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psnet.ahrq.gov/issue/broken-fragmented-health-care-system-failed-daughter-who-died-suicide
June 29, 2022 - Newspaper/Magazine Article
Broken, fragmented health-care system failed daughter who died by suicide.
Citation Text:
Broken, fragmented health-care system failed daughter who died by suicide. Klowak M. CBC News. March 9, 2020.
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psnet.ahrq.gov/issue/crushing-or-splitting-medications-unrecognized-hazards
October 26, 2010 - Commentary
Crushing or splitting medications: unrecognized hazards.
Citation Text:
Gill D, Spain M, Edlund BJ. Crushing or Splitting Medications: Unrecognized Hazards. J Gerontol Nurs. 2012. doi:10.3928/00989134-20111213-01.
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hcup-us.ahrq.gov/reports/factsandfigures/2008/pdfs/section5_3.pdf
January 01, 2008 - HCUP Facts and Figures: Statistics on Hospital-Based Care in the United States, 2008 62
EXHIBIT 5.3 MHSA Hospitalizations and Average Length of Stay
1,602 1,700 1,770 1,820 1,837
7.9
7.3 7.1 7.2 7.1
0
1
2
3
4
5
6
7
8
9
10
1,400
1,500
1,600
1,700
1,800
1,900
1997 2005 2006 2007 2008
A
v…
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psnet.ahrq.gov/issue/managing-can-improve-teamwork-or
September 23, 2020 - Commentary
"Managing up" can improve teamwork in the OR.
Citation Text:
Smith SL. "Managing up" can improve teamwork in the OR. AORN J. 2010;91(5):576-82. doi:10.1016/j.aorn.2009.08.014.
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psnet.ahrq.gov/issue/optimal-use-telehealth-deliver-safe-patient-care
October 10, 2018 - Newspaper/Magazine Article
The optimal use of telehealth to deliver safe patient care.
Citation Text:
The optimal use of telehealth to deliver safe patient care. Quick Safety. October 6, 2020;55:1-4.
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psnet.ahrq.gov/issue/interruptions-and-multitasking-nursing-care
September 28, 2010 - Study
Interruptions and multitasking in nursing care.
Citation Text:
Kalisch BJ, Aebersold M. Interruptions and multitasking in nursing care. Jt Comm J Qual Patient Saf. 2010;36(3):126-132.
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psnet.ahrq.gov/issue/aorn-guidance-statement-creating-patient-safety-culture
March 14, 2018 - Organizational Policy/Guidelines
AORN guidance statement: creating a patient safety culture.
Citation Text:
Nurses A of periOR. AORN guidance statement: creating a patient safety culture. AORN journal. 2006;83(4):936-42.
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psnet.ahrq.gov/issue/all-her-head-truth-and-lies-early-medicine-taught-us-about-womens-bodies-and-why-it-matters
March 06, 2024 - Book/Report
All in Her Head. The Truth and Lies Early Medicine Taught Us About Women's Bodies and Why It Matters Today.
Citation Text:
All in Her Head. The Truth and Lies Early Medicine Taught Us About Women's Bodies and Why It Matters Today. New York, NY: Harper Wave; 2024. ISBN: 978006…
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psnet.ahrq.gov/issue/patient-and-family-engagement-primary-care-case-studies
November 01, 2016 - Book/Report
Patient and Family Engagement in Primary Care: Case Studies.
Citation Text:
Patient and Family Engagement in Primary Care: Case Studies. Rockville, MD: Agency for Healthcare Research and Quality; September 2016. AHRQ Publication No. 16-0035-2-EF.
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effectivehealthcare.ahrq.gov/sites/default/files/pdf/TND-0594-131115.pdf
March 13, 2013 - Topic 0505 Genetic Testing for Developmental Diseases NSD FINAL_SJ
§ Genetic Testing for Developmental Diseases
Nomination Summary Document
…
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psnet.ahrq.gov/issue/improving-safety-information-technology
July 25, 2011 - Commentary
Classic
Improving safety with information technology.
Citation Text:
Bates DW, Gawande AA. Improving safety with information technology. N Engl J Med. 2003;348(25):2526-34.
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psnet.ahrq.gov/issue/medicares-oversight-ambulatory-surgery-centers-report
February 11, 2015 - Book/Report
Medicare's Oversight of Ambulatory Surgery Centers Report.
Citation Text:
Medicare's Oversight of Ambulatory Surgery Centers Report. Washington, DC: Office of the Inspector General; September 2019. Report No. OEI-01-15-00400.
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digital.ahrq.gov/ahrq-funded-projects/medication-management-closed-computerized-loop
January 01, 2023 - Medication Management: A Closed Computerized Loop
Project Description
Other Resources
Project Details -
Completed
Grant Number
UC1 HS015231
Funding Mechanism(s)
Transforming Healthcare Quality Through Information Technology (THQIT…
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psnet.ahrq.gov/issue/mail-service-and-community-pharmacies-must-work-tandem
December 07, 2022 - Newspaper/Magazine Article
Mail service and community pharmacies must work in tandem.
Citation Text:
Mail service and community pharmacies must work in tandem. ISMP Safe Medication Alert! Acute care edition. November 17, 2005.
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psnet.ahrq.gov/issue/best-practices-administering-sops-surveys
January 10, 2024 - Webinar
Best Practices for Administering SOPS Surveys.
Citation Text:
Best Practices for Administering SOPS Surveys. Agency for Healthcare Research and Quality. January 24, 2024.
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psnet.ahrq.gov/issue/care-transitions-threat-and-opportunity-patient-safety
May 20, 2009 - Commentary
Care transitions: a threat and an opportunity for patient safety.
Citation Text:
Clancy CM. Care Transitions: A Threat and an Opportunity for Patient Safety. American Journal of Medical Quality. 2006;21(6). doi:10.1177/1062860606293537.
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psnet.ahrq.gov/issue/epidural-iv-route-mix-ups-reducing-risk-deadly-errors
May 02, 2018 - Newspaper/Magazine Article
Epidural-IV route mix-ups: reducing the risk of deadly errors.
Citation Text:
Epidural-IV route mix-ups: reducing the risk of deadly errors. ISMP Medication Safety Alert! Acute Care Edition. July 3, 2008;13:1-3.
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psnet.ahrq.gov/issue/fda-advise-err-prevent-dangerous-drug-device-interaction-causing-falsely-elevated-glucose
May 02, 2018 - Newspaper/Magazine Article
FDA Advise-ERR: prevent dangerous drug-device interaction causing falsely elevated glucose levels.
Citation Text:
FDA Advise-ERR: prevent dangerous drug-device interaction causing falsely elevated glucose levels. ISMP Medication Safety Alert! Acute Care Edition…
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psnet.ahrq.gov/issue/serious-reportable-events-massachusetts
May 03, 2023 - Book/Report
Serious Reportable Events in Massachusetts.
Citation Text:
Serious Reportable Events in Massachusetts. Fillo KT, Saunders K. Bureau of Health Care Safety and Quality, Department of Public Health. Boston, MA: Commonwealth of Massachusetts; 2023.
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psnet.ahrq.gov/issue/falls-prevention-mayo-clinic-rochester-path-quality-care
January 22, 2017 - Commentary
Falls prevention at Mayo Clinic Rochester: a path to quality care.
Citation Text:
Sulla SJ, McMyler E. Falls prevention at Mayo Clinic Rochester: a path to quality care. J Nurs Care Qual. 2007;22(2):138-44.
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