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psnet.ahrq.gov/issue/safety-competencies-framework
October 25, 2017 - Multi-use Website
The Safety Competencies Framework.
Citation Text:
The Safety Competencies Framework. Ottawa, ON: Canadian Patient Safety Institute; 2020.
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/long-term-care/resources/ontime/prevhosp/hrccdocumentationhandout_0.pdf
June 02, 2025 - AHRQ’s Safety Program for Nursing Homes: On-Time Preventable Hospital and
Emergency Department Visits: Electronic Reports
High-Risk Change in Condition and Documentation Elements
Documentation Element
CHF/Chest
Pain/MI
Pneumonia/
Bronchitis
Mental
Status
Change UTI
Sepsis/Fever/
Infection Dehy…
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psnet.ahrq.gov/issue/learning-invited-reviews
May 29, 2019 - Book/Report
Learning From Invited Reviews.
Citation Text:
Learning From Invited Reviews. London, UK: Royal College of Surgeons of England; 2019.
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psnet.ahrq.gov/issue/positive-working-relationships-matter-better-nurse-and-patient-outcomes
September 27, 2017 - Special or Theme Issue
Positive Working Relationships Matter for Better Nurse and Patient Outcomes.
Citation Text:
Positive Working Relationships Matter for Better Nurse and Patient Outcomes. Spence Laschinger HK, ed. J Nurs Manag. 2010;18(8):875-1086
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effectivehealthcare.ahrq.gov/sites/default/files/pdf/TND_0119_06-17-2009.pdf
January 01, 2009 - Effective Health Care
Topic Number: 0160
Document Completion Date: 1-12-10
1
Results of Topic Selection Process & Next Steps
Pharmacologic therapy versus medical foods and nondietary approaches for the treatment of
phenylketonuria (PKU) will go forward for refinement as a systematic review. …
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effectivehealthcare.ahrq.gov/sites/default/files/pdf/TND_0107_05-19-2009.pdf
January 01, 2009 - Effective Health Care
Topic Number: 0155
Document Completion Date: 1-11-10
1
Results of Topic Selection Process & Next Steps
Sublingual and subcutaneous immunotherapy will go forward for refinement as a systematic review.
The scope of this topic, including populations, interventions, compar…
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psnet.ahrq.gov/issue/patient-safety-canada-update
December 04, 2019 - Book/Report
Patient Safety in Canada: An Update.
Citation Text:
Patient Safety in Canada: An Update. Ottawa, ON: Canadian Institute for Health Information; August 14, 2007.
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psnet.ahrq.gov/issue/patient-safety-project-2015-2017
April 15, 2005 - Measurement Tool/Indicator
Patient Safety Project 2015–2017.
Citation Text:
Patient Safety Project 2015–2017. National Quality Forum; NQF.
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psnet.ahrq.gov/issue/considering-insulin-pens-routine-hospital-use-consider
May 03, 2023 - Newspaper/Magazine Article
Considering insulin pens for routine hospital use? Consider this...
Citation Text:
Considering insulin pens for routine hospital use? Consider this... ISMP Medication Safety Alert! Acute Care Edition. May 8, 2008;13:1-3.
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psnet.ahrq.gov/issue/patient-safety-exploring-quality-care-us
December 03, 2018 - Multi-use Website
Patient Safety: Exploring Quality of Care in the US.
Citation Text:
Patient Safety: Exploring Quality of Care in the US. ProPublica, Inc. New York, NY. 2012-2016.
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psnet.ahrq.gov/issue/fires-during-surgeries-bigger-risk-thought
August 24, 2016 - Newspaper/Magazine Article
Fires during surgeries a bigger risk than thought.
Citation Text:
Fires during surgeries a bigger risk than thought. Kowalczyk L. Boston Globe. November 7, 2007
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www.ahrq.gov/news/newsroom/case-studies/201534.html
December 01, 2015 - North Carolina Physicians Use AHRQ Materials to Boost Communication with Patients
Search All Impact Case Studies
December 2015
G and G Healthcare P.C., a four-office primary care practice based in Whiteville, North Carolina, uses AHRQ’s " Questions Are the Answer " educational materials to improve communica…
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psnet.ahrq.gov/issue/behaviors-undermine-culture-safety
April 24, 2024 - Sentinel Event Alerts
Behaviors that undermine a culture of safety.
Citation Text:
Behaviors that undermine a culture of safety. Sentinel event alert. 2008;(40):1-3.
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Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId RIS …
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www.ahrq.gov/news/newsroom/case-studies/201514.html
June 01, 2015 - New York Hospital Uses AHRQ Resources to Improve Patients' Experience of Care
Search All Impact Case Studies
June 2015
Adoption of AHRQ's TeamSTEPPS® patient safety training program at the 233-bed Northern Westchester Hospital in Mount Kisco, New York, has enhanced communication and teamwork among clinica…
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effectivehealthcare.ahrq.gov/sites/default/files/pdf/TND_0064_11-23-2008.pdf
January 01, 2008 - Effective Health Care
Topic Number(s): 0118/0154
Document Completion Date: 6-25-09
1
Results of Topic Selection Process & Next Steps
Treatment of open-angle glaucoma will go forward for refinement as a comparative effectiveness or
effectiveness review. The scope of this topic, including pop…
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psnet.ahrq.gov/issue/diagnostic-error-acute-care
December 15, 2010 - Newspaper/Magazine Article
Diagnostic error in acute care.
Citation Text:
Diagnostic error in acute care. PA-PSRS Patient Saf Advis. September 2010;7:76-86.
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digital.ahrq.gov/ahrq-funded-projects/regional-approach-thqit-rural-settings
January 01, 2023 - Regional Approach for THQIT in Rural Settings
Project Description
Other Resources
Project Details -
Completed
Grant Number
P20 HS015457
Funding Mechanism(s)
Transforming Healthcare Quality Through Information Technology (THQIT) - …
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psnet.ahrq.gov/issue/adverse-outcomes-why-bad-things-happen-good-people
August 30, 2023 - Commentary
Adverse outcomes: why bad things happen to good people.
Citation Text:
Sonnenberg A. Adverse outcomes: why bad things happen to good people. Clin Gastroenterol Hepatol. 2015;13(5):820-3.e1. doi:10.1016/j.cgh.2014.07.064.
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psnet.ahrq.gov/issue/learning-use-patient-stories
July 18, 2018 - Book/Report
Learning to Use Patient Stories.
Citation Text:
Learning to Use Patient Stories. Cardiff, UK: NHS Wales; April 2010.
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psnet.ahrq.gov/issue/prevention-perioperative-medication-errors
March 22, 2023 - Review
Prevention of perioperative medication errors.
Citation Text:
Prevention of perioperative medication errors. Nanji K. UpToDate. March 7, 2023.
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