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Showing results for "failures".

8401. Two-state collaborative study of a multifaceted intervention to decrease ventilator-associated events. | PSNet
      psnet.ahrq.gov/issue/two-state-collaborative-study-multifaceted-intervention-decrease-ventilator-associated-events
      January 15, 2014 - Study Two-state collaborative study of a multifaceted intervention to decrease ventilator-associated events. Citation Text: Rawat N, Yang T, Ali KJ, et al. Two-State Collaborative Study of a Multifaceted Intervention to Decrease Ventilator-Associated Events. Crit Care Med. 2017;45(7):120…

8402. Strengthening Patient Engagement to Improve Care and Shared Decision Making - Emerging Research | Digital Healthcare Research
      digital.ahrq.gov/2020-year-review/research-summary/strengthening-patient-engagement-improve-care-and-shared-decision-making-emerging-research
      January 01, 2020 - Strengthening Patient Engagement to Improve Care and Shared Decision Making - Emerging Research Using Technology to Support Patient-Centered, Shared Decision Making in Care and Treatment Decisions Patient-centered shared decision making refers to the collaborative effort of a healthc…

8403. Delisted PSOs | PSO
      pso.ahrq.gov/pso/delisted
      SHARE: Filter the Results Search for a Delisted PSO Search by Keyword Search   Delisted PSOs Below are PSOs that have been delisted. A PSO may be “delisted” for three reasons: Voluntary Relinquishment — the PSO …

8404. Collaboration-Oriented Approach to Controlling High Blood Pressure (COACH) | Digital Healthcare Research
      digital.ahrq.gov/ahrq-funded-projects/collaboration-oriented-approach-controlling-high-blood-pressure-coach
      June 30, 2025 - Collaboration-Oriented Approach to Controlling High Blood Pressure (COACH) Project Description Publications Events Use of a standards-based shareable, interoperable patient-facing clinical decision support tool for high blood pressure management has the potential to…

8405. Ensuring effective care transition communication: implementation of an electronic medical record-based tool for improved cancer treatment handoffs between clinic and infusion nurses. | PSNet
      psnet.ahrq.gov/issue/ensuring-effective-care-transition-communication-implementation-electronic-medical-record
      July 12, 2023 - Study Ensuring effective care transition communication: implementation of an electronic medical record-based tool for improved cancer treatment handoffs between clinic and infusion nurses. Citation Text: Pandya C, Clarke T, Scarsella E, et al. Ensuring Effective Care Transition Communica…

8406. Patient safety threats in information management using health information technology in ambulatory cancer care: an exploratory, prospective study. | PSNet
      psnet.ahrq.gov/issue/patient-safety-threats-information-management-using-health-information-technology-ambulatory
      April 01, 2020 - Study Patient safety threats in information management using health information technology in ambulatory cancer care: an exploratory, prospective study. Citation Text: Pfeiffer Y, Zimmermann C, Schwappach DLB. Patient safety threats in information management using health information tech…

8407. Seven features of safety in maternity units: a framework based on multisite ethnography and stakeholder consultation. | PSNet
      psnet.ahrq.gov/issue/seven-features-safety-maternity-units-framework-based-multisite-ethnography-and-stakeholder
      February 20, 2019 - Study Seven features of safety in maternity units: a framework based on multisite ethnography and stakeholder consultation. Citation Text: Liberati EG, Tarrant C, Willars J, et al. Seven features of safety in maternity units: a framework based on multisite ethnography and stakeholder con…

8408. Continuous Predictive Analytics Monitoring to Improve Care for At-Risk Patients with Cardiac Disease | Digital Healthcare Research
      digital.ahrq.gov/program-overview/research-stories/continuous-predictive-analytics-monitoring-improve-care-risk
      January 01, 2023 - Continuous Predictive Analytics Monitoring to Improve Care for At-Risk Patients with Cardiac Disease Theme: Optimizing Care Delivery for Clinicians Subtheme: Using Real-Time Digital Healthcare Data to Improve Timely Treatment or Diagnosis An artificial intelligence digital health tool that…

8409. Identifying trigger concepts to screen emergency department visits for diagnostic errors. | PSNet
      psnet.ahrq.gov/issue/identifying-trigger-concepts-screen-emergency-department-visits-diagnostic-errors
      March 12, 2025 - Study Identifying trigger concepts to screen emergency department visits for diagnostic errors. Citation Text: Mahajan P, Pai C-W, Cosby KS, et al. Identifying trigger concepts to screen emergency department visits for diagnostic errors. Diagnosis (Berl). 2021;8(3):340-346. doi:10.1515/d…

8410. A strategic solution to preventing the harm associated with ambulance handover delays. | PSNet
      psnet.ahrq.gov/issue/strategic-solution-preventing-harm-associated-ambulance-handover-delays
      July 22, 2020 - Study A strategic solution to preventing the harm associated with ambulance handover delays. Citation Text: Evans C, Da’Costa A. A strategic solution to preventing the harm associated with ambulance handover delays. Emerg Nurse. 2024;32(6):32(6):15-20. doi:10.7748/en.2024.e2199. Copy C…

8411. Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis. | PSNet
      psnet.ahrq.gov/issue/delivering-high-quality-cancer-care-charting-new-course-system-crisis
      August 15, 2012 - Book/Report Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis. Citation Text: Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis. Levit L, Balogh E, Nass S, Ganz PA, eds. Committee on Improving the Quality of Cancer Care: Add…

8412. Making soft intelligence hard: a multi-site qualitative study of challenges relating to voice about safety concerns. | PSNet
      psnet.ahrq.gov/issue/making-soft-intelligence-hard-multi-site-qualitative-study-challenges-relating-voice-about
      June 16, 2021 - Study Emerging Classic Making soft intelligence hard: a multi-site qualitative study of challenges relating to voice about safety concerns. Citation Text: Martin G, Aveling E-L, Campbell A, et al. Making soft intelligence hard: a multi-site qualitative study of …

8413. C2 Prioritization Worksheet Example (xls file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/pdi/c2_pdi_prioritizationworksheetexample.xlsx
      June 02, 2025 - C2 Prioritization Worksheet Example Prioritization Matrix Pediatric Toolkit for Using the AHRQ Quality Indicators How To Improve Hospital Quality and Safety AHRQ Quality Indicators Prioritization Matrix Section 1- Blue Section 2-Green Section 3-Purple Section 4-Orange Own Rate and Natio…

8414. Introduction to the Pediatric Best Practices Tool (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/pdi/d4_pdi_bestpracticescover.pdf
      June 02, 2025 - Introduction to the Pediatric Best Practices Tool Pediatric Toolkit for Using the AHRQ Quality Indicators How To Improve Hospital Quality and Safety i Tool D.4 Introduction to the Pediatric Best Practices Tool What is the purpose of this tool? The purpose of this tool is to provide: • Detailed description of…

8415. National hospital ratings systems share few common scores and may generate confusion instead of clarity. | PSNet
      psnet.ahrq.gov/issue/national-hospital-ratings-systems-share-few-common-scores-and-may-generate-confusion-instead
      October 31, 2014 - Study Classic National hospital ratings systems share few common scores and may generate confusion instead of clarity. Citation Text: Austin M, Jha AK, Romano PS, et al. National hospital ratings systems share few common scores and may generate confusion instead…

8416. Opportunities and challenges for quality and safety applications in ICD-11: an international survey of users of coded health data. | PSNet
      psnet.ahrq.gov/issue/opportunities-and-challenges-quality-and-safety-applications-icd-11-international-survey
      February 17, 2017 - Study Opportunities and challenges for quality and safety applications in ICD-11: an international survey of users of coded health data. Citation Text: Southern DA, Hall M, White DE, et al. Opportunities and challenges for quality and safety applications in ICD-11: an international surve…

8417. A World Health Organization field trial assessing a proposed ICD-11 framework for classifying patient safety events. | PSNet
      psnet.ahrq.gov/issue/world-health-organization-field-trial-assessing-proposed-icd-11-framework-classifying-patient
      December 29, 2014 - Study A World Health Organization field trial assessing a proposed ICD-11 framework for classifying patient safety events. Citation Text: Forster AJ, Bernard B, Drösler SE, et al. A World Health Organization field trial assessing a proposed ICD-11 framework for classifying patient safety…

8418. Burnout in the NICU setting and its relation to safety culture. | PSNet
      psnet.ahrq.gov/issue/burnout-nicu-setting-and-its-relation-safety-culture
      February 13, 2019 - Study Burnout in the NICU setting and its relation to safety culture. Citation Text: Profit J, Sharek PJ, Amspoker AB, et al. Burnout in the NICU setting and its relation to safety culture. BMJ Qual Saf. 2014;23(10):806-813. doi:10.1136/bmjqs-2014-002831. Copy Citation Format: …

8419. Tele-Rapid Response Team (Tele-RRT): the effect of implementing patient safety network system on outcomes of medical patients- a before and after cohort study. | PSNet
      psnet.ahrq.gov/issue/tele-rapid-response-team-tele-rrt-effect-implementing-patient-safety-network-system-outcomes
      March 24, 2021 - Study Tele-Rapid Response Team (Tele-RRT): the effect of implementing patient safety network system on outcomes of medical patients- a before and after cohort study. Citation Text: Balshi AN, Al-Odat MA, Alharthy AM, et al. Tele-Rapid Response Team (Tele-RRT): The effect of implementing …

8420. Design and implementation of an analgesia, sedation, and paralysis order set to enhance compliance of pro re nata medication orders with Joint Commission medication management standards in a pediatric ICU. | PSNet
      psnet.ahrq.gov/issue/design-and-implementation-analgesia-sedation-and-paralysis-order-set-enhance-compliance-pro
      February 09, 2022 - Study Design and implementation of an analgesia, sedation, and paralysis order set to enhance compliance of pro re nata medication orders with Joint Commission medication management standards in a pediatric ICU. Citation Text: Procaccini D, Rapaport R, Petty BG, et al. Design and Impleme…