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psnet.ahrq.gov/innovation/care-managers-use-software-aided-medication-review-protocol-frail-community-dwelling
September 13, 2023 - Care Managers Use Software-Aided Medication Review Protocol for Frail, Community-Dwelling Seniors, Leading to More Appropriate Medication Use
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March 31…
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psnet.ahrq.gov/web-mm/case-mistaken-capacity-why-thorough-psychosocial-history-can-improve-care
July 08, 2022 - SPOTLIGHT CASE
A Case of Mistaken Capacity: Why A Thorough Psychosocial History Can Improve Care.
Citation Text:
Pasao K, Kashkouli P. A Case of Mistaken Capacity: Why A Thorough Psychosocial History Can Improve Care.. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, …
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psnet.ahrq.gov/perspective/conversation-withsanjay-saint-md-mph
November 01, 2008 - In Conversation with…Sanjay Saint, MD, MPH
November 1, 2008
Also Read an Essay
Citation Text:
In Conversation with…Sanjay Saint, MD, MPH. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 200…
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psnet.ahrq.gov/perspective/health-care-acquired-urinary-tract-infection-problem-and-solutions
November 01, 2008 - Health Care–Acquired Urinary Tract Infection: The Problem and Solutions
Lindsay E. Nicolle, MD | November 1, 2008
Also Read a Conversation
View more articles from the same authors.
Citation Text:
Nicolle LE. Health Care–Acquired Urinary Tract Infection: The Pr…
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psnet.ahrq.gov/primer/retained-surgical-items-causation-and-prevention
January 04, 2024 - Retained Surgical Items: Causation and Prevention
Citation Text:
Gibbs V, Romano P. Retained Surgical Items: Causation and Prevention. PSNet [internet]. Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2025.
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Format:
Google Scholar BibTeX End…
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psnet.ahrq.gov/perspective/missed-nursing-care-key-measure-patient-safety
March 01, 2018 - Missed Nursing Care: A Key Measure for Patient Safety
Jane Ball, PhD, and Peter Griffiths, PhD | March 1, 2018
Also Read a Conversation
View more articles from the same authors.
Citation Text:
Ball JE, Griffiths P. Missed Nursing Care: A Key Measure for Patient…
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digital.ahrq.gov/sites/default/files/docs/publication/r18hs017075-sequist-final-report-2010.pdf
January 01, 2010 - Can Risk Score Alerts Improve Office Care for Chest Pain? - Final Report
Grant Final Report
Grant ID: 5R18HS017075-03
Can Risk Score Alerts Improve Office Care
for Chest Pain?
Inclusive Dates: 09/01/07 - 08/31/10
Principal Investigator:
Thomas Dean Sequist, MD, MPH
Team Members:
Thomas H. Lee, M…
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psnet.ahrq.gov/node/865373/psn-pdf
March 27, 2024 - In Conversation with...Patrick Tighe about Artificial
Intelligence
March 27, 2024
Tighe P. In Conversation with..Patrick Tighe about Artificial Intelligence . PSNet [internet]. 2024.
https://psnet.ahrq.gov/perspective/conversation-withpatrick-tighe-about-artificial-intelligence
Editor's note: Patrick Tighe, MD, MS…
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psnet.ahrq.gov/perspective/conversation-withdonald-norman-phd
November 01, 2006 - In Conversation With...Donald A. Norman, PhD
November 1, 2006
Also Read an Essay
Citation Text:
In Conversation With..Donald A. Norman, PhD. PSNet [internet]. 2006.In Conversation With...Donald A. Norman, PhD. PSNet [internet]. Rockville (MD): Agency for Healthca…
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psnet.ahrq.gov/node/836850/psn-pdf
March 31, 2022 - Annual Perspective: Topics in Medication Safety
March 31, 2022
Harris IB, Dowell P, Mossburg SE. Annual Perspective: Topics in Medication Safety. PSNet [internet].
2022.
https://psnet.ahrq.gov/perspective/annual-perspective-topics-medication-safety
Introduction
Issues with medication management and errors in medi…
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effectivehealthcare.ahrq.gov/sites/default/files/pdf/topic-brief3-SUD.pdf
April 01, 2021 - Rapid Evidence Product
April 2021
Treatments, Technologies, and Models
for Management of Acute and Chronic
Pain in People With a History of
Substance Use Disorder
Purpose
The purpose of this topic development brief is to explore and scope the evidence on
treatments, technologies, and models for managem…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/long-term-care/resources/ontime/fallsprev/fallspximpl-handouts.pdf
June 02, 2025 - AHRQ's Safety Program for Nursing Homes: On-Time Falls Prevention Training
On-Time
Falls Prevention:
Implementation
AHRQ’s Safety Program for Nursing Homes: On-Time Falls Prevention 1
AHRQ’s Safety Program for Nursing Homes: On-
Time Falls Prevention Training
Handout 1: Implementation Scripted Exer…
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www.ahrq.gov/sites/default/files/wysiwyg/sops/events/webinar/unc-webcast-transcript.pdf
January 01, 2020 - Implementation of an Event Reporting and Learning System Leads to Improvements in Patient Safety Culture at UNC Medical Center Webcast Transcript
January 2020 https://www.ahrq.gov/sops/index.html 1
Implementation of an Event Reporting and Learning System Leads to Improvements in Patient Sa…
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www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/chronic/chipra-0138-fullreport.pdf
April 01, 2018 - Appropriate Antibiotic Prophylaxis for Children With Sickle Cell Disease
1
Appropriate Antibiotic Prophylaxis for Children with
Sickle Cell Disease
Section 1. Basic Measure Information
1.A. Measure Name
Appropriate Antibiotic Prophylaxis for Children with Sickle Cell Disease
1.B. Measure Number
0138
1.C…
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www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/chronic/chipra-246-fullreport.pdf
December 01, 2019 - Depression Screening and Follow-up for Adolescents and Adults
1
Depression Screening and Follow-up for Adolescents
and Adults
Section 1. Basic Measure Information
1.A. Measure Name
Depression Screening and Follow-up for Adolescents and Adults (Health Plan)
1.B. Measure Number
0246
1.C. Measure Description
P…
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www.ahrq.gov/sites/default/files/2024-05/kobayashi-report.pdf
January 01, 2024 - Final Progress Report: Targeted Delivery of Multiparametric Telemetry Clinical Messages to Mitigate Alarm Fatigue - PERSEUS
AHRQ Grant Final Progress Report 12/2018
Title of Project: Targeted Delivery of Multiparametric Telemetry Clinical Messages to Mitigate Alarm Fatigue
(Push Electronic Relay for Smart Alerts f…
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www.ahrq.gov/sites/default/files/2025-03/lacson-report.pdf
January 01, 2025 - Final Progress Report: Factors That Enhance Diagnostic Imaging Safety in the Ambulatory Setting
Project Title: Factors that Enhance Diagnostic Imaging Safety in the Ambulatory Setting
Principal Investigator: Ronilda Lacson, MD, PHD
Team Members:
Ramin Khorasani, MD, MPH
Ivan Ip, MD, MPH
Sonali Desai, MD
Allen Ka…
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www.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/demoeval/what-we-learned/perspectives-quality-improvement-collaboratives.pdf
January 01, 2018 - Perspectives on Implementing Quality Improvement Collaboratives Effectively: Qualitative Findings from the CHIPRA Quality Demonstration Grant Program
The Joint Commission Journal on Quality and Patient Safety 2018; 44:12–22
Perspectives on Implementing Quality Improvement
Collaboratives Effectively: Qualitative Fi…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/candor/module4/mod4-system-focused-event-guide.pdf
April 01, 2016 - Purpose: To help teams adopt a system-focused approached to event investigation and analysis.
Who should use this tool? Event Reporting, Investigation, and Analysis Team.
How to use this tool: Review the guide information when developing and implementing a systems approaching to
event investigation and analysis.
T…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol2/Advances-Shah_99.pdf
March 23, 2008 - Views of Emergency Medicine Trainees on Adverse Events and Negligence: Survey Results from an Emergency Medicine Training Program in a Regional Health Care System Following the National Standard of Care
Views of Emergency Medicine Trainees on Adverse
Events and Negligence: Survey Results from an
Emergency Medicine …