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psnet.ahrq.gov/issue/why-dont-we-know-whether-care-safe
January 14, 2014 - Commentary
Why don't we know whether care is safe?
Citation Text:
Pham JC, Frick KD, Pronovost P. Why don't we know whether care is safe? Am J Med Qual. 2013;28(6):457-63. doi:10.1177/1062860613479397.
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digital.ahrq.gov/track-6-using-reporting-systems-safety-and-quality-improvement
January 01, 2023 - This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: https://digital.ahrq.gov/contact-us . Let us know th…
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psnet.ahrq.gov/issue/effect-computerisation-quality-and-safety-chemotherapy-prescription
December 29, 2014 - Study
Effect of computerisation on the quality and safety of chemotherapy prescription.
Citation Text:
Voeffray M, Pannatier A, Stupp R, et al. Effect of computerisation on the quality and safety of chemotherapy prescription. Qual Saf Health Care. 2006;15(6):418-21.
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psnet.ahrq.gov/issue/factors-influencing-patient-safety-during-postoperative-handover
March 03, 2021 - Review
Factors influencing patient safety during postoperative handover.
Citation Text:
Factors influencing patient safety during postoperative handover. Rose M, Newman SD. AANA J. 2016;84:329-338.
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psnet.ahrq.gov/issue/effective-approaches-control-non-actionable-alarms-and-alarm-fatigue
January 15, 2025 - Commentary
Effective approaches to control non-actionable alarms and alarm fatigue.
Citation Text:
Winters BD. Effective approaches to control non-actionable alarms and alarm fatigue. J Electrocardiol. 2018;51(6S):S49-S51. doi:10.1016/j.jelectrocard.2018.07.007.
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psnet.ahrq.gov/issue/tapping-front-line-knowledge-identifying-problems-they-occur-helps-enhance-patient-safety
July 21, 2009 - Newspaper/Magazine Article
Tapping front-line knowledge: identifying problems as they occur helps enhance patient safety.
Citation Text:
Luther K, Resar RK. Tapping front-line knowledge: identifying problems as they occur helps enhance patient safety. Healthcare executive. 2013;28(1):84-…
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psnet.ahrq.gov/issue/patient-safety-planting-seed
February 09, 2011 - Commentary
Patient safety: planting the seed.
Citation Text:
Poe SS. Patient safety: planting the seed. J Nurs Care Qual. 2005;20(3):198-202.
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psnet.ahrq.gov/issue/meaning-justice-safety-incident-reporting
April 11, 2011 - Commentary
The meaning of justice in safety incident reporting.
Citation Text:
Weiner BJ, Hobgood C, Lewis MA. The meaning of justice in safety incident reporting. Soc Sci Med. 2008;66(2):403-13.
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www.ahrq.gov/policymakers/chipra/demoeval/what-we-learned/finalsummary/finalsummary7.html
September 01, 2015 - Key Lessons from the National Evaluation of the CHIPRA Quality Demonstration Grant Program
Using Federal grants to build intellectual capital at the State level
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Table of Contents
Key Lessons from the National Evaluation of the CHIPRA Quality Demonstration Grant Program
Intr…
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psnet.ahrq.gov/issue/patient-safety-rounds-description-inexpensive-important-strategy-improve-safety-culture
December 15, 2008 - Commentary
Patient safety rounds: description of an inexpensive but important strategy to improve the safety culture.
Citation Text:
Campbell D, Thompson M. Patient safety rounds: description of an inexpensive but important strategy to improve the safety culture. Am J Med Qual. 2007;22…
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psnet.ahrq.gov/issue/patient-safety-during-anaesthesia-incorporation-who-safe-surgery-guidelines-clinical-practice
September 20, 2011 - Review
Patient safety during anaesthesia: incorporation of the WHO safe surgery guidelines into clinical practice.
Citation Text:
Schlack WS, Boermeester MA. Patient safety during anaesthesia: incorporation of the WHO safe surgery guidelines into clinical practice. Curr Opin Anaesthesi…
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psnet.ahrq.gov/issue/edgeware-insights-complexity-science-health-care-leaders
June 23, 2021 - Book/Report
Edgeware: Insights from Complexity Science for Health Care Leaders. Second ed.
Citation Text:
Edgeware: Insights from Complexity Science for Health Care Leaders. Second ed. Zimmerman B, Lindberg C, Plsek P. Irving, TX: VHA Incorporated; 2008. ISBN: 9780966782806
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www.ahrq.gov/practiceimprovement/systemdesign/leancasestudies/lean-exhibit5-4.html
November 01, 2014 - Improving Care Delivery Through Lean: Implementation Case Studies
Exhibit 5.4. Chronology of Quality Improvement (QI) and Lean at Heights Hospital
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Improving Care Delivery Through Lean: Implementation Case Studies
Introduction to the Case Studies
Case 1. …
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psnet.ahrq.gov/issue/clinical-decision-support-and-malpractice-risk
September 24, 2017 - Commentary
Clinical decision support and malpractice risk.
Citation Text:
Greenberg MD, Ridgely MS. Clinical Decision Support and Malpractice Risk. JAMA. 2011;306(1). doi:10.1001/jama.2011.929.
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psnet.ahrq.gov/issue/rapid-response-systems-should-we-still-question-their-implementation
January 06, 2017 - Commentary
Rapid response systems: should we still question their implementation?
Citation Text:
Winters BD, Pronovost P. Rapid response systems: should we still question their implementation? J Hosp Med. 2013;8(5):278-81. doi:10.1002/jhm.2050.
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psnet.ahrq.gov/issue/rapid-response-teams-whats-latest
December 12, 2012 - Commentary
Rapid response teams: what's the latest?
Citation Text:
Jackson SA. Rapid response teams: What's the latest? Nursing (Brux). 2017;47(12):34-41. doi:10.1097/01.NURSE.0000526885.10306.21.
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www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/chronic/chipra-0232-technicalspecs.pdf
June 02, 2025 - Hypertension Screening for Children Who Are Overweight or Obese: Technical Specifications
The percentage of children aged 3 through 17 years with an outpatient care visit and a BMI ≥85th
percentile who had a blood pressure percentile documented and classified as normal or abnormal during
the measure…
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psnet.ahrq.gov/issue/rethinking-peer-review-what-aviation-can-teach-radiology-about-performance-improvement
July 01, 2017 - Commentary
Rethinking peer review: what aviation can teach radiology about performance improvement.
Citation Text:
Larson DB, Nance JJ. Rethinking peer review: what aviation can teach radiology about performance improvement. Radiology. 2011;259(3):626-32. doi:10.1148/radiol.11102222.
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psnet.ahrq.gov/issue/spectrum-medical-errors-when-patients-sue
October 28, 2020 - Review
The spectrum of medical errors: when patients sue.
Citation Text:
Grant-Kels J, Kels B. The spectrum of medical errors: when patients sue. Int J Gen Med. 2012. doi:10.2147/ijgm.s24257.
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psnet.ahrq.gov/issue/covid-19-focused-inspection-initiative-healthcare
April 01, 2024 - Press Release/Announcement
COVID-19 Focused Inspection Initiative in Healthcare.
Citation Text:
COVID-19 Focused Inspection Initiative in Healthcare. Occupational Safety and Health Administration. March 2, 2022.
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