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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/60162/psn-pdf
    March 25, 2020 - Patient Safety Improvement Act of 2020. March 25, 2020 SB 3380. 116th Congress (2020). https://psnet.ahrq.gov/issue/patient-safety-improvement-act-2020 This bill submits amendments to existing US federal law to strengthen state-organized efforts to improve health care-associated infection control efforts, pediatri…
  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42213/psn-pdf
    April 17, 2013 - Quality: performance improvement, teamwork, information technology and protocols. April 17, 2013 Coleman NE, Pon S. Quality: performance improvement, teamwork, information technology and protocols. Crit Care Clin. 2013;29(2):129-51. doi:10.1016/j.ccc.2012.11.002. https://psnet.ahrq.gov/issue/quality-performance-im…
  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/837708/psn-pdf
    July 20, 2022 - Without question. July 20, 2022 Liebowitz J. Without Question. N Engl J Med. 2022;386(26):2456-2457. doi:10.1056/nejmp2204361. https://psnet.ahrq.gov/issue/without-question Diagnostic errors caused by premature closure and anchoring bias occur when clinicians rely on initial diagnosis despite receiving subsequent …
  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/45064/psn-pdf
    April 20, 2016 - Making Care Safer. April 20, 2016 Agency for Healthcare Research and Quality. Priorities in Focus. March 2016. https://psnet.ahrq.gov/issue/making-care-safer The National Quality Strategy is part of AHRQ's ongoing efforts to enhance patient safety. This brief summarizes the results of the Partnership for Patients …
  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/50668/psn-pdf
    November 13, 2019 - Case Study Webinar Series on Clinician Burnout: The Ohio State University November 13, 2019 NAM Action Collaborative on Clinician Well-Being and Resilience. Case Study Webinar Series on Clinician Burnout: The Ohio State University. National Academies of Medicine. https://psnet.ahrq.gov/issue/case-study-webinar-ser…
  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44583/psn-pdf
    February 17, 2016 - Root Cause Analysis Playbook. February 17, 2016 Chicago, IL: American Society for Healthcare Risk Management; 2015. https://psnet.ahrq.gov/issue/root-cause-analysis-playbook Risk management has recently focused on organization-wide improvement in patient safety. This publication discusses root cause analysis metho…
  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/35034/psn-pdf
    November 05, 2015 - Seven Leadership Leverage Points for Organization-Level Improvement in Health Care. Second edition. November 5, 2015 Reinertsen JL, Bisognano M, Pugh MD. Cambridge, MA: Institute for Healthcare Improvement; 2008. https://psnet.ahrq.gov/issue/seven-leadership-leverage-points-organization-level-improvement-health-car…
  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/35555/psn-pdf
    January 05, 2017 - A comprehensive grassroots model for statewide safety improvement. January 5, 2017 Joshi MS, Kazandjian VA, Martin P, et al. A comprehensive grassroots model for statewide safety improvement. Jt Comm J Qual Patient Saf. 2005;31(12):671-677. https://psnet.ahrq.gov/issue/comprehensive-grassroots-model-statewide-safe…
  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/38685/psn-pdf
    August 18, 2010 - HomeNet: ensuring patient safety with medical device use in the home. August 18, 2010 Kaufman D, Weick-Brady M. HomeNet: ensuring patient safety with medical device use in the home. Home Healthc Nurse. 2009;27(5):300-7. https://psnet.ahrq.gov/issue/homenet-ensuring-patient-safety-medical-device-use-home This arti…
  10. www.ahrq.gov/opioids/about.html
    August 01, 2021 - About AHRQ's Work on Opioids and Substance Use Disorders Deaths from drug overdoses have risen steadily over the past two decades and have become a leading cause of injury death in the United States. The rise in drug overdose deaths was initially driven by misuse of prescription opioids but is now also fueled …
  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/37557/psn-pdf
    February 27, 2008 - Learning from patient safety incidents: creating participative risk regulation in healthcare. February 27, 2008 Macrae C. Learning from patient safety incidents: Creating participative risk regulation in healthcare. Health Risk Soc. 2008;10(1). doi:10.1080/13698570701782452. https://psnet.ahrq.gov/issue/learning-p…
  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44071/psn-pdf
    November 16, 2015 - Quality Improvement in Neurosurgery. November 16, 2015 Rolston JD, Han SJ, Parsa AT, eds. Neurosurg Clin N Am. 2015;26(2):143-322. https://psnet.ahrq.gov/issue/quality-improvement-neurosurgery This special issue covers elements of safe care delivery in neurosurgery and features articles exploring the use of simula…
  13. digital.ahrq.gov/funding-mechanism/accelerating-change-and-transformation-organizations-and-networks-action-iv
    January 01, 2023 - Accelerating Change and Transformation in Organizations and Networks (ACTION) IV Clinical Decision Support Innovation Collaborative (CDSiC) Description This research continues to build the Clinical Decision Support Innovation Collaborative (CDSiC) to advance the field of pat…
  14. psnet.ahrq.gov/training-catalog/leading-healthcare-quality-and-safety
    August 11, 2025 - Leading Healthcare Quality and Safety Save Save to your library Print Share Facebook Twitter Linkedin Copy URL Organization: Organization Coursera Event Description: Ensuring patient safety and…
  15. effectivehealthcare.ahrq.gov/sites/default/files/related_files/cer-253-maternal-child-outcomes-wic-executive-summary.pdf
    April 01, 2022 - Executive Summary_Comparative Effectiveness Review No. 253: Maternal and Child Outcomes Associated With the Special Supplemental Nutritional Program for Women, Infants, and Children (WIC) Comparative Effectiveness Review Number 253 Maternal and Child Outcomes Associated With the Special Supplemental Nutritional P…
  16. psnet.ahrq.gov/web-mm/listen-family
    April 15, 2015 - Listen to the Family Citation Text: Campbell D. Listen to the Family. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2004. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId…
  17. psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.263_slideshow.ppt
    March 01, 2012 - Spotlight Case July 2008 Spotlight Case Postdischarge Follow-Up Phone Call * * Source and Credits This presentation is based on the March 2012 AHRQ WebM&M Spotlight Case See the full article at http://webmm.ahrq.gov CME credit is available Commentary by: Michelle Mourad, MD, and Stephanie Rennke, MD; Divi…
  18. www.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/statesummaries/chipra-750-maine-state-snapshot.pdf
    January 01, 2018 - Spotlight on Maine -- The National Evaluation of the CHIPRA Quality Demonstration Grant Program January 2018 This brief highlights the major strategies, lessons learned, and outcomes from Maine’s experience from February 2010 to February 2016 with the quality demonstration funded by the Centers for Medicare & Med…
  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33633/psn-pdf
    May 01, 2006 - Patient Safety in the Physician Office Setting May 1, 2006 Elder NC. Patient Safety in the Physician Office Setting. PSNet [internet]. 2006. https://psnet.ahrq.gov/perspective/patient-safety-physician-office-setting Perspective Dr. Jones was sure he had increased Mr. H's cholesterol-lowering medication to 80 mg 6 …
  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49746/psn-pdf
    October 01, 2015 - An Obstructed View October 1, 2015 Carter J. An Obstructed View. PSNet [internet]. 2015. https://psnet.ahrq.gov/web-mm/obstructed-view The Case A 66-year-old man with a history of benign prostatic hyperplasia and obstructive sleep apnea presented to the emergency department (ED) with subacute abdominal pain that …