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psnet.ahrq.gov/node/38354/psn-pdf
September 24, 2010 - Barriers to emergency departments' adherence to four
medication safety–related Joint Commission National
Patient Safety Goals.
September 24, 2010
Juarez A, Gacki-Smith J, Bauer MR, et al. Barriers to emergency departments' adherence to four
medication safety-related Joint Commission National Patient Safety Goals. …
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psnet.ahrq.gov/node/39970/psn-pdf
January 22, 2017 - Hospital board checklist to improve culture and reduce
central line–associated bloodstream infections.
January 22, 2017
Goeschel CA, Holzmueller CG, Pronovost P. Hospital Board Checklist to improve culture and reduce
central line-associated bloodstream infections. Jt Comm J Qual Patient Saf. 2010;36(11):525-8.
htt…
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psnet.ahrq.gov/node/43063/psn-pdf
May 01, 2015 - More Than 1,000 Preventable Deaths a Day Is Too Many:
The Need to Improve Patient Safety.
May 1, 2015
Hearing Before the Subcommittee on Primary Health and Aging, 113th Cong (July 17, 2014).
https://psnet.ahrq.gov/issue/more-1000-preventable-deaths-day-too-many-need-improve-patient-safety
A group of patient safety…
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psnet.ahrq.gov/node/38455/psn-pdf
January 02, 2017 - Clinical triggers: an alternative to a rapid response team.
January 2, 2017
Moldenhauer K, Sabel A, Chu ES, et al. Clinical triggers: an alternative to a rapid response team. Jt Comm
J Qual Patient Saf. 2009;35(3):164-74.
https://psnet.ahrq.gov/issue/clinical-triggers-alternative-rapid-response-team
A national cam…
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psnet.ahrq.gov/node/42396/psn-pdf
July 31, 2013 - Developing and implementing a standardized process for
Global Trigger Tool application across a large health
system.
July 31, 2013
Garrett PR, Sammer C, Nelson A, et al. Developing and implementing a standardized process for global
trigger tool application across a large health system. Jt Comm J Qual Saf. 2013;39(…
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psnet.ahrq.gov/node/46343/psn-pdf
March 21, 2018 - Outpatient CPOE orders discontinued due to 'erroneous
entry': prospective survey of prescribers' explanations for
errors.
March 21, 2018
Hickman T-TT, Quist AJL, Salazar A, et al. Outpatient CPOE orders discontinued due to 'erroneous entry':
prospective survey of prescribers' explanations for errors. BMJ Qual Saf.…
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psnet.ahrq.gov/node/38616/psn-pdf
June 08, 2009 - Cost and workforce implications of subjecting all
physicians to aviation industry work-hour restrictions.
June 8, 2009
Payette M, Chatterjee A, Weeks WB. Cost and workforce implications of subjecting all physicians to
aviation industry work-hour restrictions. Am J Surg. 2009;197(6):820-5; discussion 826-7.
doi:1…
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psnet.ahrq.gov/node/46112/psn-pdf
December 21, 2017 - Analysis of variations in the display of drug names in
computerized prescriber-order-entry systems.
December 21, 2017
Quist AJL, Hickman T-TT, Amato MG, et al. Analysis of variations in the display of drug names in
computerized prescriber-order-entry systems. American Journal of Health-System Pharmacy. 2017;74(7).
…
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psnet.ahrq.gov/node/44056/psn-pdf
May 19, 2018 - Impact of inpatient harms on hospital finances and
patient clinical outcomes.
May 19, 2018
Adler L, Yi D, Li M, et al. Impact of Inpatient Harms on Hospital Finances and Patient Clinical Outcomes. J
Patient Saf. 2018;14(2):67-73. doi:10.1097/PTS.0000000000000171.
https://psnet.ahrq.gov/issue/impact-inpatient-harms…
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psnet.ahrq.gov/node/38628/psn-pdf
May 13, 2009 - Fast forward rounds: an effective method for teaching
medical students to transition patients safely across care
settings.
May 13, 2009
Ouchida K, LoFaso VM, Capello CF, et al. Fast forward rounds: an effective method for teaching medical
students to transition patients safely across care settings. J Am Geriatr So…
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psnet.ahrq.gov/node/41283/psn-pdf
April 11, 2012 - Clinical diagnoses and autopsy findings: discrepancies in
critically ill patients.
April 11, 2012
Tejerina E, Esteban A, Fernández-Segoviano P, et al. Clinical diagnoses and autopsy findings:
discrepancies in critically ill patients*. Crit Care Med. 2012;40(3):842-6.
doi:10.1097/CCM.0b013e318236f64f.
https://psne…
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psnet.ahrq.gov/node/837299/psn-pdf
June 01, 2022 - A new index for obstetrics safety and quality of care:
integrating cesarean delivery rates with maternal and
neonatal outcomes.
June 1, 2022
Ramani S, Halpern TA, Akerman M, et al. A new index for obstetrics safety and quality of care: integrating
cesarean delivery rates with maternal and neonatal outcomes. Am J O…
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psnet.ahrq.gov/node/37484/psn-pdf
April 01, 2010 - Using patient safety indicators to estimate the impact of
potential adverse events on outcomes.
April 1, 2010
Rivard PE, Luther SL, Christiansen CL, et al. Using Patient Safety Indicators to Estimate the Impact of
Potential Adverse Events on Outcomes. Med Care Res Rev. 2008;65(1):67-87.
doi:10.1177/107755870730961…
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psnet.ahrq.gov/node/43224/psn-pdf
June 11, 2014 - Look alike/sound alike drugs: a literature review on
causes and solutions.
June 11, 2014
Ciociano N, Bagnasco L. Look alike/sound alike drugs: a literature review on causes and solutions. Int J
Clin Pharm. 2014;36(2):233-242. doi:10.1007/s11096-013-9885-6.
https://psnet.ahrq.gov/issue/look-alikesound-alike-drugs-l…
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digital.ahrq.gov/health-it-tools-and-resources/evaluation-resources/workflow-assessment-health-it-toolkit/all-workflow-tools/value-stream-mapping
January 01, 2023 - Value Stream Mapping
Acronym
VSM
Description
Value stream mapping (VSM) is a method of improvement that allows an entire process to be visualized. It represents the flow of both materials and information in an attempt to improve a process by finding sources of waste. The technique identifies a…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/engagingfamilies/strategy1/Strat1_Tool_6_Checklist_508.docx
June 02, 2025 - Strategy 1: Working with Patients & Families as Advisors (Tool 6)
Strategy 1: Working with Patients & Families as Advisors
[Type text] [Type text] [Type text]
Strategy 1: Working With Patients & Families as Advisors (Tool 6)
Am I Ready to Become an Advisor?
Are you thinking about becoming a patient and family adviso…
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www.ahrq.gov/takeheart/training/module-9/index.html
December 01, 2022 - Module 9: Engaging and Empowering Patients and Families for Success in Cardiac Rehabilitation
YouTube embedded video: https://www.youtube-nocookie.com/embed/M0gL99Fwyzk
Video: Activating Patients to Engage and Complete Cardiac Rehabilitation (59:10)
Slides: Activating Patients To Engage and Complete…
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www.ahrq.gov/ncepcr/communities/pbrn/registry/massage-northern-ohio-practice-based-research-network.html
March 12, 2015 - Massage of Northern Ohio Practice Based Research Network
Status:
Active
Registered Date:
March 12, 2015
PBRN Acronym:
MNO-PBRN
PBRN Type:
Other
PBRN Type Other:
Non-traditional clinician - Massage Therapy
Network Category:
Affiliate
City:
Cleveland
Sta…
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www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/chronic/chipra-201-asthma-section-5-table-3.pdf
February 19, 2016 - CHIPRA 201: Section 5, Table 3
Table 3: Evidence in Support of Education for Proper Use of New Medication Delivery Devices for
Children with Asthma
TYPE OF
EVIDENCE
KEY FINDINGS
LEVEL OF
EVIDENCE
(USPSTF
RANKING*)
CITATION(S)
Clinical
guidelines
The Expert Panel recommends that
clinicians d…
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www.ahrq.gov/talkingquality/measures/setting/long-term-care/home-health/examples.html
November 01, 2018 - Examples of Home Health Care Quality Measures for Consumers
The development of measures for home health is in the early stages, but several measures have been endorsed by NQF and are being reported. Here are some examples of measures that would be appropriate for reporting to consumers and are currently include…