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Showing results for "failures".

  1. psnet.ahrq.gov/curated-library/patient-team-member-clinical-care
    March 15, 2025 - Breadcrumb Home The PSNet Collection Curated Libraries Subscribed Patient as a Team Member in Clinical Care  Download  Share Facebook Twitter Linkedin Copy URL Subscribe Created By: Lorri Zipperer, Cybraria…
  2. psnet.ahrq.gov/web-mm/challenges-diabetes-management-and-medication-reconciliation
    March 15, 2023 - Challenges of Diabetes Management and Medication Reconciliation Citation Text: Lee S, Molla M. Challenges of Diabetes Management and Medication Reconciliation . PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2022. Copy Citation …
  3. effectivehealthcare.ahrq.gov/sites/default/files/pdf/patient-generated-health-data-protocol-chronic-conditions.pdf
    March 17, 2020 - Automated-Entry Patient Generated Health Data for Chronic Conditions: The Evidence on Health Outcomes Evidence-based Practice Center Technical Brief Protocol Project Title: Automated-Entry Patient Generated Health Data for Chronic Conditions: The Evidence on Health Outcomes Initial Publication Date: Dec…
  4. S116 (pdf file)

    effectivehealthcare.ahrq.gov/sites/default/files/s116.pdf
    October 01, 2007 - ORIGINAL ARTICLE Evaluating the Validity of an Instrumental Variable Study of Neuroleptics Can Between-Physician Differences in Prescribing Patterns Be Used to Estimate Treatment Effects? M. Alan Brookhart, PhD, Jeremy A. Rassen, MS, Philip S. Wang, MD, DrPH, Colin Dormuth, ScD, Helen Mogun, MS, and Sebastian Schnee…
  5. Ced -Appendix-2 (xls file)

    effectivehealthcare.ahrq.gov/sites/default/files/related_files/ced%20-appendix-2.xlsx
    May 29, 2025 - Summary_Out of Scope Comments There were many comments that were outside of the scope of this project in that they addressed the CED process rather including when and how it should be implemented. Multiple comments proposed that AHRQ should undertake a similar exercise to this one, with the goal of revising the CED p…
  6. Spotlight (pdf file)

    psnet.ahrq.gov/sites/default/files/2024-03/final_spotlight_case_not_missing_sepsis_needles_in_viral_haystacks_slides_march_date.pdf
    January 01, 2024 - Spotlight Spotlight Do Not Miss Sepsis Needles in Viral Haystacks! Source and Credits • This presentation is based on the March 2024 AHRQ WebM&M Spotlight Case o See the full article at https://psnet.ahrq.gov/webmm o CME credit is available o Commentary by: Michelle Hamline, MD, PhD, MAS and Ulfat Shaikh, MD, M…
  7. psnet.ahrq.gov/perspective/peacehealth-governance-journey-support-quality-and-safety
    August 01, 2007 - The PeaceHealth Governance Journey in Support of Quality and Safety John L. Haughom, MD | August 1, 2007  Also Read a Conversation View more articles from the same authors. Citation Text: Haughom JL. The PeaceHealth Governance Journey in Support of Quality and …
  8. www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol1/Cook.pdf
    January 01, 2004 - From Here to There: Lessons from an Integrative Patient Safety Project in Rural Health Care Settings 381 From Here to There: Lessons from an Integrative Patient Safety Project in Rural Health Care Settings Ann Freeman Cook, Helena Hoas, Katarina Guttmannova Abstract To date, few studies have focused on pat…
  9. www.ahrq.gov/sites/default/files/wysiwyg/action-alliance/engineering-safety-practice/healthcare-safety-competency-environmental-scan.pdf
    March 27, 2025 - Healthcare Safety Competencies Affinity Group Environmental Scan Page 1 of 15 Healthcare Safety Competencies Affinity Group Environmental Scan, Resources, and Strategies version 4.7.2025 Table of Contents Background ...............................................................................................…
  10. www.ahrq.gov/sites/default/files/wysiwyg/research/findings/ta/topicrefinement/ced-appendix2-comments.xlsx
    June 02, 2025 - Appendix 2: CED Compiled Public Comment Themes Summary_Out of Scope Comments There were many comments that were outside of the scope of this project in that they addressed the CED process rather including when and how it should be implemented. Multiple comments proposed that AHRQ should undertake a similar exercise …
  11. hcup-us.ahrq.gov/reports/statbriefs/sb179-Emergency-Department-Trends.pdf
    November 01, 2013 - Trends in Emergency Department Visits, 2006–2011 1 September 2014 Trends in Emergency Department Visits, 2006–2011 Halcyon G. Skinner Ph.D., M.P.H., Janice Blanchard M.D., Ph.D., and Anne Elixhauser, Ph.D. Introduction There has been an overall increase in emergency department (ED) visi…
  12. www.ahrq.gov/hai/tools/ambulatory-surgery/sections/implementation/training-tools/improving-fac-notes.html
    May 01, 2017 - Communication failures are a frequent cause of patient harm. … Studies have found that communication failures are the cause of up to 80 percent of operating room adverse
  13. hcup-us.ahrq.gov/db/nation/nis/APS-DRGs%20V21%20Weights%20Manual.pdf
    January 06, 2025 - Microsoft Word - APS_DRG_Def_Public_V21.doc APS-DRGs® NORMALIZED WEIGHTS – VERSION 21.0 TABLE OF CONTENTS All Payer Severity-adjusted DRGs (APS-DRGs®) Normalized Charge, LOS, and Mortality Weights Version 0402H (for APS-DRGs® Version 21.0) Copyrigh…
  14. psnet.ahrq.gov/perspective/how-does-health-care-simulation-affect-patient-care
    August 01, 2018 - How Does Health Care Simulation Affect Patient Care? Joseph O. Lopreiato, MD, MPH | August 1, 2018  Also Read a Conversation View more articles from the same authors. Citation Text: Lopreiato JO. How Does Health Care Simulation Affect Patient Care?. PSNet [inter…
  15. digital.ahrq.gov/sites/default/files/docs/citation/r01hs022110-windle-final-report-2019.pdf
    January 01, 2019 - Optimizing the Electronic Health Record for Cardiac Care - Final Report AHRQ Grant No. R01HS022110 Optimizing the Electronic Health Record for Cardiac Care (09/02/2014 – 09/30/2019) …
  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/73334/psn-pdf
    August 01, 2024 - An Inadvertent Bolus of Norepinephrine. May 26, 2021 Fazio S, Blackmon E, Doroy A, et al. An Inadvertent Bolus of Norepinephrine. PSNet [internet]. 2021. https://psnet.ahrq.gov/web-mm/inadvertent-bolus-norepinephrine Disclosure of Relevant Financial Relationships: As a provider accredited by the Accreditation Counc…
  17. www.ahrq.gov/sites/default/files/2024-01/muller-report.pdf
    January 01, 2024 - Final Progress Report: Medication Reconciliation: Bridging Communications Across the Continuum of Care Title: Medication Reconciliation: Bridging Communications Across the Continuum of Care Principal Investigator and Team Members: Melinda Muller, MD, Lynn Belcher, RPh, Melissa Blanchard, MP, Amy Caster-Winegeart, …
  18. www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/surgery/modules/onboarding/onboarding_overview_impmodel_facnotes.docx
    December 01, 2017 - Facilitator Guide: Overview of the Improvement Model Program Overview – Facilitator Notes Slide Title and Commentary Slide Number and Slide Title Slide Project Overview SAY: You have embarked on a unique journey. Slide 1 Mead Quotation SAY: Margaret Mead was a popular and sometimes controversial cultural an…
  19. www.ahrq.gov/hai/tools/surgery/modules/on-boarding/overview-fac-notes.html
    December 01, 2017 - Program Overview: Facilitator Notes AHRQ Safety Program for Surgery Slide 1: Program Overview Say: You have embarked on a unique journey. Slide 2: Mead Quotation Say: Margaret Mead was a popular and sometimes controversial cultural anthropologist in the ’60s and ’70s. This statement still resona…
  20. hcup-us.ahrq.gov/reports/statbriefs/sb190-Hospital-Stays-Super-Utilizers-Payer-2012.pdf
    January 01, 2012 - Characteristics of Hospital Stays for Super-Utilizers by Payer, 2012 1 May 2015 Characteristics of Hospital Stays for Super- Utilizers by Payer, 2012 H. Joanna Jiang, Ph.D., Audrey J. Weiss, Ph.D., Marguerite L. Barrett, M.S., and Minya Sheng, M.S. Introduction A large proportion of he…