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digital.ahrq.gov/2019-year-review/research-summary/health-information-exchange-streamlines-communication-between
January 01, 2019 - Health Information Exchange Streamlines Communication Between Poison Control Centers and Emergency Departments
The research team created the first HIE capability between a poison control center (PCC) and ED to reduce errors, improve decision making, and improve continuity of care for poisonings, including drug ove…
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www.ahrq.gov/news/newsroom/case-studies/202301.html
October 01, 2024 - Ohio Veterans’ Facility Relied on AHRQ Resource to Develop Diabetes Initiative
Search All Impact Case Studies
March 2023
The Dayton (Ohio) Veterans Affairs (VA) Medical Center facility has adopted AHRQ’s SHARE Approach as part of the U.S. Department of Veterans Affairs' national Hypoglycemic Safety Initia…
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psnet.ahrq.gov/issue/developing-and-testing-health-care-safety-hotline-prototype-consumer-reporting-system-patient
October 26, 2016 - Book/Report
Developing and Testing the Health Care Safety Hotline: A Prototype Consumer Reporting System for Patient Safety Events. Final Report.
Citation Text:
Developing and Testing the Health Care Safety Hotline: A Prototype Consumer Reporting System for Patient Safety Events. Final R…
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digital.ahrq.gov/2020-year-review/research-summary/virtual-smart-assistant-how-voice-controlled-technology-can-support-self-management-healthcare
January 01, 2020 - The Virtual Smart Assistant: How Voice-Controlled Technology Can Support Self-Management of Healthcare in Older Adults
Enhancing an evidence-based electronic health intervention, Elder Tree, with voice-controlled technology can broaden its use, leading to improved overall health and reduced hospital readmission for…
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psnet.ahrq.gov/issue/mitigating-july-effect
August 05, 2020 - Commentary
Mitigating the July effect.
Citation Text:
Wu AW, Vincent CA, Shapiro DW, et al. Mitigating the July effect. J Patient Saf Risk Manag. 2021;26(3):93-96. doi:10.1177/25160435211019142.
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psnet.ahrq.gov/issue/using-telehealth-improve-quality-and-safety-findings-ahrq-portfolio
May 07, 2014 - Book/Report
Using Telehealth to Improve Quality and Safety: Findings from the AHRQ Portfolio.
Citation Text:
Using Telehealth to Improve Quality and Safety: Findings from the AHRQ Portfolio. Dixon BE, Hook JM, McGowan JJ, for AHRQ National Resource Center for Health IT. Rockville, MD: Ag…
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psnet.ahrq.gov/issue/factors-affecting-patient-safety-culture-among-dental-healthcare-workers-nationwide-cross
June 16, 2021 - Study
Factors affecting patient safety culture among dental healthcare workers: A nationwide cross-sectional survey
Citation Text:
Cheng H-C, Yen AM-F, Lee Y-H. Factors affecting patient safety culture among dental healthcare workers: A nationwide cross-sectional survey. J Dent Sci. 2019…
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psnet.ahrq.gov/issue/parent-participation-morbidity-and-mortality-review-parent-and-physician-perspectives
May 18, 2022 - Study
Parent participation in morbidity and mortality review: parent and physician perspectives.
Citation Text:
de Loizaga SR, Clarke-Myers K, R Khoury P, et al. Parent participation in morbidity and mortality review: parent and physician perspectives. J Patient Exp. 2022;9:2374373522110…
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psnet.ahrq.gov/issue/flaw-medicine-addressing-racial-and-gender-disparities-critical-care
June 16, 2010 - Commentary
The flaw of medicine: addressing racial and gender disparities in critical care.
Citation Text:
Hilton EJ, Goff KL, Sreedharan R, et al. The flaw of medicine: addressing racial and gender disparities in critical care. Anesthesiol Clin. 2020;38(2):357-368. doi:10.1016/j.anclin.…
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www.uspreventiveservicestaskforce.org/home/getfilebytoken/6dqHx6xQGq9GUv92rZUf2q
August 01, 2022 - Statin Use for the Primary Prevention of Cardiovascular Disease in Adults
The USPSTF recognizes that clinical decisions involve more considerations
than evidence alone. Clinicians should understand the evidence but
individualize decision making to the specific patient or situation.
Clinician Summary of USP…
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psnet.ahrq.gov/issue/consumer-directed-technologies-improve-medication-management-and-safety
December 29, 2014 - Commentary
Consumer-directed technologies to improve medication management and safety.
Citation Text:
Andrade AQ, Roughead EE. Consumer-directed technologies to improve medication management and safety. Med J Aust. 2019;210(suppl 6):S24-S27. doi:10.5694/mja2.50029.
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psnet.ahrq.gov/issue/undermining-and-bullying-surgical-training-review-and-recommendations-association-surgeons
July 25, 2018 - Review
Undermining and bullying in surgical training: a review and recommendations by the Association of Surgeons in Training.
Citation Text:
Wild JRL, Ferguson HJM, McDermott FD, et al. Undermining and bullying in surgical training: a review and recommendations by the Association of Sur…
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psnet.ahrq.gov/issue/usability-and-accessibility-publicly-available-patient-safety-databases
May 12, 2021 - Study
Usability and accessibility of publicly available patient safety databases.
Citation Text:
Sheehan JG, Howe JL, Fong A, et al. Usability and accessibility of publicly available patient safety databases. J Patient Saf. 2022;18(6):565-569. doi:10.1097/pts.0000000000001018.
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psnet.ahrq.gov/issue/understanding-link-between-burnout-and-sub-optimal-care-why-should-healthcare-education-be
August 03, 2022 - Review
Understanding the link between burnout and sub-optimal care: why should healthcare education be interested in employee silence?
Citation Text:
Montgomery A, Lainidi O. Understanding the link between burnout and sub-optimal care: why should healthcare education be interested in emp…
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psnet.ahrq.gov/issue/explaining-ethnic-disparities-patient-safety-qualitative-analysis
April 14, 2021 - Study
Explaining ethnic disparities in patient safety: a qualitative analysis.
Citation Text:
Suurmond J, Uiters E, de Bruijne M, et al. Explaining ethnic disparities in patient safety: a qualitative analysis. Am J Public Health. 2010;100 Suppl 1:S113-7. doi:10.2105/AJPH.2009.167064.
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psnet.ahrq.gov/issue/patient-safety-and-quality-improvement-ethical-principles-regulatory-approach-bias-healthcare
April 21, 2021 - Commentary
Emerging Classic
Patient safety and quality improvement: ethical principles for a regulatory approach to bias in healthcare machine learning.
Citation Text:
McCradden MD, Joshi S, Anderson JA, et al. Patient safety and quality improvement: Ethical pri…
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psnet.ahrq.gov/issue/evaluation-occult-fractures-injured-children
August 20, 2014 - Study
Evaluation for occult fractures in injured children.
Citation Text:
Wood JN, French B, Song L, et al. Evaluation for Occult Fractures in Injured Children. Pediatrics. 2015;136(2):232-40. doi:10.1542/peds.2014-3977.
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digital.ahrq.gov/population/office-staff
January 01, 2023 - Office Staff
Adapting an electronic STI risk assessment program for use in pediatric primary care.
Citation
Ahmad FA, Chan P, McGovern C, Dickey V, Foraker R, McKay V. Adapting an electronic STI risk assessment program for use in pediatric primary care. J Prim Care Community H…
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psnet.ahrq.gov/issue/nurse-leader-attitudes-and-beliefs-regarding-medical-errors
March 12, 2025 - Study
Nurse leader attitudes and beliefs regarding medical errors.
Citation Text:
Prothero MM, Huefner K, Sorhus M. Nurse leader attitudes and beliefs regarding medical errors. J Nurs Adm. 2024;54(1):10-15. doi:10.1097/nna.0000000000001371.
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psnet.ahrq.gov/issue/effect-fit-between-organizational-culture-and-structure-medication-errors-medical-group
June 30, 2009 - Study
The effect of the fit between organizational culture and structure on medication errors in medical group practices.
Citation Text:
Kaissi A, Kralewski J, Dowd B, et al. The effect of the fit between organizational culture and structure on medication errors in medical group practi…