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psnet.ahrq.gov/node/41836/psn-pdf
November 14, 2012 - "Team time-out" and surgical safety—experiences in
12,390 neurosurgical patients.
November 14, 2012
Oszvald Á, Vatter H, Byhahn C, et al. “Team time-out” and surgical safety—experiences in 12,390
neurosurgical patients. Neurosurg Focus. 2012;33(5). doi:10.3171/2012.8.focus12261.
https://psnet.ahrq.gov/issue/team-t…
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psnet.ahrq.gov/node/46418/psn-pdf
September 20, 2017 - Iatrogenesis in Pediatrics.
September 20, 2017
Michalska-Smith M, ed. AMA J Ethics. 2017;19(8):737-842
https://psnet.ahrq.gov/issue/iatrogenesis-pediatrics
Iatrogenesis—an adverse effect of medical care—is an area of focus in patient safety. Articles in this
special issue explore cases involving iatrogenic harm in…
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psnet.ahrq.gov/node/42021/psn-pdf
February 13, 2013 - Nurses discuss bedside handover and using written
handover sheets.
February 13, 2013
Johnson M, Cowin LS. Nurses discuss bedside handover and using written handover sheets. J Nurs
Manag. 2013;21(1):121-9. doi:10.1111/j.1365-2834.2012.01438.x.
https://psnet.ahrq.gov/issue/nurses-discuss-bedside-handover-and-using-w…
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psnet.ahrq.gov/node/46442/psn-pdf
October 04, 2017 - Handoff Communication.
October 4, 2017
APSF Newsletter. October 2017;32:29-56.
https://psnet.ahrq.gov/issue/handoff-communication
Handoff processes are known to carry risks of communication errors. This special issue focuses on
transfers involving anesthesia care. Articles review different types of handoffs, chara…
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www.ahrq.gov/nursing-home/resources/respirator-protection-guidance.html
May 01, 2022 - Respirator Protection Guidance for the Employers of Those Working in Nursing Homes, Assisted Living, and Other Long-Term Care Facilities During the COVID-19 Pandemic
Resource: Respirator Protection Guidance for the Employers of Those Working in Nursing Homes, Assisted Living, and Other Long-Term Care Faciliti…
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psnet.ahrq.gov/node/35278/psn-pdf
March 04, 2011 - Appropriateness of use of medicines in elderly inpatients:
qualitative study.
March 4, 2011
Spinewine A, Swine C, Dhillon S, et al. Appropriateness of use of medicines in elderly inpatients: qualitative
study. BMJ. 2005;331(7522). doi:10.1136/bmj.38551.410012.06.
https://psnet.ahrq.gov/issue/appropriateness-use-me…
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psnet.ahrq.gov/node/50407/psn-pdf
October 02, 2019 - Patient Safety in the Traditional and Evolving
Nontraditional Office Setting
October 2, 2019
Keats JP, Gambone JC. Patient Safety in the Traditional and Evolving Nontraditional Office Setting. Clin
Obstet Gynecol. 2019;62(3):580-593. doi:10.1097/GRF.0000000000000471.
https://psnet.ahrq.gov/issue/patient-safety-tra…
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digital.ahrq.gov/ahrq-funded-projects/patient-centered-outcomes-research-clinical-decision-support-cds-connect/citation/nothing
January 01, 2023 - Nothing for me or about me, without me: codesign of clinical decision support.
Citation
van Leeuwen D, Mittelman M, Fabian L, Lomotan EA. Nothing for me or about me, without me: codesign of clinical decision support. Appl Clin Inform. 2022;13(3):641-646. doi:10.1055/s-0042-1750355. PMID: 35768012.
…
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digital.ahrq.gov/location/usa-ca-stanford
January 01, 2023 - USA, CA, Stanford
Precision Emergency Medicine: Setting a Research Agenda
Description
This research will use a consensus conference format during the 2023 Society for Academic Emergency Medicine conference to develop and publish an actionable research agenda for precision emer…
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psnet.ahrq.gov/node/41165/psn-pdf
December 08, 2016 - IHI Open School Patient Safety Curriculum
December 8, 2016
Institute for Healthcare Improvement.
https://psnet.ahrq.gov/issue/patient-safety-curriculum-2nd-edition
There is a documented interest in postgraduate professional education that enables practicing clinicians to
improve the safety of their actions and beh…
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www.ahrq.gov/hai/tools/enhanced-recovery/planning.html
June 01, 2023 - Planning for Sustainability
Tools and Resources To Help Hospitals Sustain an ISCR Program
You have reached sustainability when the Improving Surgical Care and Recovery (ISCR) pathway components are part of daily practice and little to no effort is needed to change behavior. The tools included in this section …
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digital.ahrq.gov/funding-mechanism/accelerating-change-and-transformation-organizations-and-networks-action-iv
January 01, 2023 - Accelerating Change and Transformation in Organizations and Networks (ACTION) IV
Clinical Decision Support Innovation Collaborative (CDSiC)
Description
This research continues to build the Clinical Decision Support Innovation Collaborative (CDSiC) to advance the field of pat…
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digital.ahrq.gov/ahrq-funded-projects/feasibility-touch-screen-computer-based-breastfeeding-educational-support/citation-0
January 01, 2023 - Exploration of factors influencing initiation and continuation of breastfeeding among Hispanic women living in rural settings: a multi-methods study.
Citation
Joshi A, Trout KE, Aguirre T, et al. Exploration of factors influencing initiation and continuation of breastfeeding among Hispanic women livin…
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psnet.ahrq.gov/training-catalog/leading-healthcare-quality-and-safety
August 11, 2025 - Leading Healthcare Quality and Safety
Save
Save to your library
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Organization:
Organization
Coursera
Event Description: Ensuring patient safety and…
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digital.ahrq.gov/ahrq-funded-projects/portals-inpatient-care-evaluating-usability-use-and-patient-experience/citation/framework
January 01, 2023 - Framework for evaluating and implementing inpatient portals: a multi-stakeholder perspective.
Citation
Walker DM, Hefner JL, Sieck CJ, et al. Framework for evaluating and implementing inpatient portals: a multi-stakeholder perspective. J Med Syst 2018 Jul 16;42(9):158. PMID: 30014267.
Link
htt…
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digital.ahrq.gov/ahrq-funded-projects/evaluating-prediction-tool-and-decision-aid-patients-crohns-disease/citation-2
January 01, 2023 - Novel statistical approach to determine inflammatory bowel disease: patients' perspectives on shared decision making.
Citation
Siegel CA, Lofland JH, Naim A, et al. Novel statistical approach to determine inflammatory bowel disease: patients' perspectives on shared decision making. Patient 2016 Feb;9(…
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www.ahrq.gov/patient-safety/quality-resources/tools/chtoolbx/measures/measure-6.html
November 01, 2017 - Established Child Health Care Quality Measures--Child and Adolescent Health Measurement Initiative (CAHMI): Promoting Healthy Development Survey (PHDS)
Child Health Care Quality Toolbox
The Child Health Toolbox contains concepts, tips, and tools for evaluating the quality of health care for children.
Conten…
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www.ahrq.gov/sites/default/files/wysiwyg/lhs/lhs_case_studies_utah_health.pdf
April 01, 2019 - University of Utah Health: Creating a Formula for Value-Based Care
University of Utah Health: Creating a Formula for Value-
Based Care
The Agency for Healthcare Research and Quality (AHRQ) has developed a series of case studies
to help health system chief executive officers and other C-suite leaders better unde…
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.263_slideshow.ppt
March 01, 2012 - Spotlight Case July 2008
Spotlight Case
Postdischarge Follow-Up Phone Call
*
*
Source and Credits
This presentation is based on the March 2012
AHRQ WebM&M Spotlight Case
See the full article at http://webmm.ahrq.gov
CME credit is available
Commentary by: Michelle Mourad, MD, and Stephanie Rennke, MD; Divi…
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www.ahrq.gov/sites/default/files/wysiwyg/teamstepps-program/tools/ts-learning-benchmarks.pdf
June 02, 2025 - TeamSTEPPS Learning Benchmarks
TeamSTEPPS Learning Benchmarks
Instructions: These questions focus on medical teamwork and communication and their effect
on quality and safety in patient care. For each of the following questions, please circle the
letter next to the one best answer.
1. A nurse is called t…