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psnet.ahrq.gov/issue/discontinuity-chronic-medications-patients-discharged-intensive-care-unit
November 03, 2015 - Study
Discontinuity of chronic medications in patients discharged from the intensive care unit.
Citation Text:
Bell CM, Rahimi-Darabad P, Orner AI. Discontinuity of chronic medications in patients discharged from the intensive care unit. J Gen Intern Med. 2006;21(9):937-41.
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psnet.ahrq.gov/issue/patient-and-carer-identified-factors-which-contribute-safety-incidents-primary-care
March 18, 2016 - Study
Patient and carer identified factors which contribute to safety incidents in primary care: a qualitative study.
Citation Text:
Hernan AL, Giles SJ, Fuller J, et al. Patient and carer identified factors which contribute to safety incidents in primary care: a qualitative study. BMJ Q…
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psnet.ahrq.gov/issue/identifying-and-characterizing-preventable-adverse-drug-events-prioritizing-pharmacist
July 15, 2010 - Study
Identifying and characterizing preventable adverse drug events for prioritizing pharmacist intervention in hospitals.
Citation Text:
Jeon N, Staley B, Johns T, et al. Identifying and characterizing preventable adverse drug events for prioritizing pharmacist intervention in hospital…
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psnet.ahrq.gov/issue/reporting-health-information-technology-system-related-patient-safety-incidents-effects
August 19, 2020 - Study
Reporting of health information technology system-related patient safety incidents: the effects of organizational justice.
Citation Text:
Gluschkoff K, Kaihlanen A, Palojoki S, et al. Reporting of health information technology system-related patient safety incidents: the effects of…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/cusptoolkit/toolkit/contentcalls/assertion-slides/Assertion-Dec-14-2010-508.ppt
January 01, 2010 - On the CUSP: Stop BSI
On the CUSP: Stop BSI
Appropriate Assertion
David Thompson, DNSc, MS, RN
Jill Marsteller, PhD, MPP
Department of Anesthesiology and Critical Care Medicine
The Johns Hopkins Quality and Safety Research Group
*
Communication Styles
Assertive
Aggressive
Passive or Passive Aggressive ?
© 2004…
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psnet.ahrq.gov/issue/point-prevalence-surgical-checklist-use-europe-relationship-hospital-mortality
January 23, 2019 - Study
Point prevalence of surgical checklist use in Europe: relationship with hospital mortality.
Citation Text:
Jammer I, Ahmad T, Aldecoa C, et al. Point prevalence of surgical checklist use in Europe: relationship with hospital mortality. Br J Anaesth. 2015;114(5):801-807. doi:10.1093…
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psnet.ahrq.gov/issue/clinical-pharmacist-led-integrated-approach-evaluation-medication-errors-among-medical
December 09, 2020 - Study
A clinical pharmacist-led integrated approach for evaluation of medication errors among medical intensive care unit patients.
Citation Text:
Aghili M, Neelathahalli Kasturirangan M. A clinical pharmacist-led integrated approach for evaluation of medication errors among medical inte…
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psnet.ahrq.gov/issue/residents-perspectives-acgme-regulation-supervision-and-duty-hours-national-survey
December 02, 2014 - Study
Residents' perspectives on ACGME regulation of supervision and duty hours—a national survey.
Citation Text:
Drolet BC, Spalluto LB, Fischer SA. Residents' perspectives on ACGME regulation of supervision and duty hours--a national survey. N Engl J Med. 2010;363(23):e34. doi:10.105…
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psnet.ahrq.gov/issue/what-can-we-learn-about-patient-safety-information-sources-within-acute-hospital-step-ladder
October 09, 2024 - Study
What can we learn about patient safety from information sources within an acute hospital: a step on the ladder of integrated risk management?
Citation Text:
Hogan H, Olsen S, Scobie S, et al. What can we learn about patient safety from information sources within an acute hospital…
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www.ahrq.gov/hai/tools/surgery/tools/applying-cusp/briefing-debriefing.html
December 01, 2017 - Briefing and Debriefing Tool
AHRQ Safety Program for Surgery
Introduction
Problem Statement
Surgical site infection (SSI) prevention remains a global public health priority. Patients in acute care hospitals underwent more than 16 million surgical procedures in the United States in 2010. 1 Usi…
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psnet.ahrq.gov/issue/identification-hospital-complications-claims-data-it-valid
June 13, 2011 - Study
Classic
Identification of in-hospital complications from claims data. Is it valid?
Citation Text:
Lawthers AG, McCarthy EP, Davis RB, et al. Identification of in-hospital complications from claims data. Is it valid? Med Care. 2000;38(8):785-95.
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psnet.ahrq.gov/issue/incidence-opioid-misuse-among-surgical-patients-persistent-opioid-use
October 13, 2018 - Study
The incidence of opioid misuse among the surgical patients with persistent opioid use.
Citation Text:
Namiranian, MD, PhD K. The incidence of opioid misuse among the surgical patients with persistent opioid use. J Opioid Manag. 2023;19(1):69-76. doi:10.5055/jom.2023.0760.
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/surgery/tools/applying-cusp/briefing_debriefing.docx
December 01, 2017 - Tool: Briefing and Debriefing Tool
Briefing and Debriefing Tool
Introduction
Problem Statement
Surgical site infection (SSI) prevention remains a global public health priority. Patients in acute care hospitals underwent more than 16 million surgical procedures in the United States in 2010.1 Using National Healthcare S…
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psnet.ahrq.gov/issue/preventing-potential-patient-harm-through-clinical-content-interventions-during-oncology
October 30, 2024 - Study
Preventing potential patient harm through clinical content interventions during oncology clinical trial implementation.
Citation Text:
Loo VC, Kim S, Johnson LM, et al. Preventing potential patient harm through clinical content interventions during oncology clinical trial implement…
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psnet.ahrq.gov/issue/impact-inpatient-electronic-prescribing-system-prescribing-error-causation-qualitative
February 16, 2022 - Study
Impact of an inpatient electronic prescribing system on prescribing error causation: a qualitative evaluation in an English hospital.
Citation Text:
Puaar SJ, Franklin BD. Impact of an inpatient electronic prescribing system on prescribing error causation: a qualitative evaluation …
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www.ahrq.gov/faqs/index.html?page=26
May 26, 2025 - Frequently Asked Questions
Check to find the answers to your questions about the Agency for Healthcare Research and Quality (AHRQ)
programs and activities. You can search by category or key words. You can also send us your questions or website
feedback here. We will respond to your requests based on the bes…
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psnet.ahrq.gov/issue/time-listen-review-methods-solicit-patient-reports-adverse-events
November 23, 2016 - Review
Time to listen: a review of methods to solicit patient reports of adverse events.
Citation Text:
King A, Daniels J, Lim J, et al. Time to listen: a review of methods to solicit patient reports of adverse events. Qual Saf Health Care. 2010;19(2):148-57. doi:10.1136/qshc.2008.0301…
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psnet.ahrq.gov/issue/academic-half-day-improves-resident-perception-education-without-compromising-patient-safety
April 10, 2024 - Study
Academic half day improves resident perception of education without compromising patient safety.
Citation Text:
Spence MC, Sugarman A, Uong A, et al. Academic half day improves resident perception of education without compromising patient safety. Acad Pediatr. 2024;24(6):1010-1016.…
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psnet.ahrq.gov/issue/7-year-analysis-attributable-costs-healthcare-associated-infections-network-community
April 24, 2018 - Study
A 7-year analysis of attributable costs of healthcare-associated infections in a network of community hospitals in the southeastern United States.
Citation Text:
Zhang HL, Crane L, Cromer AL, et al. A 7-year analysis of attributable costs of healthcare-associated infections in a ne…
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psnet.ahrq.gov/issue/diagnostic-accuracy-prehospital-triage-tools-identifying-major-trauma-elderly-injured
September 07, 2022 - Review
Diagnostic accuracy of prehospital triage tools for identifying major trauma in elderly injured patients: a systematic review.
Citation Text:
Fuller G, Pandor A, Essat M, et al. Diagnostic accuracy of prehospital triage tools for identifying major trauma in elderly injured patient…