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psnet.ahrq.gov/node/73082/psn-pdf
March 31, 2021 - The potential of artificial intelligence to improve patient
safety: a scoping review.
March 31, 2021
Bates DW, Levine DM, Syrowatka A, et al. The potential of artificial intelligence to improve patient safety: a
scoping review. NPJ Digit Med. 2021;4(1):54. doi:10.1038/s41746-021-00423-6.
https://psnet.ahrq.gov/iss…
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psnet.ahrq.gov/node/60225/psn-pdf
April 15, 2020 - Beyond 'find and fix': improving quality and safety
through resilient healthcare systems.
April 15, 2020
Anderson JE, Ross AJ, Back J, et al. Beyond ‘find and fix’: improving quality and safety through resilient
healthcare systems. Int J Qual Health Care. 2020;32(3):204-211. doi:10.1093/intqhc/mzaa007.
https://psn…
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psnet.ahrq.gov/node/848043/psn-pdf
April 26, 2023 - Tools for establishing a sustainable safety culture within
maternity services: a retrospective case study.
April 26, 2023
Løland M, Braut GS, Lichtenberg SM, et al. Tools for establishing a sustainable safety culture within
maternity services: a retrospective case study. SAGE Open Med. 2023;11:205031212311642.
doi…
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psnet.ahrq.gov/node/61100/psn-pdf
November 04, 2020 - Patient errors in use of injectable antidiabetic
medications: a need for improved clinic-based education.
November 4, 2020
Wei ET, Koh E, Kelly MS, et al. Patient errors in use of injectable antidiabetic medications: a need for
improved clinic-based education. J Am Pharm Assoc (2003). 2020;60(5):e76-e80.
doi:10.10…
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psnet.ahrq.gov/node/44292/psn-pdf
September 01, 2016 - Recommendations to improve the usability of drug–drug
interaction clinical decision support alerts.
September 1, 2016
Payne TH, Hines LE, Chan RC, et al. Recommendations to improve the usability of drug-drug interaction
clinical decision support alerts. J Am Med Inform Assoc. 2015;22(6):1243-50. doi:10.1093/jamia/o…
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psnet.ahrq.gov/node/43631/psn-pdf
December 19, 2014 - An internal quality improvement collaborative
significantly reduces hospital-wide medication error
related adverse drug events.
December 19, 2014
McClead RE, Catt C, Davis T, et al. An internal quality improvement collaborative significantly reduces
hospital-wide medication error related adverse drug events. J Ped…
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psnet.ahrq.gov/node/43982/psn-pdf
April 01, 2015 - Human factors and ergonomics and quality improvement
science: integrating approaches for safety in healthcare.
April 1, 2015
Hignett S, Jones EL, Miller D, et al. Human factors and ergonomics and quality improvement science:
integrating approaches for safety in healthcare. BMJ Qual Saf. 2015;24(4):250-254. doi:10.1…
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psnet.ahrq.gov/node/47298/psn-pdf
September 24, 2018 - Physician engagement in malpractice risk reduction: a
UPHS case study.
September 24, 2018
Diraviam SP, Sullivan P, Sestito JA, et al. Physician Engagement in Malpractice Risk Reduction: A UPHS
Case Study. Jt Comm J Qual Patient Saf. 2018;44(10):605-612. doi:10.1016/j.jcjq.2018.03.009.
https://psnet.ahrq.gov/issue/…
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psnet.ahrq.gov/node/73505/psn-pdf
July 21, 2021 - Improving medication reconciliation with comprehensive
evaluation at a Veterans Affairs skilled-nursing facility.
July 21, 2021
Baughman AW, Triantafylidis LK, O'Neil N, et al. Improving medication reconciliation with comprehensive
evaluation at a Veterans Affairs skilled-nursing facility. Jt Comm J Qual Patient Sa…
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psnet.ahrq.gov/node/46858/psn-pdf
May 11, 2019 - Evidence review conducted for the Agency for Healthcare
Research and Quality Safety Program for Improving
Surgical Care and Recovery: focus on anesthesiology for
colorectal surgery.
May 11, 2019
Ban KA, Gibbons MM, Ko CY, et al. Evidence Review Conducted for the Agency for Healthcare Research
and Quality Safety …
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psnet.ahrq.gov/node/37912/psn-pdf
September 25, 2008 - Association of a clinical knowledge support system with
improved patient safety, reduced complications and
shorter length of stay among Medicare beneficiaries in
acute care hospitals in the United States.
September 25, 2008
Bonis PA, Pickens GT, Rind DM, et al. Association of a clinical knowledge support system wi…
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psnet.ahrq.gov/node/46126/psn-pdf
June 19, 2019 - A guide to evaluation of quality improvement and patient
safety educational programs: lessons from the VA Chief
Resident in Quality and Safety Program.
June 19, 2019
Butcher RL, Carluzzo KL, Watts B, et al. A Guide to Evaluation of Quality Improvement and Patient Safety
Educational Programs: Lessons From the VA Ch…
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psnet.ahrq.gov/node/50834/psn-pdf
January 29, 2020 - Medication reconciliation improvement utilizing process
redesign and clinical decision support.
January 29, 2020
Rungvivatjarus T, Kuelbs CL, Miller L, et al. Medication Reconciliation Improvement Utilizing Process
Redesign and Clinical Decision Support. Jt Comm J Qual Patient Saf. 2020;46(1):27-36.
doi:10.1016/j.…
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psnet.ahrq.gov/node/45480/psn-pdf
November 16, 2016 - Improving patient safety reporting with the common
formats: common data representation for Patient Safety
Organizations.
November 16, 2016
Elkin PL, Johnson HC, Callahan MR, et al. Improving patient safety reporting with the common formats:
Common data representation for Patient Safety Organizations. J Biomed Info…
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psnet.ahrq.gov/node/46544/psn-pdf
September 12, 2018 - Interventions to improve follow-up of laboratory test
results pending at discharge: a systematic review.
September 12, 2018
Whitehead NS, Williams L, Meleth S, et al. Interventions to Improve Follow-Up of Laboratory Test Results
Pending at Discharge: A Systematic Review. J Hosp Med. 2018. doi:10.12788/jhm.2944.
ht…
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psnet.ahrq.gov/node/43137/psn-pdf
May 28, 2015 - Weaving quality improvement and patient safety skills
into all levels of medical training: an annotated
bibliography.
May 28, 2015
Mochan E, Nash DB. Weaving quality improvement and patient safety skills into all levels of medical
training: an annotated bibliography. Am J Med Qual. 2015;30(3):232-47. doi:10.1177/1…
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psnet.ahrq.gov/node/45239/psn-pdf
August 24, 2016 - Using simulation to improve first-year pharmacy students'
ability to identify medication errors involving the top 100
prescription medications.
August 24, 2016
Atayee RS, Awdishu L, Namba J. Using Simulation to Improve First-Year Pharmacy Students' Ability to
Identify Medication Errors Involving the Top 100 Prescr…
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www.ahrq.gov/sites/default/files/2025-03/trowbridge-report.pdf
January 01, 2025 - Final Progress Report: Diagnostic Error in Medicine Annual Conference
AHRQ Grant Final Progress Report
Title of Project: Diagnostic Error in Medicine Annual Conference
Principal Investigator: Robert Trowbridge, MD
Team Members:
• Paul L. Epner, MEd, MBA, Executive Vice President, Society to Improve Diagnosis in …
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/best-practices/bacteremia-slides.pptx
November 01, 2019 - Best Practices in the Diagnosis and Treatment of Bacteremia
Best Practices in the Diagnosis and Treatment of Bacteremia
Acute Care
AHRQ Safety Program for
Improving Antibiotic Use
AHRQ Pub. No. 17(20)-0028-EF
November 2019
Bacteremia
AHRQ Safety Program for Improving Antibiotic Use – Acute Care
1
Objectives
Rev…
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effectivehealthcare.ahrq.gov/sites/default/files/15_crosscutting_potential_high_impact_2012-12-11.pdf
January 01, 2012 - its full potential and that more data are
needed to determine whether this intervention actually improves