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digital.ahrq.gov/ahrq-funded-projects/school-based-tele-physiatry-assistance-rehabilitative-and-therapeutic-services/citation/physician
January 01, 2024 - Parent, physician, and therapist experience of in-person, hybrid, and all-virtual models of physiatry care for children with special healthcare needs.
Citation
Haynes SC, Davidson L, Tancredi DJ, Burns RD, Garrison SL, Marcin JP. Parent, physician, and therapist experience of in-person, hybrid, and al…
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www.ahrq.gov/sites/default/files/wysiwyg/sops/action-planning-tool-infographic-sops.pdf
March 01, 2024 - Surveys on Patient Safety Culture Action Planning Steps
ACTION PLANNING FOR
THE SOPS SURVEYS
The AHRQ Surveys on Patient Safety
Culture® (SOPS®) Action Planning Tool
consists of a three-step process to
guide teams as they work to improve
patient safety culture.
1
Identify Areas
To Improve
• What areas do you…
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www.ahrq.gov/cpi/about/organization/nac/levy.html
February 01, 2025 - NAC Member Biography: Cari Levy
Cari Levy, M.D., Ph.D., CMD Goodstein Professor of Medicine Division Head, Geriatric Medicine Director, Multidisciplinary Center on Aging Department of Medicine, University of Colorado School of Medicine Cari Levy, M.D., Ph.D., CMD , is a professor of medicine at the University o…
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www.ahrq.gov/action-alliance/webinars/teamwork-ptsafety-norms.html
April 01, 2025 - Improving Safety Using Teamwork and Patient Safety Norms
Creating and Maintaining a Culture of Safety Series (Session 2)
This webinar was the second of a three-part series on Safety Culture in Healthcare. On March 18 at 12:00 PM ET, presenters discussed how to improve teamwork in healthcare settings using Tea…
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digital.ahrq.gov/ahrq-funded-projects/direct-patient-alert-glycated-hemoglobin-screening-using-prediction-modeling/final-report
January 01, 2023 - A Direct-to-Patient Alert for Glycated Hemoglobin Screening Using Prediction Modeling and Mobile Health (mHealth) - Final Report
Citation
Wells B. A Direct-to-Patient Alert for Glycated Hemoglobin Screening Using Prediction Modeling and Mobile Health (mHealth) - Final Report. (Prepared by the Wake For…
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digital.ahrq.gov/ahrq-funded-projects/improving-allergy-documentation-and-clinical-decision-support-electronic-health/final-report
January 01, 2023 - Improving Allergy Documentation and Clinical Decision Support in the Electronic Health Record - Final Report
Citation
Zhou L. Improving Allergy Documentation and Clinical Decision Support in the Electronic Health Record - Final Report. (Prepared by Mass General Brigham (Partners HealthCare System) un…
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digital.ahrq.gov/location/usa-il-evanston
January 01, 2023 - USA, IL, Evanston
Preventing Wrong-Drug and Wrong-Patient Errors With Indication Alerts in CPOE Systems
Description
This research implemented indication alerts, which occur when an ordered or prescribed medication lacks a corresponding problem on the patient’s problem list. Th…
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digital.ahrq.gov/ahrq-funded-projects/expansion-implementation-evaluation-electronic-health-record-integrated-patient/citation/implementation
January 01, 2023 - Implementation and feasibility of an electronic health record-integrated patient-reported outcomes symptom and needs monitoring pilot in ambulatory oncology.
Citation
Penedo FJ, Medina HN, Moreno PI, Sookdeo V, Natori A, Boland C, Schlumbrecht MP, Calfa C, MacIntyre J, Crane TE, Garcia SF. Implementat…
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digital.ahrq.gov/ahrq-funded-projects/expansion-implementation-evaluation-electronic-health-record-integrated-patient/final-report
January 01, 2023 - Expansion, Implementation, and Evaluation of Electronic Health Record-Integrated Patient-Reported Symptom Screening in a Comprehensive Cancer Center – Final Report
Citation
Garcia S., Penedo F. Expansion, Implementation, and Evaluation of Electronic Health Record-Integrated Patient-Reported Symptom Sc…
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psnet.ahrq.gov/taxonomy/term/3440
April 10, 2025 - Situational Awareness
Situational awareness refers to the degree to which one's perception of a situation matches reality. In the context of crisis management, where the phrase is most often used, situational awareness includes awareness of fatigue and stress among team members (including oneself), environmental thre…
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psnet.ahrq.gov/node/46020/psn-pdf
July 21, 2017 - Towards high-reliability organising in healthcare: a
strategy for building organisational capacity.
July 21, 2017
Aboumatar HJ, Weaver SJ, Rees D, et al. Towards high-reliability organising in healthcare: a strategy for
building organisational capacity. BMJ Qual Saf. 2017;26(8):663-670. doi:10.1136/bmjqs-2016-00624…
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psnet.ahrq.gov/node/60992/psn-pdf
October 14, 2020 - Another medical malpractice crisis?: Try something
different.
October 14, 2020
Sage WM, Boothman RC, Gallagher TH. Another medical malpractice crisis?: Try something different.
JAMA. 2020;324(14):1395-1396. doi:10.1001/jama.2020.16557.
https://psnet.ahrq.gov/issue/another-medical-malpractice-crisis-try-something-d…
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psnet.ahrq.gov/node/73969/psn-pdf
October 26, 2021 - Important Actions Community Pharmacists Need to Take
Now to Reduce Potentially Harmful Dispensing Errors.
October 13, 2021
Institute for Safe Medication Practices. October 26, 2021.
https://psnet.ahrq.gov/issue/important-actions-community-pharmacists-need-take-now-reduce-potentially-
harmful-dispensing
Community …
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psnet.ahrq.gov/node/34113/psn-pdf
December 24, 2008 - MEDMARX 5th Anniversary Data Report: A Chartbook of
2003 Findings and Trends 1999-2003.
December 24, 2008
Hicks RW, Santell JP, Cousins DD, et al. Rockville, MD: USP Center for the Advancement of
Patient Safety; 2004.
https://psnet.ahrq.gov/issue/medmarx-5th-anniversary-data-report-chartbook-2003-fi…
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psnet.ahrq.gov/node/854387/psn-pdf
October 11, 2023 - Healthcare resilience: a meta-narrative systematic review
and synthesis of reviews.
October 11, 2023
Tan MZY, Prager G, McClelland A, et al. Healthcare resilience: a meta-narrative systematic review and
synthesis of reviews. BMJ Open. 2023;13(9):e072136. doi:10.1136/bmjopen-2023-072136.
https://psnet.ahrq.gov/issu…
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psnet.ahrq.gov/node/47165/psn-pdf
June 13, 2018 - Changing how we think about healthcare improvement.
June 13, 2018
Braithwaite J. Changing how we think about healthcare improvement. BMJ. 2018;361:k2014.
doi:10.1136/bmj.k2014.
https://psnet.ahrq.gov/issue/changing-how-we-think-about-healthcare-improvement
In learning organizations, leadership behavior creates a s…
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psnet.ahrq.gov/node/33904/psn-pdf
January 25, 2016 - Healthcare Cost and Utilization Project (HCUP).
January 25, 2016
Agency for Healthcare Research and Quality.
https://psnet.ahrq.gov/issue/healthcare-cost-and-utilization-project-hcup
The Healthcare Cost and Utilization Project (HCUP) is a family of databases and related software tools and
products developed throug…
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psnet.ahrq.gov/node/43647/psn-pdf
November 12, 2014 - Mid Staffordshire NHS Foundation Trust Quality Report.
November 12, 2014
Newcastle Upon Tyne, UK: Care Quality Commission; October 9, 2014.
https://psnet.ahrq.gov/issue/mid-staffordshire-nhs-foundation-trust-quality-report
The Mid Staffordshire Trust has been under much scrutiny in recent years. This report highlig…
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psnet.ahrq.gov/node/44893/psn-pdf
March 09, 2016 - Improving the governance of patient safety in emergency
care: a systematic review of interventions.
March 9, 2016
Hesselink G, Berben S, Beune T, et al. Improving the governance of patient safety in emergency care: a
systematic review of interventions. BMJ Open. 2016;6(1):e009837. doi:10.1136/bmjopen-2015-009837.
…
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psnet.ahrq.gov/node/46380/psn-pdf
September 06, 2017 - What defines a high-performing health system: a
systematic review.
September 6, 2017
Ahluwalia SC, Damberg CL, Silverman M, et al. What Defines a High-Performing Health Care Delivery
System: A Systematic Review. Jt Comm J Qual Patient Saf. 2017;43(9):450-459.
doi:10.1016/j.jcjq.2017.03.010.
https://psnet.ahrq.gov…