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psnet.ahrq.gov/node/850361/psn-pdf
June 14, 2023 - Critical Echocardiogram Result Lost to Follow-up
June 14, 2023
Boctor N, Molla M. Critical Echocardiogram Result Lost to Follow-up. PSNet [internet]. 2023.
https://psnet.ahrq.gov/web-mm/critical-echocardiogram-result-lost-follow
The Case
A 63-year-old man with history of stroke, systolic heart failure, and ventric…
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psnet.ahrq.gov/node/846975/psn-pdf
March 28, 2023 - In Conversation with... Christie Allen about Maternal
Safety and Perinatal Mental Health
March 28, 2023
In Conversation with.. Christie Allen about Maternal Safety and Perinatal Mental Health. PSNet [internet].
2023.
https://psnet.ahrq.gov/perspective/conversation-christie-allen-about-maternal-safety-and-perinatal…
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digital.ahrq.gov/sites/default/files/docs/publication/r13hs021925-pratt-final-report-2013.pdf
January 01, 2013 - Workshop on Interactive Systems in Healthcare (WISH) 2012 - Final Report
Small Grant Program for Conference Support (R13)
AHRQ Grant Final Progress Report
Title of Project: Workshop on Interactive Systems in Healthcare (WISH) 2012
Principal Investigator: Wanda Pratt, PhD …
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psnet.ahrq.gov/perspective/conversation-jeffrey-shuren-md-jd
May 28, 2020 - In Conversation With... Jeffrey Shuren, MD, JD
May 28, 2020
Also Read the Essay
Citation Text:
In Conversation With.. Jeffrey Shuren, MD, JD. PSNet [internet]. 2020.In Conversation With... Jeffrey Shuren, MD, JD. PSNet [internet]. Rockville (MD): Agency for Healt…
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www.ahrq.gov/research/findings/factsheets/children/new-starts/2011.html
October 01, 2014 - Fiscal Year 2011 Research on Child and Adolescent Health
New Starts
This fact sheet summarizes new grants and contracts focused on child and adolescent health and health care—including research, conference, and training projects, as well as other initiatives—funded in FY 2011 by the Agency for Hea…
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psnet.ahrq.gov/node/867497/psn-pdf
February 26, 2025 - Retained Surgical Items: Causation and Prevention
February 26, 2025
Gibbs V, Romano P. Retained Surgical Items: Causation and Prevention. PSNet [internet]. 2025.
https://psnet.ahrq.gov/primer/retained-surgical-items-causation-and-prevention
Background
A retained surgical item (RSI) is a surgical patient safety pro…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/cusp/actionplan-trip-facguide.docx
January 01, 2017 - Facilitator Guide: Build Your SSI Prevention Bundle
Slide Title and Commentary
Slide Number and Slide
Title Slide
Action Plan for Translating Research Into Practice: Gap Analysis and Tests of Change
SAY:
This module will cover the Translating Research Into Practice (TRIP) framework. The TRIP framework lets us dig…
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www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/perinatal-care-2/hypertension_2-team-structure.pptx
July 01, 2023 - Team Structure and Assembly - PowerPoint Presentation
Team Structure and Assembly
Module 2 of 8
SPPC-II
Toolkit
AHRQ Pub. No. 23-0046
July 2023
Hospital AIM Team
Leads
SPPC-II
SCRIPT
Thank you for participating in the Safety Program for Perinatal Care II (also known as SPPC-II) Teamwork Toolkit presented by the …
-
www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/perinatal-care-2/hypertension_2-team-structure-speaker-notes.pdf
July 01, 2023 - Team Structure and Assembly
Hospital AIM
Team
Leads
SPPC‐II
Team Structure and Assembly
Module 2 of 8
SPPC‐II
Toolkit
SCRIPT
Thank you for participating in the Safety Program for Perinatal Care II (also known as SPPC‐
II) Teamwork Toolkit presented by the Johns Hopkins University, Agency for Healthcare
Re…
-
www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/perinatal-care-2/hemorrhage_2-team-structure-speaker-notes.pdf
July 01, 2023 - Team Structure and Assembly
SPPC‐II
Toolkit
Hospital AIM
Team
Leads
SPPC II
Team Structure and Assembly
Module 2 of 8
‐
SCRIPT
Thank you for participating in the Safety Program for Perinatal Car…
-
www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/perinatal-care-2/hemorrhage_2-team-structure.pptx
July 01, 2023 - Team Structure and Assembly - PowerPoint Presentation
Team Structure and Assembly
Module 2 of 8
SPPC-II
Toolkit
AHRQ Pub. No. 23-0046
July 2023
Hospital AIM Team
Leads
SPPC-II
SCRIPT
Thank you for participating in the Safety Program for Perinatal Care II (also known as SPPC-II) Teamwork Toolkit presented by the …
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www.ahrq.gov/patient-safety/settings/hospital/resource/pressureinjury/guide/apf.html
October 01, 2017 - They identified innovative and inspiring solutions to overcome these obstacles and decrease pressure
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cdsic.ahrq.gov/sites/default/files/2024-07/Final%20MO%20Patient%20Prioritization%20of%20Measurement%20Areas%207.18.24.pdf
January 01, 2024 - Patient Prioritization of Measurement Areas for Patient-Centered Clinical Decision Support
Measurement and Outcomes
Workgroup: Patient Prioritization
of Measurement Areas for Patient-
Centered Clinical Decision Support
Agency for Healthcare Research and Quality
5600 Fishers Lane
Rockville, MD 20…
-
digital.ahrq.gov/sites/default/files/Final%20MO%20Patient%20Prioritization%20of%20Measurement%20Areas%207.18.24.pdf
July 01, 2024 - Patient Prioritization of Measurement Areas for Patient-Centered Clinical Decision Support
Measurement and Outcomes
Workgroup: Patient Prioritization
of Measurement Areas for Patient-
Centered Clinical Decision Support
Agency for Healthcare Research and Quality
5600 Fishers Lane
Rockville, MD 20…
-
www.ahrq.gov/sites/default/files/2024-01/scott-cawiezell-report.pdf
January 01, 2024 - Final Progress Report: Technology To Improve Medication Safety in Nursing Homes
Nursing Home Medication Safety 1
Technology to Improve Medication Safety in Nursing Homes
Jill Scott-Cawiezell, PhD
Principal Investigator
Marilyn Rantz, PhD, Lanis Hicks, PhD, Richard Madsen, PhD, & Greg Petroski, PhD
Investigators
…
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www.ahrq.gov/sites/default/files/wysiwyg/sops/surveys/hospital/hospitalresourcelist.pdf
January 01, 2019 - Improving Patient Safety in Hospitals: A Resource List for Users of the AHRQ Hospital Survey on Patient Safety Culture
Improving Patient Safety in Hospitals: A Resource List
for Users of the AHRQ Hospital Survey on Patient
Safety Culture
I. Purpose
This document provides a list of references to websites and othe…
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www.ahrq.gov/sites/default/files/2025-03/blike-report.pdf
January 01, 2025 - Final Progress Report: Failure To Rescue-Patient Safety Learning Lab (FTR-PSLL)
Title of Project: Failure to Rescue-Patient Safety Learning Lab (FTR-PSLL)
Principal Investigator and Team Members:
Dartmouth-Hitchcock: George Blike, MD, MHCDS, PI; Susan McGrath, PhD, CoI; Todd McKenzie, PhD;
Irina Pearrard, PhD…
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psnet.ahrq.gov/perspective/surveillance-monitoring-improve-patient-safety-acute-hospital-care-units
April 26, 2023 - Future Directions
Surveillance monitoring is a promising and innovative approach to preventing failure
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www.ahrq.gov/sites/default/files/wysiwyg/patient-safety/highlights/ps-project-highlights-medication-safety.pdf
April 30, 2025 - Report
Purpose: Evaluate adaptation in non-Veterans Affairs health systems of the EQUIPPED
program, an innovative … learning laboratory that brings together older adults,
caregivers, researchers, and healthcare teams in innovative … clinicians and researchers encountered
related to pediatric medication safety research and identified innovative … the RC
created a research core that supported clinicians and scientists in developing and testing
innovative … MedSafeMap is an innovative approach that
pharmacists and pharmacy technicians will use to better navigate
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/pressure_ulcer_prevention/pu_training-impguide.docx
October 01, 2017 - Needlessly limit the team’s ability to plan and conduct innovative small tests of change with formal … Advisory Panel (NPUAP) Clinical Practice Guidelines specific to nutrition in wound healing and examines innovative … They identified innovative and inspiring solutions to overcome these obstacles and decrease pressure