Population Ages 18-64 Without Intellectual/Developmental Disabilities or Serious Mental Illness Previous Page Next Page Table of Contents Assessing the Health and Welfare of the HCBS Population Introduction HCBS Population …

  9. Part 3: National Quality Strategy Priority—Effective Treatment | Agency for Healthcare Research and Quality

    www.ahrq.gov/research/findings/nhqrdr/chartbooks/blackhealth/part3-nqs5.html
    June 01, 2018 - Chartbook on Health Care for Blacks Part 3: National Quality Strategy Priority—Effective Treatment Previous Page Next Page Table of Contents Chartbook on Health Care for Blacks Health Care for Blacks Acknowledgments Part 1: Overviews of the Report and the Black Population Part 2: Trends in P…

  10. Introduction to the Quality Indicators Best Practices Tool (pdf file)

    www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d4_combo_bestpracticescover.pdf
    June 02, 2025 - Introduction to the Quality Indicators Best Practices Tool Toolkit for Using the AHRQ Quality Indicators How To Improve Hospital Quality and Safety i Tool D.4 Introduction to the Quality Indicators Best Practices Tool What is the purpose of this tool? The purpose of this tool is to provide: • Detailed descr…

  11. Enhancing Patient Safety Through Cognition and Communication (M-Safety Lab) | Agency for Healthcare Research and Quality

    www.ahrq.gov/patient-safety/resources/learning-lab/enhancing-long-desc.html
    April 01, 2021 - Enhancing Patient Safety Through Cognition and Communication (M-Safety Lab) Principal Investigator: Sanjay Saint, M.D., M.P.H., University of Michigan, Ann Arbor, MI AHRQ Grant No.: HS24385 Project Period: 09/30/15-12/31/19 Description: The goal of this learning lab was to implement novel methods to …

  12. Cognitive Load Theory and Its Impact on Diagnostic Accuracy: Issue Brief (pdf file)

    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…

  13. Final Progress Report: Malpractice Insurers’ Medical Error Surveillance and Prevention Study (MIMESPS) (pdf file)

    www.ahrq.gov/sites/default/files/2024-09/studdert-report.pdf
    January 01, 2024 - The IOM report, moreover, linked the principal underlying causes of medical error— most notably, failures

  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/854897/psn-pdf
    October 31, 2023 - First, they include both "active failures," referring to actions committed at the "sharp end" by individuals

  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/60745/psn-pdf
    October 01, 2020 - Periodic random audits may help identify failures to comply with organizational policies, and collaboration

  16. Complaints as Safety Surveillance | PSNet

    psnet.ahrq.gov/web-mm/complaints-safety-surveillance
    May 05, 2021 - The aim should be a just culture where physicians are not punished for isolated lapses or systems failures

  17. Delayed Recognition of a Positive Blood Culture | PSNet

    psnet.ahrq.gov/web-mm/delayed-recognition-positive-blood-culture
    January 29, 2020 - WebM&M Cases Delay in Malignancy Diagnosis Reflects Systemic Failures

  18. Weight and Height Juxtaposition in the Electronic Medical Record Causing an Accidental Medication Overdose | PSNet

    psnet.ahrq.gov/web-mm/weight-and-height-juxtaposition-electronic-medical-record-causing-accidental-medication
    March 15, 2023 - First, they include both " active failures ," referring to actions committed at the "sharp end" by individuals

  19. The Danger of 10% Intravenous Calcium Chloride Extravasation. | PSNet

    psnet.ahrq.gov/web-mm/danger-10-intravenous-calcium-chloride-extravasation
    April 24, 2024 - this process is called infiltration; when it is a vesicant medication, it is called extravasation. 8 Failures

  20. Endotracheal Tube Fallout in a Patient with Severe Obesity During Eye Surgery. | PSNet

    psnet.ahrq.gov/web-mm/endotracheal-tube-fallout-patient-severe-obesity-during-eye-surgery
    January 29, 2021 - Improper Medication Labeling in an Operating Room April 27, 2022 Automation failures
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