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psnet.ahrq.gov/node/41498/psn-pdf
December 31, 2014 - Standard practices for computerized clinical decision
support in community hospitals: a national survey.
December 31, 2014
Ash JS, McCormack JL, Sittig DF, et al. Standard practices for computerized clinical decision support in
community hospitals: a national survey. J Am Med Inform Assoc. 2012;19(6):980-7. doi:10.…
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psnet.ahrq.gov/node/37401/psn-pdf
March 28, 2012 - Interventions for preventing falls in acute- and chronic-
care hospitals: a systematic review and meta-analysis.
March 28, 2012
Coussement J, De Paepe L, Schwendimann R, et al. Interventions for preventing falls in acute- and
chronic-care hospitals: a systematic review and meta-analysis. J Am Geriatr Soc. 2008;56(1…
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psnet.ahrq.gov/node/74009/psn-pdf
October 27, 2021 - Quantifying discharge medication reconciliation errors at
2 pediatric hospitals.
October 27, 2021
Morse KE, Chadwick WA, Paul W, et al. Quantifying discharge medication reconciliation errors at 2
pediatric hospitals. Pediatr Qual Saf. 2021;6(4):e436. doi:10.1097/pq9.0000000000000436.
https://psnet.ahrq.gov/issue/q…
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psnet.ahrq.gov/node/38276/psn-pdf
December 10, 2008 - Addressing delays in medication administration for
patients transferred from the hospital to the nursing
home: a pilot quality improvement project.
December 10, 2008
Ward KT, Bates-Jensen B, Eslami MS, et al. Addressing delays in medication administration for patients
transferred from the hospital to the nursing h…
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psnet.ahrq.gov/node/40911/psn-pdf
November 09, 2011 - Preventable and non-preventable adverse drug events in
hospitalized patients: a prospective chart review in the
Netherlands.
November 9, 2011
Dequito AB, Mol PGM, van Doormaal J, et al. Preventable and non-preventable adverse drug events in
hospitalized patients: a prospective chart review in the Netherlands. Drug…
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psnet.ahrq.gov/node/35583/psn-pdf
June 17, 2010 - Using a bar-coded medication administration system to
prevent medication errors in a community hospital
network.
June 17, 2010
Sakowski J, Leonard T, Colburn S, et al. Using a bar-coded medication administration system to prevent
medication errors in a community hospital network. American Journal of Health-System …
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psnet.ahrq.gov/node/35043/psn-pdf
June 22, 2009 - Human factors engineering: a tool for medical device
evaluation in hospital procurement decision-making.
June 22, 2009
Ginsburg G. Human factors engineering: a tool for medical device evaluation in hospital procurement
decision-making. J Biomed Inform. 2005;38(3):213-9.
https://psnet.ahrq.gov/issue/human-factors-e…
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psnet.ahrq.gov/node/34960/psn-pdf
June 22, 2009 - Making hospital care safer and better: the structure-
process connection leading to adverse events.
June 22, 2009
El-Jardali F, Lagacé M. Making hospital care safer and better: the structure-process connection leading to
adverse events. Healthc Q. 2005;8(2):40-8.
https://psnet.ahrq.gov/issue/making-hospital-care-s…
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psnet.ahrq.gov/node/50625/psn-pdf
November 06, 2019 - Pediatric medication safety considerations for
pharmacists in an adult hospital setting.
November 6, 2019
Kennedy AR, Massey LR. Pediatric medication safety considerations for pharmacists in an adult hospital
setting. Am J Health Syst Pharm. 2019;76(19):1481-1491. doi:10.1093/ajhp/zxz168.
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psnet.ahrq.gov/node/35760/psn-pdf
July 19, 2010 - Achieving rapid door-to-balloon times: how top hospitals
improve complex clinical systems.
July 19, 2010
Bradley EH, Curry LA, Webster TR, et al. Achieving rapid door-to-balloon times: how top hospitals improve
complex clinical systems. Circulation. 2006;113(8):1079-85.
https://psnet.ahrq.gov/issue/achieving-rapid…
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psnet.ahrq.gov/node/41303/psn-pdf
March 11, 2013 - Clinical risk management in hospitals: strategy, central
coordination and dialogue as key enablers.
March 11, 2013
Briner M, Manser T, Kessler O. Clinical risk management in hospitals: strategy, central coordination and
dialogue as key enablers. J Eval Clin Pract. 2013;19(2):363-369. doi:10.1111/j.1365-2753.2012.01…
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psnet.ahrq.gov/node/39458/psn-pdf
April 12, 2011 - Hospital admission medication reconciliation in medically
complex children: an observational study.
April 12, 2011
Stone BL, Boehme S, Mundorff MB, et al. Hospital admission medication reconciliation in medically
complex children: an observational study. Arch Dis Child. 2009. doi:10.1136/adc.2009.167528.
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psnet.ahrq.gov/node/40457/psn-pdf
May 18, 2011 - An in-depth analysis of medication errors in hospitalized
patients with HIV.
May 18, 2011
Snyder AM, Klinker K, Orrick JJ, et al. An in-depth analysis of medication errors in hospitalized patients
with HIV. Ann Pharmacother. 2011;45(4):459-68. doi:10.1345/aph.1P599.
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psnet.ahrq.gov/node/41771/psn-pdf
March 20, 2018 - Improving Patient Safety Systems for Patients With
Limited English Proficiency: A Guide For Hospitals.
March 20, 2018
Rockville, MD: Agency for Healthcare Research and Quality; September 2012. AHRQ Publication No. 12-
0041.
https://psnet.ahrq.gov/issue/improving-patient-safety-systems-patients-limited-english-prof…
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psnet.ahrq.gov/node/38112/psn-pdf
December 30, 2014 - Preparing your hospital for compliance with The Joint
Commission's National Patient Safety Goals.
December 30, 2014
Murdaugh L, Jordin R. Preparing your hospital for compliance with The Joint Commission's National Patient
Safety Goals. Hosp Pharm. 2010;43(9):728-733. doi:10.1310/hpj4309-728.
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www.ahrq.gov/practiceimprovement/systemdesign/leancasestudies/lean-exhibit2-8.html
November 01, 2014 - Improving Care Delivery Through Lean: Implementation Case Studies
Exhibit 2.8. Lean Team Training at Central Hospital
Previous Page Next Page
Table of Contents
Improving Care Delivery Through Lean: Implementation Case Studies
Introduction to the Case Studies
Case 1. Lakeview Healthcare
Case 2.…
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www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/chronic/chipra-0217-section-6-tables-6-7.pdf
June 02, 2025 - Section 6, Tables 6 and 7
Table 6: Agreement and Kappa Statistics for Inter‐Rater Reliability at Three Sites
Site Measure Numerator/
Eligibility Criteria
Number of Records Reviewed N Agreed (%) Kappa Statistic
Hospital #1 Pain Numerator 3 100% 1.00
Pain Criterion 3 100% 1.00
Hospital #2 Pain Numerator …
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www.ahrq.gov/practiceimprovement/systemdesign/leancasestudies/lean-exhibit3-16.html
November 01, 2014 - Improving Care Delivery Through Lean: Implementation Case Studies
Exhibit 3.16. Project Team Composition–Cardiology Follow-up Appointment Scheduling
Previous Page Next Page
Table of Contents
Improving Care Delivery Through Lean: Implementation Case Studies
Introduction to the Case Studies
Case 1…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/cauti-tools/archived-webinars/preventing-cauti-engaging-clinicians-051413.ppt
January 01, 2013 - Slide 1
Preventing CAUTI: Engaging Clinicians and Senior Leadership to Implement Change
*
Sanjay Saint, MD, MPH
M. Todd Greene, MPH, PhD
University of Michigan Medical School
Ann Arbor VA Medical Center
Learning Objectives
Describe the methods to engage clinicians in CAUTI prevention
Describe methods to engage l…
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www.ahrq.gov/patient-safety/settings/hospital/resource/pressureinjury/guide/phases.html
September 01, 2017 - Pressure Injury Prevention Program Implementation Guide
Pressure Injury Prevention Program Phases
Previous Page Next Page
Table of Contents
Pressure Injury Prevention Program Implementation Guide
Overview
Get Ready
Pressure Injury Prevention Program Phases
Appendix A. RACI Chart
Appendix B…