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psnet.ahrq.gov/web-mm/missed-bowel-perforation-importance-diagnostic-reasoning
January 29, 2021 - 1 In this case, anchoring on fluid overload or heart failure likely led to neglecting nonconforming data … However, a lactate level >2mmol/L in the setting of sepsis is associated with increased risk of inpatient … 1 in every 3 hospital deaths are associated with sepsis, which continues to be the leading cause of inpatient … should be used in conjunction with bedside markers and laboratory assessments, not in lieu of those data … Incidence and trends of sepsis in US hospitals using clinical vs claims data, 2009-2014.
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psnet.ahrq.gov/primer/maternal-safety
January 10, 2024 - nationwide maternal safety movement with their early application of high reliability theory to the inpatient … Conditions (AIM) Cardiac Conditions in Obstetrical Care (AIM) Obstetric Hemorrhage (AIM) Postpartum Discharge … to identify and review complementary data to MMRC data from other population-based sources that may … Strengthen maternal mortality data. … NCHS Data Brief . 2023;(477):1-8. [ Free full text ] Births – Method of Delivery.
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psnet.ahrq.gov/perspective/conversation-lawrence-smith-md
February 01, 2012 - In many teaching hospitals, the hospitalist program has replaced the role of the inpatient ward attendings … In the past, hundreds of attending physicians who only occasionally took care of inpatients were a very … The number of minor mistakes is increased slightly, but the data also shows that the overall care of … patients shift-to-shift independently by the middle of their intern year but not to coordinate a complex discharge … How residents view their clinical supervision: a reanalysis of classic national survey data.
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psnet.ahrq.gov/node/60362/psn-pdf
April 13, 2018 - Case management/follow-up care: Hospital discharge data are used to generate lists of patients to
receive … RNs call postpartum patients within 24 hours of discharge and antepartum patients who
have been referred … conjunction with the UAMS
Women and Infants Service Line for nurses who have specialty experience with inpatient … Costs: Data on program costs are unavailable. … [PubMed] Data
updated January 2010 by ANGELS program developers.
2 Harvard University Government Innovators
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psnet.ahrq.gov/web-mm/poor-prognosis
March 15, 2016 - Data on physicians' prognostic accuracy primarily comes from studies of physicians caring for patients … Predicting life span for applicants to inpatient hospice.
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psnet.ahrq.gov/periodic-issue/periodic-issue-471
December 31, 2024 - This article describes the PFPS-US Artificial Intelligence Working Group's priority areas of concern: data … challenge of preventing falls and explores strategies for preventing falls and falls with injury in both inpatient
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psnet.ahrq.gov/web-mm/snfs-opening-black-box
August 27, 2012 - concerns about the level of care that could be provided, but they were told that the patient "didn't meet inpatient … Based on publicly available data, the quality of care in many SNFs appears to be improving ( 2 ), but … quality AHRQ Nursing Home Survey on Patient Safety Culture allows facilities to enter and benchmark data … 2011
WebM&M Cases
Treatment Challenges After Discharge
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psnet.ahrq.gov/node/866995/psn-pdf
October 30, 2024 - and decompression but
had persistent virtually complete paralysis below the C7 level upon hospital discharge … The Commentary
by Garth Utter, MD
Modern inpatient care is highly capable—but also highly complex—and … Tethered to the EHR: primary care physician workload
assessment using EHR event log data and time-motion … Thromboembolism after trauma: an analysis of 1602
episodes from the American College of Surgeons National Trauma Data
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psnet.ahrq.gov/perspective/medical-scribes-and-patient-safety
August 01, 2019 - New medical scribe exam keeps an eye on EHR data integrity. Xtelligent Healthcare Media. … In our inpatient practice, they usually have residents and fellows who can help with documentation, but … So this is just speculative, not based on data. … The impact of automated notification on follow-up of actionable tests pending at discharge … 2019
Impact of an automated email notification system for results of tests pending at discharge
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psnet.ahrq.gov/periodic-issue/periodic-issue-403
August 30, 2023 - Researchers and patient advocates have raised concerns about the accuracy of self-reported data on Care … Researchers and patient advocates have raised concerns about the accuracy of self-reported data on Care … Study
Parent experiences with the process of sharing inpatient safety concerns
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psnet.ahrq.gov/web-mm/novel-drug-misuse
September 30, 2010 - randomized trial of patients with sepsis but low risk of death (ADDRESS) was recently stopped by the Data … February 12, 2020
Medical large language models are vulnerable to data-poisoning attacks … February 13, 2019
A trigger tool to detect harm in pediatric inpatient settings.
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psnet.ahrq.gov/web-mm/no-news-may-not-be-good-news
December 07, 2009 - This process stretches the human limit for effective data management and likely degrades work performance … Missed hypothyroidism diagnosis uncovered by linking laboratory and pharmacy data. … March 1, 2023
Medical errors related to discontinuity of care from an inpatient to an
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psnet.ahrq.gov/web-mm/do-you-want-everything-done-clarifying-code-status
March 27, 2024 - In fact, the rate of surviving in-hospital CPR for cardiac arrest to the endpoint of hospital discharge … hospital-acquired methicillin-resistant Staphylococcus aureus: hospital-level analysis of administrative data … January 1, 2000
Hospital inpatient nutrition service errors and patient safety interventions … Related Resources
Association between hospital-reported Leapfrog Safe Practices scores and inpatient
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psnet.ahrq.gov/perspective/conversation-richard-kronick-phd
February 01, 2014 - report shows that there has been very little progress in reducing disparities, although the disparities data … Fourth, engaging patients and families in discharge planning throughout the hospital stay. … This particular resource is focused on inpatient hospital care. … A third tool is the Re-Engineered Discharge toolkit , or RED, which was designed to help hospitals reengineer … and improve their discharge process.
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psnet.ahrq.gov/primer/burnout
November 20, 2024 - Data increasingly support taking a systems perspective; for example, a recent meta-analysis concluded … WebM&M Cases
Be Picky about your PICCs—Fragmented Care and Poor Communication at Discharge … March 28, 2023
Shared understanding of resilient practices in the context of inpatient
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psnet.ahrq.gov/web-mm/cognitive-and-communication-blind-spot-contributes-permanent-paralysis
January 13, 2010 - and decompression but had persistent virtually complete paralysis below the C7 level upon hospital discharge … The Commentary by Garth Utter, MD Modern inpatient care is highly capable—but also highly complex—and … Tethered to the EHR: primary care physician workload assessment using EHR event log data and time-motion … Thromboembolism after trauma: an analysis of 1602 episodes from the American College of Surgeons National Trauma Data
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psnet.ahrq.gov/glossary
January 01, 2003 - Adverse Events after Hospital Discharge View Patient Safety Primer
See Primer . … Nearly 20% of patients experience an adverse event in the first 3 weeks after discharge, including medication … , performance or outcomes data. … with atypical chest pain from the emergency department, you might step back and consider how much the discharge … More recent structural measures include the adoption of organizational models for inpatient care (e.g
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psnet.ahrq.gov/glossary-0
January 01, 2003 - View Patient Safety Primer
Adverse Events after Hospital Discharge
See Primer … Nearly 20% of patients experience an adverse event in the first 3 weeks after discharge, including medication … , performance or outcomes data. … with atypical chest pain from the emergency department, you might step back and consider how much the discharge … More recent structural measures include the adoption of organizational models for inpatient care (e.g
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psnet.ahrq.gov/node/49657/psn-pdf
July 01, 2012 - required residents to perform and document 5 procedures to be considered competent.(
19) However, after data … scheduling an IR procedure can
potentially increase hospital days and overall patient costs (unpublished data … Impact of a bedside procedure service on general medicine
inpatients: a firm-based trial.
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psnet.ahrq.gov/web-mm/not-so-therapeutic-tap
December 01, 2014 - required residents to perform and document 5 procedures to be considered competent.( 19 ) However, after data … scheduling an IR procedure can potentially increase hospital days and overall patient costs (unpublished data … Impact of a bedside procedure service on general medicine inpatients: a firm-based trial.