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1501. Module 2: How To Manage Change | Agency for Healthcare Research and Quality
      www.ahrq.gov/patient-safety/settings/hospital/resource/pressureinjury/workshop/guide2.html
      October 01, 2017 - tasks for Key Intervention 1: Analyze current state of pressure injury prevention practices at this institution

1502. Module 2: How To Manage Change (doc file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/pressure_ulcer_prevention/module2/module2_managingchange.docx
      June 02, 2025 - tasks for Key Intervention 1: Analyze current state of pressure injury prevention practices at this institution

1503. 103-How-To-Integrate-Cusp-Approach-Periop-Fg (doc file)
      www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/mrsa-2/103-how-to-integrate-cusp-approach-periop-fg.docx
      April 01, 2025 - The structure of the CUSP Team should reflect your institution ‘s workflow and resources.

1504. Meeting Minutes, November 2017 | Agency for Healthcare Research and Quality
      www.ahrq.gov/news/events/nac/2017-11-nac/nacmtg1117-minutes.html
      February 01, 2018 - Will the institution decide to continue the new operations? Dr.

1505. Imbedding Research in Practice to Improve Medication Safety (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol4/Advances-Raebel_53.pdf
      May 07, 2008 - Imbedding Research in Practice to Improve Medication Safety Imbedding Research in Practice to Improve Medication Safety Marsha A. Raebel, PharmD; Elizabeth A. Chester, PharmD; David W. Brand, MSPH; David J. Magid, MD, MPH Abstract Objective: The objective of this project was to improve medication saf…

1506. Final Progress Report: Chronic Care Technology Planning Project (pdf file)
      www.ahrq.gov/sites/default/files/2024-07/branscombe-report.pdf
      January 01, 2024 - Final Progress Report: Chronic Care Technology Planning Project Chronic Care Technology Planning Project John M. Branscombe, Jr., MSB, Principal Investigator Team Members and Organizations: David Peterson, President/CEO, The Aroostook Medical Center, Presque Isle, Maine Joy Barresi-Saucier, RN, The Aroostook Medic…

1507. Implementing Shared Decision-Making: Barriers and Solutions—An Orthopedic Case Study | Agency for Healthcare Research and Quality
      www.ahrq.gov/patient-safety/reports/liability/mincer.html
      August 01, 2017 - Advances in Patient Safety and Medical Liability Implementing Shared Decision-Making: Barriers and Solutions—An Orthopedic Case Study Previous Page Next Page Table of Contents Advances in Patient Safety and Medical Liability Preface Acknowledgments Prologue Silence A Commentary Reforming t…

1508. Quantitative and Qualitative Analysis of Medication Errors: The New York Experience (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol1/Duthie.pdf
      January 01, 2004 - Quantitative and Qualitative Analysis of Medication Errors: The New York Experience 131 Quantitative and Qualitative Analysis of Medication Errors: The New York Experience Elizabeth Duthie, Barbara Favreau, Angelo Ruperto, Janet Mannion, Ellen Flink, Ruth Leslie Abstract Objectives: In June 2000, the New Yo…

1509. VHA’s National Falls Collaborative and Prevention Programs (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol2/Advances-Stalhandske2_70.pdf
      March 01, 2006 - VHA’s National Falls Collaborative and Prevention Programs VHA’s National Falls Collaborative and Prevention Programs Erik Stalhandske, MPP, MHSA; Peter Mills, PhD; Pat Quigley, PhD, ARNP, CRRN, FAAN; Julia Neily, MS, MPH; James P. Bagian, MD, PE Abstract Falls are a high-volume, high-cost problem in he…

1510. Proactive Postmarketing Surveillance: Overview and Lessons Learned from Medication Safety Research in the Veterans Health Administration (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol1/Advances-Campbell-R_106.pdf
      April 14, 2008 - Proactive Postmarketing Surveillance: Overview and Lessons Learned from Medication Safety Research in the Veterans Health Administration Proactive Postmarketing Surveillance: Overview and Lessons Learned from Medication Safety Research in the Veterans Health Administration Robert R. Campbell, JD, MPH, PhD; An…

1511. News Media and Health Care Providers at the Crossroads of Medical Adverse Events (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol1/Advances-Whitten_85.pdf
      June 05, 2008 - News Media and Health Care Providers at the Crossroads of Medical Adverse Events News Media and Health Care Providers at the Crossroads of Medical Adverse Events Pamela Whitten, PhD; Mohan J. Dutta, PhD; Serena Carpenter, PhD; Graham D. Bodie Abstract In 2005, Indiana Governor Mitch Daniels issued an executi…

1512. Beyond Nursing Quality Measurement: The Nation’s First Regional Nursing Virtual Dashboard (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol1/Advances-Aydin_2.pdf
      January 01, 2021 - Beyond Nursing Quality Measurement: The Nation’s First Regional Nursing Virtual Dashboard rds Beyond Nursing Quality Measurement: The Nation’s First Regional Nursing Virtual Dashboard Carolyn E. Aydin, PhD; Linda Burnes Bolton, DrPH, RN, FAAN; Nancy Donaldson, DNSc, RN, FAAN; Diane Storer Brown, PhD, RN, FN…

1513. What Exactly Is Patient Safety? (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol1/Advances-Emanuel-Berwick_110.pdf
      July 02, 2008 - the “Swiss cheese” model of accident causation.19 The components that make up the system include the institution

1514. Final Progress Report: Immersive Simulation for Design and Evaluation of an Emergency Department IT System (pdf file)
      www.ahrq.gov/sites/default/files/2025-05/bisantz-report.pdf
      January 01, 2025 - Final Progress Report: Immersive Simulation for Design and Evaluation of an Emergency Department IT System Immersive Simulation for Design and Evaluation of an Emergency Department IT System Principal Investigator: Ann Bisantz, PhD1 Co-Investigators: Rollin J. Terry Fairbanks, MD1, 2,5 Li Lin, PhD1 A. Zachary He…

1515. Meeting Minutes, March 2021 | Agency for Healthcare Research and Quality
      www.ahrq.gov/news/events/nac/2021-03-nac/nacmtg031821-minutes.html
      July 01, 2021 - Meeting Minutes, March 2021 Virtual Meeting Minutes from the March 18, 2021, virtual meeting of the Agency for Healthcare Research and Quality's National Advisory Council. Contents Summary Call to Order and Approval of November 10, 2020, Meeting Summary Recent AHRQ Accomplishments Update on AHRQ Bud…

1516. 26,000 Close Call Reports: Lessons from the University of Texas Close Call Reporting System (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol1/Advances-Simmons_66.pdf
      April 03, 2008 - 26,000 Close Call Reports: Lessons from the University of Texas Close Call Reporting System 26,000 Close Call Reports: Lessons from the University of Texas Close Call Reporting System Debora Simmons, RN, MSN, CCRN, CCNS; JoAnn Mick, PhD, RN, MBA, AOCN, CNAA, BC; Krisanne Graves, RN, BSN, CPHQ; Sharon K. Martin, ME…

1517. Risk Reduction and Systematic Error Management: Standardization of the Pediatric Chemotherapy Process (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol2/Advances-David_13.pdf
      March 19, 2008 - Risk Reduction and Systematic Error Management: Standardization of the Pediatric Chemotherapy Process Risk Reduction and Systematic Error Management: Standardization of the Pediatric Chemotherapy Process Beverly Ann David, PhD; Ana Rodriguez, PharmD; Stanley W. Marks, MD Abstract There is an urgent need to m…

1518. Making a Case for Organizational Change in Patient Safety Initiatives (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol2/Ramanujam.pdf
      January 01, 2003 - Making a Case for Organizational Change in Patient Safety Initiatives 455 Making a Case for Organizational Change in Patient Safety Initiatives Rangaraj Ramanujam, Donna J. Keyser, Carl A. Sirio Abstract Objectives: Widespread organizational change is indispensable for significantly improved patient safety…

1519. HHS AHRQ Freedom of Information Annual Report - FY 2008 | Agency for Healthcare Research and Quality
      www.ahrq.gov/policy/foia/foiafy08.html
      October 01, 2014 - HHS AHRQ Freedom of Information Annual Report - FY 2008 Freedom of Information Act Annual Report for Fiscal Year 2008. I. Agency: Agency for Healthcare Research and Quality (AHRQ) Report Prepared by: Nancy Comfort (no longer at AHRQ) Title: Freedom of Information Officer Address:   5600 Fishers Lane,…

1520. AHRQ Safety Program for Perinatal Care: Monitoring for Perinatal Safety: Electronic Fetal Monitoring
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/strategies/safe-electronic/e-fetal-monitoring.pptx
      May 01, 2017 - AHRQ Safety Program for Perinatal Care: Monitoring for Perinatal Safety: Electronic Fetal Monitoring AHRQ Safety Program for Perinatal Care Monitoring for Perinatal Safety: Electronic Fetal Monitoring AHRQ Publication No. 17-0003-18-EF May 2017 1 Learning Objectives 2 AHRQ Safety Program for Perinatal Care Elect…