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psnet.ahrq.gov/issue/concerns-regarding-tablet-splitting-systematic-review
February 10, 2015 - Review
Concerns regarding tablet splitting: a systematic review.
Citation Text:
Saran AK, Holden NA, Garrison SR. Concerns regarding tablet splitting: a systematic review. BJGP Open. 2022;6(3):BJGPO.2022.0001. doi:10.3399/bjgpo.2022.0001.
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psnet.ahrq.gov/issue/intensive-care-units-communication-between-nurses-and-physicians-and-patients-outcomes
May 28, 2008 - Study
Intensive care units, communication between nurses and physicians, and patients' outcomes.
Citation Text:
Manojlovich M, Antonakos CL, Ronis DL. Intensive care units, communication between nurses and physicians, and patients' outcomes. Am J Crit Care. 2009;18(1):21-30. doi:10.403…
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www.ahrq.gov/news/newsroom/case-studies/cquips0901.html
October 01, 2014 - New York City Uses AHRQ Patient Safety Culture Survey to Reduce Patient Harm
Search All Impact Case Studies
November 2008
The New York City Health and Hospitals Corporation (HHC) has integrated the use of AHRQ's Hospital Survey on Patient Safety Culture as a core component of its corporate-wide patient sa…
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psnet.ahrq.gov/issue/improving-diagnosis-feedback-and-deliberate-practice-one-one-coaching-diagnostic-maturation
July 06, 2022 - Study
Improving diagnosis by feedback and deliberate practice: one-on-one coaching for diagnostic maturation.
Citation Text:
Sinha P, Pischel L, Sofair AN. Improving diagnosis by feedback and deliberate practice: one-on-one coaching for diagnostic maturation. Diagnosis (Berl). 2021;8(2):…
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psnet.ahrq.gov/issue/hospitalists-emerging-leaders-patient-safety-targeting-few-affect-many
January 29, 2010 - Commentary
Hospitalists as emerging leaders in patient safety: targeting a few to affect many.
Citation Text:
Flanders SA, Kaufman SR, Saint S, et al. Hospitalists as emerging leaders in patient safety: targeting a few to affect many. J Patient Saf. 2005;1(2):78-82. doi:10.1097/pts.0b0…
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psnet.ahrq.gov/issue/transforming-morbidity-and-mortality-conference-promote-safety-and-quality-picu
April 28, 2021 - Study
Transforming the morbidity and mortality conference to promote safety and quality in a PICU.
Citation Text:
Cifra CL, Bembea MM, Fackler JC, et al. Transforming the morbidity and mortality conference to promote safety and quality in a PICU. Crit Care Med. 2016;17(1):58-66. doi:10.1…
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psnet.ahrq.gov/issue/improving-hospital-systems-care-women-major-obstetric-hemorrhage
July 06, 2022 - Study
Improving hospital systems for the care of women with major obstetric hemorrhage.
Citation Text:
Skupski DW, Lowenwirt IP, Weinbaum FI, et al. Improving hospital systems for the care of women with major obstetric hemorrhage. Obstet Gynecol. 2006;107(5):977-983.
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www.ahrq.gov/cpi/about/otherwebsites/cds-connect/index.html
June 01, 2019 - CDS Connect: Using Clinical Decision Support To Move Evidence Into Practice
Project Summary
CDS Connect is a key component of AHRQ’s recently launched initiative on clinical decision support (CDS) to move evidence into practice and to make CDS more patient centered. This initiative has four components:
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psnet.ahrq.gov/issue/simulation-tool-improve-safety-pre-hospital-anaesthesia-pilot-study
October 19, 2022 - Study
Simulation as a tool to improve the safety of pre-hospital anaesthesia—a pilot study.
Citation Text:
Batchelder AJ, Steel A, Mackenzie R, et al. Simulation as a tool to improve the safety of pre-hospital anaesthesia--a pilot study. Anaesthesia. 2009;64(9):978-83. doi:10.1111/j.1365…
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psnet.ahrq.gov/issue/surgical-patient-safety-officers-united-states-negotiating-contradictions-between-compliance
December 31, 2018 - Commentary
Surgical patient safety officers in the United States: negotiating contradictions between compliance and workplace transformation.
Citation Text:
van de Ruit C, Bosk CL. Surgical patient safety officers in the United States: negotiating contradictions between compliance and wo…
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psnet.ahrq.gov/issue/systematic-integrative-review-specialized-nurses-role-establish-culture-patient-safety
July 10, 2024 - Review
A systematic integrative review of specialized nurses' role to establish a culture of patient safety: a modelling perspective.
Citation Text:
Glarcher M, Vaismoradi M. A systematic integrative review of specialized nurses' role to establish a culture of patient safety: a modelling…
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www.ahrq.gov/sites/default/files/wysiwyg/sops/events/webinar/03-gray-sops-action-planning-tool.pdf
June 02, 2025 - Action Planning for the SOPS Surveys-Introducing SOPS
10
Introducing the SOPS Action
Planning Tool
Laura Gray, MPH
Senior Study Director,
User Network for the AHRQ Surveys on Patient Safety Culture
(SOPS)
Westat
11
AHRQ Surveys on Patient Safety Culture
Surveys of clinicians and staff about the extent to
w…
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psnet.ahrq.gov/issue/public-perceptions-and-preferences-patient-notification-after-unsafe-injection
July 14, 2010 - Study
Public perceptions and preferences for patient notification after an unsafe injection.
Citation Text:
Schneider AK, Brinsley-Rainisch KJ, Schaefer MK, et al. Public perceptions and preferences for patient notification after an unsafe injection. J Patient Saf. 2013;9(1):8-12. doi:…
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psnet.ahrq.gov/issue/reflection-adverse-event-disclosure-postsurgical-hospital-context
August 20, 2018 - Commentary
Reflection on adverse event disclosure in the postsurgical hospital context.
Citation Text:
Roberts F, Gettings P, Torbeck L, et al. Reflection on adverse event disclosure in the postsurgical hospital context. J Surg Educ. 2015;72(4):767-70. doi:10.1016/j.jsurg.2014.12.016.
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www.ahrq.gov/ncepcr/research-transform-primary-care/transform/tpcbib/index.html
May 01, 2015 - The two models focus on complementary aspects of redesign; Care by Design focuses more on the process … of transformation, while PCMH focuses more on the structure, including policy, capacity, and populated
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www.ahrq.gov/ncepcr/reports/grants-transform/bibliography/index.html
February 01, 2017 - The two models focus on complementary aspects of redesign; Care by Design focuses more on the process … of transformation, while PCMH focuses more on the structure, including policy, capacity, and populated
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www.ahrq.gov/sites/default/files/2024-04/pines-mccarthy-report.pdf
January 01, 2024 - One of the major focuses of this conference was to identify different strategies
that may reduce crowding
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol3/Savino.pdf
July 01, 2003 - Trans-theoretical Model is one of the most commonly cited behavior
change models, according to AHRQ.10 This model focuses
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effectivehealthcare.ahrq.gov/sites/default/files/pdf/patient-generated-health-data-protocol-chronic-conditions.pdf
March 17, 2020 - This report focuses on consumer technologies that provide PGHD.
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/long-term-care/resources/ontime/fallsprev/ontimefallpxoverview-ig.pdf
June 02, 2025 - Slide 3: Introduction to On-Time
On-Time is a unique approach to quality improvement that focuses