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pso.ahrq.gov/sites/default/files/wysiwyg/working-with-pso-webinar-value-hospitals.pdf
January 01, 2020 - Acuity, Size,
IRF/IRU
Quarterly conference
calls/Safe Tables
• General webinar
and Infection
Prevention … Measures
• Discharges to Acute Care
o Early, Late, Planned,
Unplanned
• Restraint Utilization
• Falls … /Unassisted Falls
o By Diagnosis Group
• Injuries Resulting from
Falls/Unassisted Falls
o By Diagnosis … Writing an Infection Control Plan for Joint Commission Survey
• Durability of Outcomes/Readmission Prevention … • Teammate appreciation and engagement
Source: statnews.com
Restraint Utilization
Unassisted Falls
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pso.ahrq.gov/sites/default/files/wysiwyg/oig-list-long-term-care-hospitals-2019.pdf
January 01, 2019 - thromboembolisms, deep vein thrombosis, or pulmonary embolisms
• Acute pulmonary embolus with inadequate prevention … history of respiratory failure and multiple
sedating (psychotropic and pain) medications with frequent falls … hypotension while on multiple opioids (oxycodone/
acetaminophen and fentanyl patch) resulting in multiple falls … to trauma from urinary catheter placement
• Bleeding at insertion site of venous catheter due to cap falling
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pso.ahrq.gov/sites/default/files/wysiwyg/ai-healthcare-safety-program.pdf
July 01, 2025 - that strikingly similar types of interventions were in
place among patients with different risks for falls … ,
suggesting a less tailored approach to fall prevention
than what might be expected. … npsd/data/dashboard/index.html
11 https://www.ahrq.gov/sites/default/files/wysiwyg/npsd/data/npsd-falls-chartbook … VHA) National Center for Patient Safety (NCPS) has a primary goal
of, “the nationwide reduction and prevention … Like the
PSP, NCPS takes a systems approach to patient safety, focusing on prevention.
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pso.ahrq.gov/sites/default/files/wysiwyg/adverse-events-rehab-hospitals.pdf
July 01, 2016 - Adverse and Temporary Harm Events in Rehabilitation Hospitals Designated in OIG Report as Clearly Preventable or Likely Preventable by Clinical Category
Page 1 of 4
Adverse and Temporary Harm Events in Rehabilitation
Hospitals Designated in Office of Inspector General Report1
as Clearly Preventable or Likely Pr…
-
pso.ahrq.gov/sites/default/files/wysiwyg/strategies-to-improve-patient-safety_draft-report.pdf
December 21, 2021 - Falls … Dashboard
The Falls Dashboard details the extent of harm due to falls, the presence of fall assistance … of Falls in Hospitalized and Institutionalized Older People Summary of Evidence Update (all patients … Advances in the Prevention and
Control of HAIs. … Advances in the Prevention and
Control of HAIs.
-
pso.ahrq.gov/sites/default/files/wysiwyg/npsdpatient-safety-culture-brief.pdf
September 01, 2016 - during
Safe Table events:
■ Failure to inform patients of abnormal test results
■ Factors related to falls … ■ Prevention of health care-associated infections
■ Responses to patient violence and aggression