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psnet.ahrq.gov/node/43803/psn-pdf
January 29, 2015 - The new
governance structure includes oversight from a patient safety and quality board committee.
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psnet.ahrq.gov/node/45167/psn-pdf
May 25, 2016 - The toolkit includes videos, slides, gap analysis assessments and teaching materials.
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psnet.ahrq.gov/innovation/lifepoint-national-quality-program-provides-structured-framework-reducing-inpatient-harm
February 26, 2025 - Resources Used and Skills Needed
Staffing: The program relies on a centralized team that includes … This includes ensuring that staff feel empowered to speak up to express any safety concerns in a non-punitive … Resources Used and Skills Needed
Staffing: The program relies on a centralized team that includes
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psnet.ahrq.gov/print/pdf/node/73848
July 01, 2022 - The site, maintained by the American College of
Obstetricians and Gynecologists, includes... … It includes
screening, evaluation and monitoring, and antibiotic use recommendations for maternal sepsis … It includes
screening, evaluation and monitoring, and antibiotic use recommendations for maternal sepsis … The site, maintained by the American College of
Obstetricians and Gynecologists, includes...
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psnet.ahrq.gov/perspective/diagnostic-errors-medicine-what-do-doctors-and-umpires-have-common
February 01, 2007 - Diagnostic Errors in Medicine: What Do Doctors and Umpires Have in Common?
Mark L. Graber, MD | February 1, 2007
Also Read a Conversation
View more articles from the same authors.
Citation Text:
Graber ML. Diagnostic Errors in Medicine: What Do Doctors and Umpi…
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psnet.ahrq.gov/web-mm/or
August 22, 2013 - On O.R. Off?
Citation Text:
Leonard M. On O.R. Off?. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2005.
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Do…
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psnet.ahrq.gov/web-mm/home-medications-contribute-unique-opportunity-error-discharge-hospital
May 16, 2022 - Home Medications Contribute to a Unique Opportunity for Error on Discharge from the Hospital
Citation Text:
Agrawal G, Nguyen DM. Home Medications Contribute to a Unique Opportunity for Error on Discharge from the Hospital.. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US De…
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psnet.ahrq.gov/node/50930/psn-pdf
February 21, 2020 - Pharmacist Role in Patient Safety
February 21, 2020
Dopp AL, Hall KK. Pharmacist Role in Patient Safety. PSNet [internet]. 2020.
https://psnet.ahrq.gov/perspective/pharmacist-role-patient-safety
Background: The Evolving Role of the Pharmacist
Medication errors are highly pervasive across all settings of care,[1] w…
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psnet.ahrq.gov/web-mm/obstructed-view
August 07, 2019 - An Obstructed View
Citation Text:
Carter J. An Obstructed View. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2015.
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…
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psnet.ahrq.gov/web-mm/bleeding-risk
November 01, 2003 - Bleeding Risk
Citation Text:
Crowther MA. Bleeding Risk. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2003.
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psnet.ahrq.gov/web-mm/two-pills-same-drug
May 27, 2011 - Two Pills, Same Drug
Citation Text:
Horsky J, Patel VL. Two Pills, Same Drug. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2005.
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psnet.ahrq.gov/web-mm/hiding-plain-sight
April 24, 2019 - Hiding in Plain Sight
Citation Text:
Weinberg JM. Hiding in Plain Sight. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2009.
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psnet.ahrq.gov/node/49732/psn-pdf
May 01, 2015 - , sepsis always involves activation of the host inflammatory response and, in more serious
states, includes … updated in 2013 by the Surviving Sepsis Campaign (SSC) and endorsed by multiple
medical societies, includes … timely manner.(4) Based on an
initial protocol performed by Rivers and colleagues (5), the bundle includes … UCSF Bundle Compliance and Mortality (Includes All Adult Inpatients and the Emergency
Department).
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psnet.ahrq.gov/node/33707/psn-pdf
February 01, 2011 - Research and QI projects
Course content includes
(but not limited to): systems
failure and medical … interventions in CQI
framework and designing
additional or new
interventions
Duration: 6 days
Course includes … Duration: 20 days
Course includes lectures
from national experts and
completion and reporting of … science, support
to attend meetings, and
bonuses for good
performance
Duration: 8 hours
Program includes
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psnet.ahrq.gov/web-mm/missed-patient-assignment-anyone-there
September 01, 2017 - adequate data for further improvement—for instance, a daily monitoring report to the charge nurse that includes … Joint Commission recommends that each organization's: "process for effective hand off communication includes … Clinical content Includes everything on the data-information-knowledge continuum stored in the … Human–computer interface Enables unrelated entities to interact with the system and includes aspects
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.347_slideshow.ppt
May 01, 2015 - initiated by an infection
Sepsis always involves activation of the host inflammatory response and often includes … treatment with the "resuscitation bundle"
The bundle, updated in the Surviving Sepsis Campaign in 2013, includes … www.ncbi.nlm.nih.gov/pubmed/23353941
12
Resuscitation Bundle
Based on a NEJM study published in 2001, the bundle includes
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psnet.ahrq.gov/perspective/university-texas-system-clinical-safety-and-effectiveness-course
February 01, 2011 - Research and QI projects
Course content includes (but not limited to): systems failure and medical … interventions in CQI framework and designing additional or new interventions
Duration : 6 days
Course includes … Duration : 20 days
Course includes lectures from national experts and completion and reporting of a … science, support to attend meetings, and bonuses for good performance
Duration : 8 hours
Program includes
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psnet.ahrq.gov/web-mm/errors-sepsis-management
November 03, 2015 - variability, sepsis always involves activation of the host inflammatory response and, in more serious states, includes … updated in 2013 by the Surviving Sepsis Campaign (SSC) and endorsed by multiple medical societies, includes … timely manner.( 4 ) Based on an initial protocol performed by Rivers and colleagues ( 5 ), the bundle includes … UCSF Bundle Compliance and Mortality (Includes All Adult Inpatients and the Emergency Department).
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psnet.ahrq.gov/node/74226/psn-pdf
February 01, 2019 - To address the complexity of a patient’s case, STORM aims to provide a holistic intervention that
includes … by overdose as the general population.13
The Stratification Tool for Opioid Risk Mitigation (STORM) includes … Unlike previous risk identification strategies, the
STORM predictive model includes chronic health conditions … Resources Used and Skills Needed
VHA support for implementation includes training, technical assistance … keeping the patient at the center
of all development, ensuring treatment planning is collaborative and includes
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.296_slideshow.ppt
April 01, 2013 - acids, electrolytes, vitamins, minerals, trace elements, and fluids via an intravenous route
PN includes … where patients receive all of their nutritional needs intravenously through a central line
PN also includes … maintain expertise
Caregivers involved with PN should work within an interdisciplinary setting that includes